Un-met Supportive Care Needs of Iranian Breast Cancer Patients

  • Abdollahzadeh, Farahnaz (Nursing and Midwifery Faculty, Tabriz University of Medical Sciences) ;
  • Moradi, Narges (Nursing and Midwifery Faculty, Tabriz University of Medical Sciences) ;
  • Pakpour, Vahid (Students Research Committee, Tabriz University of Medical Sciences) ;
  • Rahmani, Azad (Hematology and Oncology Research Center, Tabriz University of Medical Sciences) ;
  • Zamanzadeh, Vahid (Nursing and Midwifery Faculty, Tabriz University of Medical Sciences) ;
  • Mohammadpoorasl, Asghar (Department Human Nutrition and Food Safety, School of Public Health, Qazvin University of Medical Sciences) ;
  • Howard, Fuchsia (School of Population and Public Health, Faculty of Medicine, The University of British Columbia)
  • Published : 2014.05.15


Background: Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. Materials and Methods: A descriptive-correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. Results: Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. Conclusions: The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.


  1. Abdullah A, Abdullah KL, Yip CH, et al (2013). The decision-making journey of Malaysian women with early breast cancer: a qualitative study.. Asian Pac J Cancer Prev, 14, 7143-7.
  2. Akechi T, Okuyama T, Endo C, et al (2011). Patient's perceived need and psychological distress and/or quality of life in ambulatory breast cancer patients in Japan. Psychooncology, 20, 497-505.
  3. Asadzadeh Vostakolaei F, Broeders MJ, Mousavi SM, et al (2013). The effect of demographic and lifestyle changes on the burden of breast cancer in Iranian women: a projection to 2030. Breast, 22, 277-81.
  4. Armes J, Crowe M, Colbourne L, et al (2009). Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol, 27, 6172-9.
  5. Avis NE, Crawford S, Manuel J (2004). Psychosocial problems among younger women with breast cancer. Psychooncology, 13, 295-308.
  6. Au A, Lam W, Tsang J, et al (2013). Supportive care needs in Hong Kong Chinese women confronting advanced breast cancer. Psychooncology, 22, 1144-51.
  7. Beesley V, Eakin E, Steginga S, et al (2008). Unmet needs of gynaecological cancer survivors: implications for developing community support services. Psychooncology, 17, 392-400.
  8. Ben-Arye E, Ali-Shtayeh MS, Nejmi M, et al (2012). M. Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care. Support Care Cancer, 20, 557-64.
  9. Bingley A, Clark D (2009). A comparative review of palliative care development in six countries represented by the Middle East Cancer Consortium (MECC). J Pain Symptom Manage, 37, 287-96.
  10. Bonevski B, Sanson-Fisher R, Girgis A, et al (2000). Evaluation of an instrument to assess the needs of patients with cancer. Cancer, 88, 217-25.<217::AID-CNCR29>3.0.CO;2-Y
  11. Brandberg Y, Sandelin K, Erikson S, et al (2008). Psychological reactions, quality of life, and body image after bilateral prophylactic mastectomy in women at high risk for breast cancer: a prospective 1-year follow-up study. J Clin Oncol, 26, 3943-9.
  12. Cruickshank S, Kennedy C, Lockhart K, Dosser I, Dallas L (2008). Specialist breast care nurses for supportive care of women with breast cancer. Cochrane Database Syst Rev, 23, CD005634.
  13. Farnam F, Pakgohar M, Mirmohamadali M, et al (2008). Effect of sexual education on sexual health in Iran. Sex Education, 8, 159-68.
  14. Fitch Ml (1994). Providing supportive care for individuals living with cancer. Ontario Cancer Treatment and Research Foundation, Toronto.
  15. Fobair P, Stewart SL, Chang S, et al (2006). Body Image And Sexual Problems in young women with breast cancer. Psychooncology, 15, 579-94.
  16. Fridfinnsdottir, EB (1997). Icelandic women's identifications of stressors and social support during the diagnostic phase of breast cancer. J Adv Nurs, 25, 526-31.
  17. Farnam F, Pakgohar M, Mirmohamadali M, et al (2008). Effect of sexual education on sexual health in Iran. Sex Education, 8, 159-68.
  18. Ganz PA, Hahn EE (2008). Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol, 26, 759-67.
  19. Gilbert E, Ussher JM, Perz J (2010). Sexuality after breast cancer: a review. Maturitas, 66, 397-407.
  20. Griesser AC, Vlastos G, Morel L, et al (2011). Socio-demographic predictors of high support needs in newly diagnosed breast cancer patients. Eur J Cancer Care, 20, 466-74.
  21. Gunusen NP, Inan FS, Ustun B (2013). Experiences of Turkish women with breast cancer during the treatment process and facilitating coping factors. Asian Pac J Cancer Prev, 14, 3143-9.
  22. Haghighat S, Akbari ME, Ghaffari S, Yavari P (2012). Standardized breast cancer mortality rate compared to the general female population of Iran. Asian Pac J Cancer Prev, 13, 5525-8.
  23. Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ (2004). Breast cancer in Iran: results of a multi-center study. Asian Pac J Cancer Prev, 5, 24-7.
  24. Harrison SE, Watson EK, Ward AM, et al (2011). Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. J Clin Oncol, 29, 2091-98.
