Analysis Of The Status Of Supportive Care Needs Of Patients With Head And Neck Cancer And Its Influencing Factors

Objective1.To understand the current status of supportive care needs for patients with head and neck cancer and identify their unmet needs.2.To analyze the influencing factors of supportive care needs for patients with head and neck cancer,and explore the relationship between supportive care needs and symptom burden,family support and depression.It provides a reference for clinical medical staff to reduce unmet needs of patients and formulate corresponding interventions.MethodsThe study adopted a cross-sectional design,and through convenient sampling methods,235 head and neck cancer patients who met the inclusion criteria were included in the two top three hospitals in Chengdu from July to December 2019 as the research object.Apply general situation questionnaire,Supportive Care Needs Survey Short Form(SCNS-SF),MD Anderson Symptom Inventory-Head and neck(MDASI-H & N),Family APGAR index(APGAR),Patient Health Questionnaire(PHQ-9).The general conditions,supportive care needs,symptom burden,family support and depression of patients with head and neck cancer were investigated.After the collected questionnaires were screened and sorted,Epidata 3.1 and Spss 22.0 were used for data entry and statistical analysis.Results1.The scores of the supportive care needs of patients with head and neck cancer in each dimension in descending order are: health system and information needs(2.66±0.46),care and support needs(2.46±0.41),psychological needs(2.41±0.66),physiology and daily life Needs(1.46±0.59),sexual needs(1.14±0.48).There are unmet needs in all dimensions of supportive care needs.The top three are: psychological needs(47.49%),health system and information needs(45.77%),and care and support needs(39.41%).95.75% of patients withhead and neck cancer have at least one unmet need.Of the top 10 items with the highest scores for supportive care needs,5 are in the health system and information needs dimension,and 4 are in the psychological needs dimension.2.The head and neck cancer patients' symptom mean score were(2.56±1.06),and the incidence of each symptom was between 4.3% and 93.6%;the family APGAR index score was(7.59±1.80);the average PHQ-9 score was(6.36±3.34)3.The correlation analysis showed that the total score of supportive care needs was positively correlated with the total score of symptom burden and all dimensions(r = 0.255?0.325,P<0.01);the total score of supportive care needs was negatively correlated with the total score of the family APGAR index(R =-0.338,P<0.01);the total score of supportive care needs and each dimension were positively correlated with the total score of PHQ-9(r =0.216 ? 0.706,P<0.01).4.Regression analysis showed that age,gender,education,treatment,cancer staging,work status,whether the cancer has metastasized,and whether it recurs,symptom distress,the family APGAR index,and PHQ-9 were the main influencing factors for supportive care needs of patients with head and neck cancer.Conclusions1.The unmet rate of supportive care needs for patients with head and neck cancer is high,and there are unmet needs in all dimensions.The most demanding needs of patients with head and neck cancer are the health system and information needs.The most common unmet needs are psychological needs and the least sexual needs.2.The supportive care needs of patients with head and neck cancer are mainly affected by age,gender,education level,work status,treatment method,stage of disease,whether the cancer has metastasized,and whether it recurs.Medical staff should actively carry out health education for head and neck cancer patients,provide patients with disease-related information,and pay attention to the psychological needs of patients and provide emotional support.Especially pay attention to patients who are younger,female gender,high educationlevel,be employed,are in advanced stage of cancer,have not metastasized,and are currently in relapse.3.Supportive care needs are positively correlated with symptom burden and depression,and negatively correlated with family support.More severe symptom burden and depression,and lower family support may lead to higher levels of supportive care needs for patients with head and neck cancer.Clinical health personnel can encourage family members to actively participate in the treatment of patients,give patients more emotional support and spiritual comfort,reduce patients' depression,thereby reducing patients' unmet need for supportive care and improve patients' quality of life.