Unmet Needs of Breast Cancer Survivors and Related Factors: A Cross-Sectional Study

Unmet Needs of Breast Cancer Survivors and Related Factors: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Unmet Needs of Breast Cancer Survivors and Related Factors: A Cross-Sectional Study Vildan Kocatepe, Yasemin Uslu, Derya Subaşı Zengin, Çise Aydoğdu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5379884/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: It is essential to identify the met and unmet needs of breast cancer survivors. Furthermore, the sociodemographic and disease related characteristics of survivors can influence their needs. The aim of this study is to investigate the unmet needs of breast cancer survivors and the related factors. Methods: The study was conducted as a cross-sectional study. The population of this study consisted of 442 breast cancer survivors in Senology Institute Breast Clinic in Istanbul. The data of the study were collected by Breast Cancer Survivor Evaluation Form and The Cancer Survivors’ Unmet Needs (CaSUN) Scale between January 2021 and January 2023. Results: The mean ages of the was 47.88±9.26. The womens' met needs score of CaSUN was 7.52±8.58. The unmet needs score of CaSUN was 9.37±9.82, and the total needs score was 16.93±10.74. Among the 258 women who had children, there was a statistically significant, positive correlation between the number of children and the unmet needs scores (r=.184; p=.004), negative correlation between the met needs scores of the women (r=-.129; p=.044). There was a statistically significant difference in the unmet needs scores among women based on their marital status (t=2.04; p=.042). Conclusions: The study with breast cancer survivors in Turkey identified specific unmet needs focussing on psychosocial and information-related domains. Furthermore, certain sociodemographic characteristics such as being married, having children, and employment status have been found to influence the unmet needs of survivors. Breast cancer survivor women survivorship unmet needs breast cancer Background Breast cancer is now the most common cancer worldwide, accounting for 12.5% of all new annual cancer cases worldwide. In the US, breast cancer accounts for approximately 30% of all new cancers each year in female [ 1 ]. There are currently more than 3.8 million breast cancer survivors (BCSs) in the US. This number includes women who are still undergoing or completed treatment [ 2 ]. Early detection and diagnosis, medical technology, multimodal therapies and advances treatment efficacy have greatly improved BCSs rates [ 3 ]. Five year relative survival rate was reported as 91% (2012–2018) [ 2 ]. However, this positive development leads to unmet needs of BCSs during their psychological, sociological, economic and cognitive functions related to cancer and treatment [ 4 ]. Survivors' needs are dynamic and may change over time [ 5 ]. A study analysing 26 studies of cancer survivors' unmet needs found that BCSs had a higher prevalence of reporting at least one unmet need [ 6 ]. The highest unmet need reported by cancer survivors were symptom burden [ 7 ], psychological needs [ 8 , 9 ], physical-daily life [ 9 ], information and education domain [ 9 , 10 ], fear of cancer recurrence [ 8 ]. In a systematic review of 10,574 women, information needs and psychological needs were frequently reported [ 11 ]. Unmet care needs were significantly influenced by demographic factors, disease factors and psychological factors. In the studies conducted, including such demographic factors as age [ 7 , 9 , 10 , 12 ], marital status [ 9 , 10 , 13 ], time since diagnosis [ 7 ], education level [ 7 ], employed [ 7 , 10 , 11 ], such disease factors as treatment state [ 7 , 10 ], cancer stage [ 14 ], chemotherapy [ 3 ], hormone treatment [ 11 ], such psychological factors as distress [ 3 ], stress [ 10 ], fear of recurrence[ 12 ] are affected. Unmet needs directly affect quality of life in recurrent breast cancer rather than socio-demographic or clinical characteristics [ 15 ]. The development of evidence-based care in the survivor period is a key area. Available services and resources need to be identified and matched to BCSs characteristics to achieve the best survivorship care outcomes [ 4 ]. Assessing the needs of BCSs are important to ensure timely and effective interventions. Providing care tailored to BCS' needs enable to better self-care and self-management, recover faster and require less routine follow-up, prolongs life expectancy and better adaptation and treatment of complications caused by the disease [ 5 ]. In Turkey, there are currently no survivorship care plans and structured guides and directives for the follow-up of survivors. With a large number of breast cancer patients joining the ranks of survivors in recent years, the healthcare team faces many challenges in Turkey. Therefore, it is essential to identify the met and unmet needs of BCSs. Furthermore, the sociodemographic and disease related characteristics of survivors can influence their needs. However, no study providing these data has been found in Turkey. Understanding the unmet needs of BCSs is crucial for informing healthcare planning and optimising survivorship care [ 8 ]. The aim of this study is to investigate the unmet needs of breast cancer survivors and the related factors. Methods Design The study was conducted as a cross-sectional study. Population and Sample The population of this study consisted of 442 breast cancer survivors in Senology Institute Breast Clinic in Istanbul between January 2021 and January 2023. Women aged 18 years or older, with a confirmed diagnosis of breast cancer regardless of stage or treatment status, were included in the study if at least 6 months had passed since the completion of breast cancer treatment. BSCs with language barriers, Neurological and psychiatric diseases were excluded. The sample size was calculated using the GPower 3.1.9 version program. Minimum sample size was specified to be 352 with Type I error of 0.05 and at power level of 95%. Data Collection Tools The data of the study were collected via a face-to-face survey by Breast Cancer Survivor Evaluation Form and The Cancer Survivors’ Unmet Needs (CaSUN) Scale. Breast Cancer Survivor Evaluation Form The form, created by the researchers, consisted of a total 15 questions, including 8 questions related to women's demographic characteristics (age, marital status, education level, etc.) and 7 questions related to the disease process (type of treatment, type of cancer, etc.). Information regarding the disease process was obtained from the hospital's record system. The Cancer Survivors’ Unmet Needs (CaSUN) Scale : The scale, developed by Hodgkinson and colleagues in 2007 [ 16 ], was adapted and validated into Turkish by Sütsünbüloğlu and Vural in 2020 [ 17 ]. The scale consists of 5 sub-dimensions: Psychosocial support, Information, Economic concerns, Relationships, and Quality of Life. The internal consistency reliability coefficient (Cronbach's alpha) of the scale is 0.92. The total score is the sum of all items, indicating higher scores reflect greater needs (ranging from 0 to 35). Sub-dimension scores are calculated as the sum of all items within the relevant sub-dimension. Since the sub-dimensions have different numbers of items, the average number of needs within the corresponding sub-dimension is reported. Ethical consideration The study was conducted in accordance with the Declaration of Helsinki, with the approval of the Ethics committee of the Medical Research Evaluation Committee of XXX University (2021-25/15). BCSs were informed about the study and their consent was obtained. Data Analysis Data analysis was performed using SPSS 26.00 for the Windows package program. The percentage distribution, mean, standard deviation, and median values were given in descriptive statistics. To compare the means of continuous variables, the parametric Student t-test was used for those with a normal distribution, and the non-parametric Mann-Whitney U test was used for those with an abnormal distribution. To compare the means of more than two groups of continuous variables, the parametric One-Way ANOVA was used for those with a normal distribution, and the non-parametric Kruskal-Wallis test was used for those with an abnormal distribution. Correlation analysis was used to examine the relationship between continuous variables of the participants. Significance of results in the 95% confidence interval was evaluated under p < 0.05. Results The ages of the women ranged from 26 to 86, and the mean age was 47.88±9.26. The average age of the women diagnosed with breast cancer was 44.61±8.91 years. Among BCSs, 73.3% were