  25. Hodgkinson K, Butow P, Hunt GE, et al (2007). Breast cancer survivors' supportive care needs 2-10 years after diagnosis. Support Care Cancer, 15, 515-23.
  26. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.
  27. Lam WW, Au AH, Wong JH, et al (2011). Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat, 130, 531-41.
  28. Liao MN, Chen SC, Lin YC, et al (2012). Changes and predictors of unmet supportive care needs in Taiwanese women with newly diagnosed breast cancer. Oncol Nurs Forum, 39, 380-9.
  29. Li WW, Lam WW, Au AH, et al (2013). Interpreting differences in patterns of supportive care needs between patients with breast cancer and patients with colorectal cancer. Psychooncology, 22, 792-8.
  30. McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK (2010). Predictors of change in unmet supportive care needs in cancer. Psychooncology, 19, 508-16.
  31. Montazeri A, Sajadian A, Ebrahimi M, Akbari ME (2005). Depression and the use of complementary medicine among breast cancer patients. Support Care Cancer, 13, 339-42.
  32. Montazeri A, Vahdani M, Haji-Mahmoodi M, Jarvandi S, Ebrahimi M (2002). Cancer patient education in Iran: a descriptive study. Support Care Cancer, 10, 169-73.
  33. Mousavi SM, Montazeri A, Mohagheghi MA, et al (2007). Breast cancer in Iran: an epidemiological review. Breast J, 13, 383-91.
  34. Nakaguchi T, Okuyama T, Uchida M, et al (2013). Oncology nurses' recognition of supportive care needs and symptoms of their patients undergoing chemotherapy. Jpn J Clin Oncol, 43, 369-76.
  35. Northouse LL, Mood D, Kershaw T, et al (2002). Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol, 20, 4050-64.
  36. Okuyama T, Akechi T, Yamashita H, et al (2011). Oncologists' recognition of supportive care needs and symptoms of their patients in a breast cancer outpatient consultation. Jpn J Clin Oncol, 41, 1251-8.
  37. Oztunc G, Yesil P, Paydas S, Erdogan S. (2013). Social support and hopelessness in patients with breast cancer . Asian Pac J Cancer Prev, 14, 571-8.
  38. Rahmani A, Mohammadian R, Ferguson C, et al (2012). Posttraumatic growth in Iranian cancer patients. Indian J Cancer, 49, 287-92.
  39. Rutten LJ, Arora NK, Bakos AD, Aziz N, Rowland J (2005). Information needs and sources of information among cancer patients: a systematic review of research (1980-2003). Patient Educ Couns, 57, 250-61.
  40. Sait KH, Anfinan NM, Eldeek B, et al (2014). Perception of patients with cancer towards support management services and use of complementary alternative medicine - a single institution hospital-based study in Saudi Arabia.. Asian Pac J Cancer Prev, 15, 2547-54.
  41. Salminen E, Vire J, Poussa T, Knifsund S (2004). Unmet needs in information flow between breast cancer patients, their spouses, and physicians. Support Care Cancer, 12, 663-8.
  42. Sammarco A (2001). Perceived social support, uncertainty, and quality of life of younger breast cancer survivors. Cancer Nurs, 24, 212-9.
  43. Sanson-Fisher R, Girgis A, Boyes A, et al (2000). The unmet supportive care needs of patients with cancer. Supportive care review group. Cancer, 88, 226-37.<226::AID-CNCR30>3.0.CO;2-P
  44. Schmid-Buchi S, Halfens RJ, Dassen T, van den Borne B (2011). Psychosocial problems and needs of posttreatment patients with breast cancer and their relatives. Eur J Oncol Nurs, 15, 260-6.
  45. Schmid-Buchi S, Halfens RJ, Muller M, Dassen T, van den Borne B (2012). Factors associated with supportive care needs of patients under treatment for breast cancer. Eur J Oncol Nurs, 17, 22-9.
  46. Tavoli A, Montazeri A, Roshan R, Tavoli Z, Melyani M (2008). Depression and quality of life in cancer patients with and without pain: the role of pain beliefs. BMC Cancer, 8, 177.
  47. Thewes B, Butow P, Girgis A, Pendlebury S (2004). The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors. Psychooncology, 13, 177-89.
  48. Uchida M, Akechi T, Okuyama T, et al (2011). Patients' supportive care needs and psychological distress in advanced breast cancer patients in Japan. Jpn J Clin Oncol, 41, 530-36.
  49. Vahdaninia M, Omidvari S, Montazeri A (2010). What do predict anxiety and depression in breast cancer patients? A follow-up study. Soc Psychiatry psychiatr. Epidemiol, 45, 355-61.
  50. Valizadeh L, Zamanzadeh V, Rahmani A, et al (2012). Cancer disclosure: Experiences of Iranian cancer patients. Nurs Health Sci, 14, 250-56.
  51. Whelan TJ, Mohide EA, Willan AR, et al (1997). The supportive care needs of newly diagnosed cancer patients attending a regional cancer center. Cancer, 80, 1518-24.<1518::AID-CNCR21>3.0.CO;2-7
  52. Yusuf A, Ab Hadi IS, Mahamood Z, Ahmad Z, Keng SL (2013). Understanding the breast cancer experience: a qualitative study of Malaysian women. Asian Pac J Cancer Prev, 14, 3689-98.
  53. Zamanzadeh V, Rahmani A, Valizadeh L, et al (2013). The taboo of cancer: the experiences of cancer disclosure by Iranian patients, their family members and physicians. Psychooncology, 22, 396-402.

