Unmet Psychosocial Needs of Adults With Uveal Melanoma
JAMA Ophthalmology, April 2018
Williamson et al. researched the type and frequency of medical, psychosocial, and sociodemographic factors associated with unmet needs of patients with uveal melanoma. In their study, nearly all patients had at least 1 unmet need in the week following diagnosis. Although the severity of these unmet needs subsequently declined, they did not vanish altogether, as most patients reported having the same concerns several months later. Psychosocial support represented the greatest domain of unmet needs.
The study included 107 patients (mean age, 59 years) with uveal melanoma diagnosed by an ophthalmologist. Patients used the Cancer Needs Questionnaire to report their unmet needs 1 week after diagnosis and 3 months later. Eighty-six patients completed the questionnaire at 1 week, and 82 patients completed it 3 months later.
One week after diagnosis, 99% of patients noted at least 1 unmet need. Three months later, 86% reported at least 1 unmet need. The most common concerns pertained to health information and psychosocial support. Although the number of unmet needs declined during the 3-month period, the severity of sociodemographic and medical factors remained similar. Prediagnosis factors found to correlate with lower severity of unmet needs 1 week after diagnosis were greater instrumental social support and lower neuroticism.
Although large social networks are often thought to lead to more robust emotional health, the opposite proved true in this study, as having a smaller social network correlated with lower severity of unmet needs at the 3-month assessment and a decline in needs during the 3-month period. Patients with large interactive social networks may be overwhelmed by the magnitude of available information, and smaller social networks may offer support that is better suited to the patient’s unique needs, the authors suggested.
Findings of this study suggest that needs assessments may promote early identification of patients in greatest need of supportive care. The authors encouraged testing of interventions that target health information and psychological factors, particularly neuroticism. Ensuring social support, such as transportation to medical appointments, also may be helpful. (Also see related commentary by Zélia M. Corrêa, MD, PhD, in the same issue.)
The original article can be found here.