married, and 67.2% had a university degree. Table 1 presents the characteristics of BSSs (Table 1). Table 1. Sociodemographic and Disease Related Characteristics of Breast Cancer Survivors (N= 442) Mean (Min-Max) ± SD Age (Years) 47.88 (26-86) ± 9.26 Age at cancer diagnosis 44.61 (22-82) ± 8.91 n % Marital status Married 324 73.3 Single 118 26.7 Education Primary Education 35 7.9 High School 110 24.9 Undergraduate 297 67.2 Employment Full-time employed 206 46.6 Part-time employed 32 7.2 Housewife 116 26.2 Retired 88 19.9 Living Arrangement 1 Alone 39 8.8 Partner 317 71.7 Child 258 58.4 Parent 39 8.8 Number of Children (n=258) One child 136 52.7 Two children 100 38.8 Three children 22 8.5 Cancer metastasis No metastasis, only in the breast 255 57.7 Breast and axillary lymph nodes 169 38.2 Breast, axillary lymph nodes and other organs 18 4.1 Completed Treatments 1 Surgical treatment 410 92.8 Chemotherapy 256 57.9 Targeted therapies 65 14.7 Immunotherapy 6 1.4 Recurrence Yes 16 3.6 No 426 96.4 Comorbidity Yes 41 9.3 No 401 90.7 Comorbid condition 1 Hypertension 25 5.7 Heart Failure 7 1.6 Diabetes 8 1.8 Kidney Diseases 8 1.8 Asthma/COPD 2 .5 Continuous regular medication Yes 354 80.1 No 88 19.9 Type of medication 1 Adjuvant Endocrine Therapy 327 73,9 Other 50 4,5 1 Participants can choose more than one option, SD: Standard deviation, COPD: Chronic Obstructive Pulmonary Disease) The women' met needs score of CaSUN was 7.52±8.58. The unmet needs score of CaSUN was 9.37±9.82, and the total needs score was 16.93±10.74. The participants' scores for the sub-dimensions of CaSUN were as follows: Psychosocial support needs score was 3.12±1.87, information support needs score was 3.01±1.95, economic concerns needs score was 1.13±1.27, relationships needs score was 2.59±2.33, and quality of life needs score was 2.35±1.61 (Table 2). Table 2. Needs Level of Breast Cancer Survivors Mean ± SD (Min – Max) Met needs 7.52±8.58 (0-34) Unmet needs 9.37±9.82 (0-34) Total needs 16.93±10.74 (0-34) Sub-dimensions of CaSUN Psychosocial support 3.12±1.87 (0-5) Information 3.01±1.95 (0-5) Economic concerns 1.13±1.27 (0-3) Relationships 2.59±2.33 (0-6) Quality of life 2.35±1.61 (0-4) SD: Standard deviation The table of "The Most Highly Ranked Unmet Needs of Survivors" is given in Table 3. The greatest unmet needs reported by survivors were "Help to manage my concerns about the cancer coming back" (44.6%), "Help to reduce stress in my life" (41.0%), and "Emotional support to be provided for me" (40.3%) (Table 3). Table 3 . The Most Highly Ranked Unmet Needs of Women Breast Canser Survivors The Most Highly Ranked Unmet Needs of Survivors n % Help to manage my concerns about the cancer coming back 197 44.6 Help to reduce stress in my life 181 41.0 Emotional support to be provided for me 178 40.3 Help to cope with changes to my belief that nothing bad will ever happen in my life 171 38.7 I need help to cope with others not acknowledging the impact that cancer has had on my life 159 36.0 I need help to deal with my own and/or others expectations of me as a ‘cancer survivor 148 33.5 Help to try to make decisions about my life in the context of uncertainty 148 33.5 Help to manage ongoing side effects and/or complications of treatment 147 33.3 Information provided in a way that I can understand 143 32.4 Help to adjust to changes to the way I feel about my body 142 32.1 There was no statistically significant relationship between the ages of the participants and their age at cancer diagnosis with the total needs scores (p=.834; p=.838). Among the 258 participants who had children, there was a statistically significant, positive correlation between the number of children and the unmet needs scores (r=.184; p=.004). There was a statistically significant, negative correlation between the met needs scores of the participants (r=-.129; p=.044) (Table 4). There was a statistically significant difference in the unmet needs scores among participants based on their marital status (t=2.04; p=.042). Married participants had higher unmet needs scores. Participants' employment status showed a statistically significant difference in the met needs scores (F=3.469; p=.016) and total needs scores (F=2.960; p=.032). Part-time employed participants had higher total needs scores. There was a statistically significant difference in the met needs scores among participants based on the spread of cancer (KW=6.888; p=.032). There were statistically significant differences in the met needs scores (t=-3.268; p=.001) and total needs scores (t=-2.086; p=.038) among participants based on the recurrence of the disease. Participants' continuous regular medication use status showed statistically significant differences in the met needs scores (r=-1.366; p=.002) and total needs scores (r=-2.828; p=.005) (Table 4). Table 4. Characteristics and Disease Related Needs of Breast Cancer Survivors Unmet needs Met needs Total needs Age (r / p) -.012 / .811 .003 / .947 -.010 / .834 Age at cancer Diagnosis (r / p) .009 / .854 .004 / .931 .010 /.838 Number of Children (n=258) (r / p) .184 / .004* -.129 / .044* .081 / .206 Marital Status Married 9.95±10.21 7.06±8.42 17.06± 11.05 Single 7.76±8.49 8.79±8.91 16.55±9.84 Test value / p 2.04 / .042 a* -1.84 / .066 a .429 / .668 a Education Primary Education 6.94±9.39 8.85±10.83 15.78±11.64 High School 10.87± 9.82 6.61±7.92 17.48± 10.77 Undergraduate 9.09±9.81 7.71±8.52 16.85±10.64 Test value / p 2.358 / .096 b 1.056 / .349 b .329 / .720 b Employment Full-time employed 8.27±8.96 8.64±9.05 16.91±10.53 Part-time employed 12.58± 10.08 9.45±8.07 22.03± 10.42 Housewife 10.63± 10.61 5.95±8.11 16.69±10.84 Retired 9.08±10.28 6.33±7.82 15.41±10.81 Test value / p 2.571 / .054 b 3.469 / .016 b* 2.960 / .032 b* Cancer metastasis No metastasis, only in the breast 9.51±9.88 7.22±8.63 16.78±10.86 Breast and axillary lymph nodes 9.27±9.73 7.73±8.32 17.01±10.38 Breast, axillary lymph nodes and other organs 8.33±10.23 9.72±10.15 18.05±12.6 Test value / p 5.563 / .062 c 6.888 / .032 c * 1.596 / .450 c Recurrence Yes 16.33±10.21 11.16± 9.91 27.50±5.43 No 9.62±9.91 6.67±7.91 16.36±10.23 Test value / p .393/ . 695 a 1.366 / .002 a* 2.828 / .005 a* Comorbidity Yes 10.18± 9.76 10.31±9.27 20.51±10.17 No 9.76±9.98 6.54±7.82 16.36±10.26 Test value / p .163 / .870 a 3,108 / .067 a 1.559 / .120 a Continuous regular medication Yes 9.91±9.76 6.02±7.38 15.99±10.41 No 9.27±10.85 10.27± 9.54 19.54±9.31 Test value / p .384 / .702 a -3.268 / .001 a * -2.086 / .038 a * *p<0.05; r= Spearman's correlation coefficient a=Student-t, b=One way Anova, c=Kruskal Wallis Test, d=Mann Whitney U, Discussion The identification and management of unmet needs are crucial components of providing high-quality healthcare for cancer survivors [ 10 ]. In this study, 442 women were analyzed to examine the unmet needs of Turkish BCSs and the related factors. There are only a few studies conducted in Turkey related to BCSs. Among them, this study is the most comprehensive sampling of the unmet needs of BCSs in Turkey and related factors. In addition, this study provides practical and applicable information to policy makers and health professionals on this issue. Previous studies have shown that the greatest needs among cancer survivors are related to the psychological and health system/information domains, with coping with the fear of cancer recurrence or metastasis being the most common need. According to the study conducted by Chou et al, 2020 [ 14 ], the results revealed that the highest unmet supportive need among BCSs was in the psychosocial domain (40.4%). Similarly, in the study conducted by Edib et al. 2016 [ 18 ], the most significant unmet supportive care needs were found in the psychological domain, with the physical domain following closely behind. Studies on the unmet needs of women with BCSs in different populations have yielded different results. In Palestine, the highest unmet need reported by BCSs were psychological needs, health-related systems and information and physical-daily life [ 9 ]. Martínez Arroyo et al. and Skandarajah et al. reported that needs focused on the possibility of recurrence were the most frequent [ 19 , 20 ]. In a systematic review of 10,574 women, information needs and psychological needs were frequently reported [ 21 ]. In Korean, the most prevalent unmet needs were found in the information and education domain [ 10 ]. In Chinese, the highest unmet need indicated fear of recurrence, patient-provider communication, and body image [ 7 ]. These unmet needs vary according to the individual characteristics of women, but also vary according to the country, health policies and the level of development of the country. In this study, the top three needs were concerns