Cited by

  1. Iranian Cancer Patient Perceptions of Prognosis and the Relationship to Hope vol.15, pp.15, 2014,
  2. Perceptions of Iranian Cancer Patients Regarding Respecting their Dignity in Hospital Settings vol.16, pp.13, 2015,
  3. Cancer Care Burden among Primary Family Caregivers of Iranian Hematologic Cancer Patients vol.16, pp.13, 2015,
  4. Supportive Care Needs of Iranian Cancer Survivors and Relationships with Social Support vol.16, pp.15, 2015,
  5. Financial Distress and its Predicting Factors among Iranian Cancer Patients vol.16, pp.4, 2015,
  6. Breast Cancer Screening Barriers from the Womans Perspective: a Meta-synthesis vol.16, pp.8, 2015,
  7. Integrative Review of the Supportive Care Needs of Asian and Caucasian Women with Breast Cancer vol.7, pp.3, 2015,
  8. Levels of Conscience and Related Factors among Iranian Oncology Nurses vol.16, pp.18, 2016,
  9. Viewpoints of Family Caregivers about Posttraumatic Growth in Cancer Patients vol.17, pp.2, 2016,
  10. Cancer Patients’ Informational Needs: Qualitative Content Analysis vol.31, pp.4, 2016,
  11. The Information Needs of Women Who Have Undergone Breast Cancer Surgery in the West of Turkey vol.32, pp.3, 2017,
  12. Palliative Nursing for Cancer Patients as an Abstract Concept vol.26, pp.4, 2018,