about cancer recurrence, stress management, and emotional support. Correspondingly, BCSs who had experienced cancer recurrence had higher needs than those who had not, indicating a correlation with the study's results. This results show that psychological and information needs continue to be the most important and critical priorities for BCSs even in the long term. Also these results suggest that BCSs have information needs and related psychological needs due to the lack of follow-up and monitoring policies for survivors in Turkey. In the literature, psychosocial needs and information support needs are the most frequent requirement [ 7 , 12 , 20 , 22 ]. In a study, it was revealed that financial issues, perceptions of post-treatment mood changes, familial roles, and physical changes are sources of stress for breast cancer survivors [ 23 ]. One of the striking findings of our study was that as the number of children of BCS women increases, their unmet needs increase, while their met needs increase as the number of children decreases. The reason for this may be related to women's social roles and responsibilities related to childcare. In Turkey, there is a patriarchal structure and the primary responsibility for childcare is given to women. The increase in the number of children may have led to an increase in BCSs' responsibilities and increased psychological needs. When developing survivor follow-up policies, it may be taken into account that the number of children and the needs of women may increase accordingly. Unmet care needs were influenced by other demographic factors, disease factors and psychological factors. In this study married participants had higher unmet needs scores. The results are similar to the literature [ 9 , 10 ]. It can be explained that unmarried women may have relatively fewer responsibilities and more time to access information and healthcare facilities. Since being married may also be related to having children, this supports our previous result. The employed group were found to have higher levels of unmet needs in the domains of symptom burden, function, health behaviour, and healthcare-seeking skills [ 7 ]. In this study, there was a difference in met needs scores among BCSs based on their employment status. Part-time and full-time employed BCSs had higher total needs scores. Women's employment status, not their level of education, came to the fore. Considering that part-time and full-time employed women can socialise, receive social support and take care of themselves, it can be said that they can meet their needs. It was determined that the needs met were higher in BCSs with cancer metastasis, recurrence and regular medication use. This result suggests that BCSs experiencing recurrence and metastasis are more concerned about their health and more sensitive about their needs. As in this study fear of cancer recurrence is the most frequently cited unmet need among cancer survivors [ 6 , 24 ]. Comorbidity levels of BCSs are quite low. The medications used are mostly adjuvant endocrine therapy related to breast cancer. The possible explaination was that these patients learn more about the disease and they might question the doctor’s advice. Since women regularly go to hospital for these treatments and are in contact with health professionals, they may be meeting their needs and requirements in this way. According to the Lebel and et. al 2013 survivors with elevated fear of cancer recurrence may indeed use more health care services [ 25 ]. The reverse of this Fang and et al 2018, BCSs on endocrine therapy had more unmet needs regarding information than those who were not receiving therapy [ 11 ]. Conclusion The study on the unmet needs of Turkish BCSs have specific results, with a focus on psychosocial and information-related domains. These findings highlight the importance of addressing the psychological well-being and information support of BCSs to improve their overall daily life and long-term survivorship. Furthermore, certain sociodemographic characteristics such as being married, having children, and employment status have been found to influence the unmet needs of survivors. Therefore, nurses should collect sufficient data on this matter in the women they provide care for and take part in developing protocols and systems to address these issues. Limitations Limitation of this study was its cross-sectional design, which only allowed for the analysis of unmet needs and related factors in breast cancer survivors at a single point in the disease trajectory. Another limitation of the study was its single-center design. Conducting the study with repeated data from multiple centers and different time points could provide additional insights into related factors such as survivorship. Declarations Authors’ contributions VK: data curation, formal analysis, writing— original draft, writing—review and editing, and visualization. YU: conceptualization, funding acquisition, investigation, writing—review and editing. DSS: data curation, resources, writing—review and editing. ÇA: data curation, resources, writing—review and editing. CU: conceptualization, funding acquisition, and investigation. All authors read and approved the fnal manuscript. Availability of data and material The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request Acknowledgements We thank patients who generously gave their time to participate in the study. Funding This research received no grant from any funding agency in the public, commercial, or not for profit sectors. Ethics approval and consent to participate The study was approved by the Ethics committee of the Medical Research Evaluation Committee of XXX University (2021-25/15). Informed consent was obtained from all individual participants included in the study. The research was conducted in accordance with the Declaration of Helsinki. Disclosure statement All authors have confrmed that they have no conficts of interest to disclose. Consent for publication Not applicable. Competing interests The authors declare no competing interests. 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Supportive Care in Cancer 21:901–906. https://doi.org/10.1007/S00520-012-1685-3 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5379884","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":375629920,"identity":"534013d0-e1f7-4146-b801-61bf2c78e631","order_by":0,"name":"Vildan Kocatepe","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEUlEQVRIiWNgGAWjYDACZuYGCSDF2MDAYMDwgIFBDiR44AFeLYxIWhIYGIzBWhLwWoOmJbEBJIhPi8FxxsYbP3cwyPb3H974IKHiTvr8sMMPgbbYyek24NBymLHZsvcMg/GMG2nFBglnnuVuvJ1mANSSbGx2ALsWyWbGNgneNqB7bvCYSSS2Hc7dODsBpOVA4jY8WiT/ArXMP3/G/Efiv8PphrPTP+DVws/M2CYNsmXDgRwzoF2HE+Slc/DbAtTSbC3bJmG8EegXiYRjhw03SOcUHEgwwO0XNv7DB2++bbORnXf+8MYPH2oOy8vPTt/84UOFnRwuLVAggWAagFUa4FWOBuQbSFE9CkbBKBgFIwEAAIz5ZpOqnL2TAAAAAElFTkSuQmCC","orcid":"","institution":"Izmir Demokrasi University","correspondingAuthor":true,"prefix":"","firstName":"Vildan","middleName":"","lastName":"Kocatepe","suffix":""},{"id":375629930,"identity":"d95fd750-1282-4147-bd23-c35e854caa68","order_by":1,"name":"Yasemin Uslu","email":"","orcid":"","institution":"Istanbul University Nursing Faculty","correspondingAuthor":false,"prefix":"","firstName":"Yasemin","middleName":"","lastName":"Uslu","suffix":""},{"id":375629931,"identity":"12f5687d-6688-4df5-a834-24e01d94be6a","order_by":2,"name":"Derya Subaşı Zengin","email":"","orcid":"","institution":"Global Tourism Organization","correspondingAuthor":false,"prefix":"","firstName":"Derya","middleName":"Subaşı","lastName":"Zengin","suffix":""},{"id":375629932,"identity":"d91935dd-9b45-4e07-b567-b47d5a3fb663","order_by":3,"name":"Çise Aydoğdu","email":"","orcid":"","institution":"Acibadem Health Group","correspondingAuthor":false,"prefix":"","firstName":"Çise","middleName":"","lastName":"Aydoğdu","suffix":""},{"id":375629933,"identity":"397af55a-c242-47b8-b7df-b6003efa02e1","order_by":4,"name":"Cihan Uras","email":"","orcid":"","institution":"Acibadem Mehmet Ali Aydinlar University","correspondingAuthor":false,"prefix":"","firstName":"Cihan","middleName":"","lastName":"Uras","suffix":""}],"badges":[],"createdAt":"2024-11-02 21:38:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5379884/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5379884/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90965746,"identity":"8ec667c0-94d4-4e4b-9ec7-dbfc1039debf","added_by":"auto","created_at":"2025-09-10 06:32:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1025025,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5379884/v1/91455cc8-6360-481f-a947-1feec5e5c8a2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eUnmet Needs of Breast Cancer Survivors and Related Factors: A Cross-Sectional Study\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eBreast cancer is now the most common cancer worldwide, accounting for 12.5% of all new annual cancer cases worldwide. In the US, breast cancer accounts for approximately 30% of all new cancers each year in female [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. There are currently more than 3.8\u0026nbsp;million breast cancer survivors (BCSs) in the US. This number includes women who are still undergoing or completed treatment [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Early detection and diagnosis, medical technology, multimodal therapies and advances treatment efficacy have greatly improved BCSs rates [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Five year relative survival rate was reported as 91% (2012\u0026ndash;2018) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, this positive development leads to unmet needs of BCSs during their psychological, sociological, economic and cognitive functions related to cancer and treatment [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Survivors' needs are dynamic and may change over time [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA study analysing 26 studies of cancer survivors' unmet needs found that BCSs had a higher prevalence of reporting at least one unmet need [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The highest unmet need reported by cancer survivors were symptom burden [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], psychological needs [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], physical-daily life [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], information and education domain [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], fear of cancer recurrence [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In a systematic review of 10,574 women, information needs and psychological needs were frequently reported [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUnmet care needs were significantly influenced by demographic factors, disease factors and psychological factors. In the studies conducted, including such demographic factors as age\u003c/p\u003e \u003cp\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], marital status [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], time since diagnosis [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], education level [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], employed [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], such disease factors as treatment state [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], cancer stage [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], chemotherapy [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], hormone treatment [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], such psychological factors as distress [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], stress [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], fear of recurrence[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] are affected.\u003c/p\u003e \u003cp\u003eUnmet needs directly affect quality of life in recurrent breast cancer rather than socio-demographic or clinical characteristics [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The development of evidence-based care in the survivor period is a key area. Available services and resources need to be identified and matched to BCSs characteristics to achieve the best survivorship care outcomes [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Assessing the needs of BCSs are important to ensure timely and effective interventions. Providing care tailored to BCS' needs enable to better self-care and self-management, recover faster and require less routine follow-up, prolongs life expectancy and better adaptation and treatment of complications caused by the disease [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn Turkey, there are currently no survivorship care plans and structured guides and directives for the follow-up of survivors. With a large number of breast cancer patients joining the ranks of survivors in recent years, the healthcare team faces many challenges in Turkey. Therefore, it is essential to identify the met and unmet needs of BCSs. Furthermore, the sociodemographic and disease related characteristics of survivors can influence their needs. However, no study providing these data has been found in Turkey. Understanding the unmet needs of BCSs is crucial for informing healthcare planning and optimising survivorship care [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The aim of this study is to investigate the unmet needs of breast cancer survivors and the related factors.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003eThe study was conducted as a cross-sectional study.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePopulation and Sample\u003c/h3\u003e\n\u003cp\u003eThe population of this study consisted of 442 breast cancer survivors in Senology Institute Breast Clinic in Istanbul between January 2021 and January 2023. Women aged 18 years or older, with a confirmed diagnosis of breast cancer regardless of stage or treatment status, were included in the study if at least 6 months had passed since the completion of breast cancer treatment. BSCs with language barriers, Neurological and psychiatric diseases were excluded. The sample size was calculated using the GPower 3.1.9 version program. Minimum sample size was specified to be 352 with Type I error of 0.05 and at power level of 95%.\u003c/p\u003e\n\u003ch3\u003eData Collection Tools\u003c/h3\u003e\n\u003cp\u003eThe data of the study were collected via a face-to-face survey by Breast Cancer Survivor Evaluation Form and The Cancer Survivors\u0026rsquo; Unmet Needs (CaSUN) Scale.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eBreast Cancer Survivor Evaluation Form\u003c/strong\u003e \u003cp\u003eThe form, created by the researchers, consisted of a total 15 questions, including 8 questions related to women's demographic characteristics (age, marital status, education level, etc.) and 7 questions related to the disease process (type of treatment, type of cancer, etc.). Information regarding the disease process was obtained from the hospital's record system.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe Cancer Survivors\u0026rsquo; Unmet Needs (CaSUN) Scale\u003c/b\u003e: The scale, developed by Hodgkinson and colleagues in 2007 [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], was adapted and validated into Turkish by S\u0026uuml;ts\u0026uuml;nb\u0026uuml;loğlu and Vural in 2020 [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The scale consists of 5 sub-dimensions: Psychosocial support, Information, Economic concerns, Relationships, and Quality of Life. The internal consistency reliability coefficient (Cronbach's alpha) of the scale is 0.92. The total score is the sum of all items, indicating higher scores reflect greater needs (ranging from 0 to 35). Sub-dimension scores are calculated as the sum of all items within the relevant sub-dimension. Since the sub-dimensions have different numbers of items, the average number of needs within the corresponding sub-dimension is reported.\u003c/p\u003e\n\u003ch3\u003eEthical consideration\u003c/h3\u003e\n\u003cp\u003e The study was conducted in accordance with the Declaration of Helsinki, with the approval of the Ethics committee of the Medical Research Evaluation Committee of XXX University (2021-25/15). BCSs were informed about the study and their consent was obtained.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eData analysis was performed using SPSS 26.00 for the Windows package program. The percentage distribution, mean, standard deviation, and median values were given in descriptive statistics. To compare the means of continuous variables, the parametric Student t-test was used for those with a normal distribution, and the non-parametric Mann-Whitney U test was used for those with an abnormal distribution. To compare the means of more than two groups of continuous variables, the parametric One-Way ANOVA was used for those with a normal distribution, and the non-parametric Kruskal-Wallis test was used for those with an abnormal distribution. Correlation analysis was used to examine the relationship between continuous variables of the participants. Significance of results in the 95% confidence interval was evaluated under p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe ages of the women ranged from 26 to 86, and the mean age was 47.88\u0026plusmn;9.26. The average age of the women diagnosed with breast cancer was 44.61\u0026plusmn;8.91 years. Among BCSs, 73.3% were married, and 67.2% had a university degree. Table 1 presents the characteristics of BSSs (Table 1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Sociodemographic and Disease Related Characteristics of Breast Cancer Survivors (N= 442)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23.97%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9625%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 46.0674%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (Min-Max) \u0026nbsp;\u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (Years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 46.0674%;\"\u003e\n \u003cp\u003e47.88 (26-86) \u003cstrong\u003e\u0026plusmn;\u0026nbsp;\u003c/strong\u003e9.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at cancer diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 46.0674%;\"\u003e\n \u003cp\u003e44.61 (22-82) \u003cstrong\u003e\u0026plusmn;\u0026nbsp;\u003c/strong\u003e8.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 23.97%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 29.9625%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eMarried\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e73.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eSingle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e26.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003ePrimary Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e67.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployment\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eFull-time employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003ePart-time employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e26.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving Arrangement\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eAlone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003ePartner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e71.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eChild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e58.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eParent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e8.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of Children (n=258)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eOne child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eTwo children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e38.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eThree children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCancer metastasis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eNo metastasis, only in the breast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e57.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eBreast and axillary lymph nodes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e38.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eBreast, axillary lymph nodes and other organs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompleted Treatments\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eSurgical treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e410\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e92.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eChemotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e57.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eTargeted therapies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eImmunotherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecurrence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e96.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbidity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e401\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e90.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbid condition\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eHypertension \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eHeart Failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eDiabetes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eKidney Diseases\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eAsthma/COPD\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContinuous regular medication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e80.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of medication\u003csup\u003e1\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eAdjuvant Endocrine Therapy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e73,9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 53.9326%;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.5955%;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.4719%;\"\u003e\n \u003cp\u003e4,5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e\u003csup\u003e1\u003c/sup\u003e Participants can choose more than one option, SD: Standard deviation, COPD: Chronic Obstructive Pulmonary Disease) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe women\u0026apos; met needs score of CaSUN was 7.52\u0026plusmn;8.58. The unmet needs score of CaSUN was 9.37\u0026plusmn;9.82, and the total needs score was 16.93\u0026plusmn;10.74. The participants\u0026apos; scores for the sub-dimensions of CaSUN were as follows: Psychosocial support needs score was 3.12\u0026plusmn;1.87, information support needs score was 3.01\u0026plusmn;1.95, economic concerns needs score was 1.13\u0026plusmn;1.27, relationships needs score was 2.59\u0026plusmn;2.33, and quality of life needs score was 2.35\u0026plusmn;1.61 (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Needs Level of Breast Cancer Survivors\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD (Min \u0026ndash; Max)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMet needs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e7.52\u0026plusmn;8.58 (0-34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnmet needs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e9.37\u0026plusmn;9.82 (0-34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal needs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e16.93\u0026plusmn;10.74 (0-34)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSub-dimensions of CaSUN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003ePsychosocial support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e3.12\u0026plusmn;1.87 (0-5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003eInformation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e3.01\u0026plusmn;1.95 (0-5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003eEconomic concerns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e1.13\u0026plusmn;1.27 (0-3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003eRelationships\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e2.59\u0026plusmn;2.33 (0-6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 57.0342%;\"\u003e\n \u003cp\u003eQuality of life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42.9658%;\"\u003e\n \u003cp\u003e2.35\u0026plusmn;1.61 (0-4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eSD: Standard deviation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe table of \u0026quot;The Most Highly Ranked Unmet Needs of Survivors\u0026quot; is given in Table 3. The greatest unmet needs reported by survivors were \u0026quot;Help to manage my concerns about the cancer coming back\u0026quot; (44.6%), \u0026quot;Help to reduce stress in my life\u0026quot; (41.0%), and \u0026quot;Emotional support to be provided for me\u0026quot; (40.3%) (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e. The Most Highly Ranked Unmet Needs of Women Breast Canser Survivors\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe Most Highly Ranked Unmet Needs of Survivors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eHelp to manage my concerns about the cancer coming back\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e44.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eHelp to reduce stress in my life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e41.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eEmotional support to be provided for me\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e40.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eHelp to cope with changes to my belief that nothing bad will ever happen in my life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e38.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eI need help to cope with others not acknowledging the impact that cancer has had on my life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e36.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eI need help to deal with my own and/or others expectations of me as a \u0026lsquo;cancer survivor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e33.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eHelp to try to make decisions about my life in the context of uncertainty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e33.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eHelp to manage ongoing side effects and/or complications of treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eInformation provided in a way that I can understand\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86.4238%;\"\u003e\n \u003cp\u003eHelp to adjust to changes to the way I feel about my body\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5.96026%;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.61589%;\"\u003e\n \u003cp\u003e32.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThere was no statistically significant relationship between the ages of the participants and their age at cancer diagnosis with the total needs scores (p=.834; p=.838). Among the 258 participants who had children, there was a statistically significant, positive correlation between the number of children and the unmet needs scores (r=.184; p=.004). There was a statistically significant, negative correlation between the met needs scores of the participants (r=-.129; p=.044) (Table 4).\u003c/p\u003e\n\u003cp\u003eThere was a statistically significant difference in the unmet needs scores among participants based on their marital status (t=2.04; p=.042). Married participants had higher unmet needs scores. Participants\u0026apos; employment status showed a statistically significant difference in the met needs scores (F=3.469; p=.016) and total needs scores (F=2.960; p=.032). Part-time employed participants had higher total needs scores. There was a statistically significant difference in the met needs scores among participants based on the spread of cancer (KW=6.888; p=.032). There were statistically significant differences in the met needs scores (t=-3.268; p=.001) and total needs scores (t=-2.086; p=.038) among participants based on the recurrence of the disease. Participants\u0026apos; continuous regular medication use status showed statistically significant differences in the met needs scores (r=-1.366; p=.002) and total needs scores (r=-2.828; p=.005) (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u003c/strong\u003e Characteristics and Disease Related Needs of \u0026nbsp;Breast Cancer Survivors\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"602\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnmet needs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMet needs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal needs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u0026nbsp;\u003c/strong\u003e\u003cem\u003e(r / p)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e-.012 / .811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e.003 / .947\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e-.010 / .834\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at cancer Diagnosis\u0026nbsp;\u003c/strong\u003e\u003cem\u003e(r / p)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e.009 / .854\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e.004 / .931\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e.010 /.838\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of Children (n=258)\u0026nbsp;\u003c/strong\u003e\u003cem\u003e(r / p)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e.184 / \u003cstrong\u003e.004*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e-.129 / \u003cstrong\u003e.044*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e.081 / .206\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eMarried\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.95\u0026plusmn;10.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e7.06\u0026plusmn;8.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e17.06\u0026plusmn;\u0026nbsp;11.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eSingle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e7.76\u0026plusmn;8.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e8.79\u0026plusmn;8.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.55\u0026plusmn;9.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2.04 / .042\u003csup\u003ea*\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e-1.84 / .066\u003cstrong\u003e\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cem\u003e.429 / .668\u003cstrong\u003e\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003ePrimary Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e6.94\u0026plusmn;9.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e8.85\u0026plusmn;10.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e15.78\u0026plusmn;11.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e10.87\u0026plusmn;\u0026nbsp;9.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e6.61\u0026plusmn;7.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e17.48\u0026plusmn;\u0026nbsp;10.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.09\u0026plusmn;9.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e7.71\u0026plusmn;8.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.85\u0026plusmn;10.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e2.358 /\u0026nbsp;.096\u003csup\u003eb\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e1.056 /\u0026nbsp;.349\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cem\u003e.329 / .720\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployment\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eFull-time employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e8.27\u0026plusmn;8.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e8.64\u0026plusmn;9.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.91\u0026plusmn;10.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003ePart-time employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e12.58\u0026plusmn;\u0026nbsp;10.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.45\u0026plusmn;8.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e22.03\u0026plusmn;\u0026nbsp;10.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e10.63\u0026plusmn;\u0026nbsp;10.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e5.95\u0026plusmn;8.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.69\u0026plusmn;10.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.08\u0026plusmn;10.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e6.33\u0026plusmn;7.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e15.41\u0026plusmn;10.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e2.571 /\u0026nbsp;.054\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e3.469\u0026nbsp; \u0026nbsp;/ .016\u003csup\u003e\u0026nbsp;b*\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2.960 /\u0026nbsp;.032\u003csup\u003e\u0026nbsp;b*\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCancer metastasis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eNo metastasis, only in the breast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.51\u0026plusmn;9.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e7.22\u0026plusmn;8.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.78\u0026plusmn;10.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eBreast and axillary lymph nodes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.27\u0026plusmn;9.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e7.73\u0026plusmn;8.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e17.01\u0026plusmn;10.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eBreast, axillary lymph nodes and other organs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e8.33\u0026plusmn;10.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.72\u0026plusmn;10.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e18.05\u0026plusmn;12.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e5.563 / .062\u003csup\u003ec\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e6.888 / .032\u003csup\u003ec\u003c/sup\u003e*\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cem\u003e1.596 / .450\u003csup\u003ec\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecurrence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e16.33\u0026plusmn;10.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e11.16\u0026plusmn;\u0026nbsp;9.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e27.50\u0026plusmn;5.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.62\u0026plusmn;9.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e6.67\u0026plusmn;7.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.36\u0026plusmn;10.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e.393/ .\u003c/em\u003e \u003cem\u003e695\u003csup\u003ea\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e1.366 / .002\u003csup\u003ea*\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e2.828 / .005\u003csup\u003ea*\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbidity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e10.18\u0026plusmn;\u0026nbsp;9.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e10.31\u0026plusmn;9.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e20.51\u0026plusmn;10.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.76\u0026plusmn;9.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e6.54\u0026plusmn;7.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e16.36\u0026plusmn;10.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e.163 / .870\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cem\u003e3,108 / .067\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cem\u003e1.559 / \u0026nbsp;.120\u003csup\u003e\u0026nbsp;a\u003c/sup\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eContinuous regular medication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.91\u0026plusmn;9.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e6.02\u0026plusmn;7.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e15.99\u0026plusmn;10.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e9.27\u0026plusmn;10.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e10.27\u0026plusmn;\u0026nbsp;9.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e19.54\u0026plusmn;9.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 44.8505%;\"\u003e\n \u003cp\u003e\u003cem\u003eTest value / p\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e.384 / .702\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 18.9369%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-3.268 / .001\u003csup\u003ea\u003c/sup\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17.2757%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-2.086 / .038\u003csup\u003ea\u003c/sup\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e*p\u0026lt;0.05;\u0026nbsp;r= Spearman\u0026apos;s correlation coefficient\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ea=Student-t, b=One way Anova, \u0026nbsp; c=Kruskal Wallis Test, d=Mann Whitney U,\u0026nbsp;\u003c/em\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe identification and management of unmet needs are crucial components of providing high-quality healthcare for cancer survivors [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In this study, 442 women were analyzed to examine the unmet needs of Turkish BCSs and the related factors. There are only a few studies conducted in Turkey related to BCSs. Among them, this study is the most comprehensive sampling of the unmet needs of BCSs in Turkey and related factors. In addition, this study provides practical and applicable information to policy makers and health professionals on this issue.\u003c/p\u003e \u003cp\u003ePrevious studies have shown that the greatest needs among cancer survivors are related to the psychological and health system/information domains, with coping with the fear of cancer recurrence or metastasis being the most common need. According to the study conducted by Chou et al, 2020 [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], the results revealed that the highest unmet supportive need among BCSs was in the psychosocial domain (40.4%). Similarly, in the study conducted by Edib et al. 2016 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], the most significant unmet supportive care needs were found in the psychological domain, with the physical domain following closely behind.\u003c/p\u003e \u003cp\u003eStudies on the unmet needs of women with BCSs in different populations have yielded different results. In Palestine, the highest unmet need reported by BCSs were psychological needs, health-related systems and information and physical-daily life [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Mart\u0026iacute;nez Arroyo et al. and Skandarajah et al. reported that needs focused on the possibility of recurrence were the most frequent [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In a systematic review of 10,574 women, information needs and psychological needs were frequently reported [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In Korean, the most prevalent unmet needs were found in the information and education domain [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In Chinese, the highest unmet need indicated fear of recurrence, patient-provider communication, and body image [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. These unmet needs vary according to the individual characteristics of women, but also vary according to the country, health policies and the level of development of the country.\u003c/p\u003e \u003cp\u003eIn this study, the top three needs were concerns about cancer recurrence, stress management, and emotional support. Correspondingly, BCSs who had experienced cancer recurrence had higher needs than those who had not, indicating a correlation with the study's results. This results show that psychological and information needs continue to be the most important and critical priorities for BCSs even in the long term. Also these results suggest that BCSs have information needs and related psychological needs due to the lack of follow-up and monitoring policies for survivors in Turkey. In the literature, psychosocial needs and information support needs are the most frequent requirement [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn a study, it was revealed that financial issues, perceptions of post-treatment mood changes, familial roles, and physical changes are sources of stress for breast cancer survivors [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. One of the striking findings of our study was that as the number of children of BCS women increases, their unmet needs increase, while their met needs increase as the number of children decreases. The reason for this may be related to women's social roles and responsibilities related to childcare. In Turkey, there is a patriarchal structure and the primary responsibility for childcare is given to women. The increase in the number of children may have led to an increase in BCSs' responsibilities and increased psychological needs. When developing survivor follow-up policies, it may be taken into account that the number of children and the needs of women may increase accordingly.\u003c/p\u003e \u003cp\u003eUnmet care needs were influenced by other demographic factors, disease factors and psychological factors. In this study married participants had higher unmet needs scores. The results are similar to the literature [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. It can be explained that unmarried women may have relatively fewer responsibilities and more time to access information and healthcare facilities. Since being married may also be related to having children, this supports our previous result.\u003c/p\u003e \u003cp\u003eThe employed group were found to have higher levels of unmet needs in the domains of symptom burden, function, health behaviour, and healthcare-seeking skills [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In this study, there was a difference in met needs scores among BCSs based on their employment status. Part-time and full-time employed BCSs had higher total needs scores. Women's employment status, not their level of education, came to the fore. Considering that part-time and full-time employed women can socialise, receive social support and take care of themselves, it can be said that they can meet their needs.\u003c/p\u003e \u003cp\u003eIt was determined that the needs met were higher in BCSs with cancer metastasis, recurrence and regular medication use. This result suggests that BCSs experiencing recurrence and metastasis are more concerned about their health and more sensitive about their needs. As in this study fear of cancer recurrence is the most frequently cited unmet need among cancer survivors [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Comorbidity levels of BCSs are quite low. The medications used are mostly adjuvant endocrine therapy related to breast cancer. The possible explaination was that these patients learn more about the disease and they might question the doctor\u0026rsquo;s advice. Since women regularly go to hospital for these treatments and are in contact with health professionals, they may be meeting their needs and requirements in this way. According to the Lebel and et. al 2013 survivors with elevated fear of cancer recurrence may indeed use more health care services [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The reverse of this Fang and et al 2018, BCSs on endocrine therapy had more unmet needs regarding information than those who were not receiving therapy [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study on the unmet needs of Turkish BCSs have specific results, with a focus on psychosocial and information-related domains. These findings highlight the importance of addressing the psychological well-being and information support of BCSs to improve their overall daily life and long-term survivorship. Furthermore, certain sociodemographic characteristics such as being married, having children, and employment status have been found to influence the unmet needs of survivors. Therefore, nurses should collect sufficient data on this matter in the women they provide care for and take part in developing protocols and systems to address these issues.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLimitation of this study was its cross-sectional design, which only allowed for the analysis of unmet needs and related factors in breast cancer survivors at a single point in the disease trajectory. Another limitation of the study was its single-center design. Conducting the study with repeated data from multiple centers and different time points could provide additional insights into related factors such as survivorship.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVK: data curation, formal analysis, writing\u0026mdash; original draft, writing\u0026mdash;review and editing, and visualization. YU: conceptualization, funding acquisition, investigation, writing\u0026mdash;review and editing. DSS: data curation, resources, writing\u0026mdash;review and editing. \u0026Ccedil;A: data curation, resources, writing\u0026mdash;review and editing. CU: conceptualization, funding acquisition, and investigation. All authors read and approved the fnal manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank patients who generously gave their time to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no grant from any funding agency in the public, commercial, or not for profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics committee of the Medical Research Evaluation Committee of XXX University (2021-25/15). Informed consent was obtained from all individual participants included in the study. The research was conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have confrmed that they have no conficts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmerikan Cancer Society (2022) How Common is Breast Cancer. https://www.breastcancer.org/facts-statistics#section-how-common-is-breast-cancer. Accessed 2 Aug 2023\u003c/li\u003e\n\u003cli\u003eAmerican Cancer Society (2023) Cancer Facts \u0026amp; Figures 2023. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2023-cancer-facts-figures.html. Accessed 1 Aug 2023\u003c/li\u003e\n\u003cli\u003eLo-Fo-Wong DNN, de Haes HCJM, Aaronson NK, et al (2020) Risk factors of unmet needs among women with breast cancer in the post‐treatment phase. Psychooncology 29:539. https://doi.org/10.1002/PON.5299\u003c/li\u003e\n\u003cli\u003eVuksanovic D, Sanmugarajah J, Lunn D, et al (2021) Unmet needs in breast cancer survivors are common, and multidisciplinary care is underutilised: the Survivorship Needs Assessment Project. Breast Cancer 28:289\u0026ndash;297. https://doi.org/10.1007/S12282-020-01156-2\u003c/li\u003e\n\u003cli\u003eTabari-Khomeiran R, Ahmadi F, Jafaraghaee F, et al (2023) Unmet Care Needs in Breast Cancer Survivors: An Integrative Review. Journal of Holistic Nursing And Midwifery 33:1\u0026ndash;14. https://doi.org/10.32598/JHNM.33.1.2272\u003c/li\u003e\n\u003cli\u003eMiro\u0026scaron;evič \u0026Scaron;, Prins JB, Selič P, et al (2019) Prevalence and factors associated with unmet needs in post-treatment cancer survivors: A systematic review. Eur J Cancer Care (Engl) 28:e13060. https://doi.org/10.1111/ECC.13060\u003c/li\u003e\n\u003cli\u003eBu X, Jin C, Fan R, et al (2022) Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer 22:. https://doi.org/10.1186/S12885-022-09224-W\u003c/li\u003e\n\u003cli\u003eLisy K, Langdon L, Piper A, Jefford M (2019) Identifying the most prevalent unmet needs of cancer survivors in Australia: A systematic review. Asia Pac J Clin Oncol 15:e68\u0026ndash;e78. https://doi.org/10.1111/AJCO.13176\u003c/li\u003e\n\u003cli\u003eElsous A, Radwan M, Najjar S, et al (2023) Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine. Acta Oncol 62:194\u0026ndash;209. https://doi.org/10.1080/0284186X.2023.2180326\u003c/li\u003e\n\u003cli\u003eChae BJ, Lee J, Lee SK, et al (2019) Unmet needs and related factors of Korean breast cancer survivors: A multicenter, cross-sectional study. BMC Cancer 19:1\u0026ndash;16. https://doi.org/10.1186/S12885-019-6064-8\u003c/li\u003e\n\u003cli\u003eFang SY, Fetzer SJ, Lee KT, Kuo YL (2018) Fear of Recurrence as a Predictor of Care Needs for Long-Term Breast Cancer Survivors. Cancer Nurs 41:69\u0026ndash;76. https://doi.org/10.1097/NCC.0000000000000455\u003c/li\u003e\n\u003cli\u003eEllegaard MBB, Grau C, Zachariae R, Bonde Jensen A (2017) Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study. Acta Oncol 56:314\u0026ndash;320. https://doi.org/10.1080/0284186X.2016.1268714\u003c/li\u003e\n\u003cli\u003eP\u0026eacute;rez-Fortis A, Fleer J, S\u0026aacute;nchez-Sosa JJ, et al (2017) Prevalence and factors associated with supportive care needs among newly diagnosed Mexican breast cancer patients. Supportive Care in Cancer 25:3273\u0026ndash;3280. https://doi.org/10.1007/S00520-017-3741-5\u003c/li\u003e\n\u003cli\u003eChou YH, Chia-Rong Hsieh V, Chen XX, et al (2020) Unmet supportive care needs of survival patients with breast cancer in different cancer stages and treatment phases. Taiwan J Obstet Gynecol 59:231\u0026ndash;236. https://doi.org/10.1016/J.TJOG.2020.01.010\u003c/li\u003e\n\u003cli\u003ePark BW, Hwang SY (2012) Unmet Needs and Their Relationship with Quality of Life among Women with Recurrent Breast Cancer. J Breast Cancer 15:454. https://doi.org/10.4048/JBC.2012.15.4.454\u003c/li\u003e\n\u003cli\u003eHodgkinson K, Butow P, Hunt GE, et al (2007) The development and evaluation of a measure to assess cancer survivors\u0026rsquo; unmet supportive care needs: the CaSUN (Cancer Survivors\u0026rsquo; Unmet Needs measure). Psychooncology 16:796\u0026ndash;804. https://doi.org/10.1002/PON.1137\u003c/li\u003e\n\u003cli\u003eCihan E, Vural F (2023) Gastrointestinal and Breast Cancer Survivor\u0026rsquo;s Unmet Needs During Survivorship Journey: A Reliability and Validity Study. Journal of Nursology 26:113\u0026ndash;119. https://doi.org/10.5152/JANHS.2023.23319\u003c/li\u003e\n\u003cli\u003eEdib Z, Kumarasamy V, binti Abdullah N, et al (2016) Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Health Qual Life Outcomes 14:1\u0026ndash;10. https://doi.org/10.1186/S12955-016-0428-4\u003c/li\u003e\n\u003cli\u003eMart\u0026iacute;nez Arroyo O, Andreu Va\u0026iacute;llo Y, Mart\u0026iacute;nez L\u0026oacute;pez P, Gald\u0026oacute;n Garrido MJ (2019) Emotional distress and unmet supportive care needs in survivors of breast cancer beyond the end of primary treatment. Supportive Care in Cancer 27:1049\u0026ndash;1057. https://doi.org/10.1007/S00520-018-4394-8\u003c/li\u003e\n\u003cli\u003eSkandarajah AR, Lisy K, Ward A, et al (2021) Patient-reported outcomes in survivors of breast cancer one, three, and five years post-diagnosis: a cancer registry-based feasibility study. Quality of Life Research 30:385\u0026ndash;394. https://doi.org/10.1007/S11136-020-02652-W\u003c/li\u003e\n\u003cli\u003eFan R, Wang L, Bu X, et al (2023) Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023 23:1 23:1\u0026ndash;24. https://doi.org/10.1186/S12885-023-11087-8\u003c/li\u003e\n\u003cli\u003eCheng KKF, Wong WH, Koh C (2016) Unmet needs mediate the relationship between symptoms and quality of life in breast cancer survivors. Supportive Care in Cancer 24:2025\u0026ndash;2033. https://doi.org/10.1007/S00520-015-2994-0\u003c/li\u003e\n\u003cli\u003eWells KJ, Drizin JH, Ustjanauskas AE, et al (2022) The Psychosocial Needs of Underserved Breast Cancer Survivors and Perspectives of their Clinicians and Support Providers. Supportive Care in Cancer 30:105. https://doi.org/10.1007/S00520-021-06286-7\u003c/li\u003e\n\u003cli\u003eSimard S, Thewes B, Humphris G, et al (2013) Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv 7:300\u0026ndash;322. https://doi.org/10.1007/S11764-013-0272-Z\u003c/li\u003e\n\u003cli\u003eLebel S, Tomei C, Feldstain A, et al (2013) Does fear of cancer recurrence predict cancer survivors\u0026rsquo; health care use? Supportive Care in Cancer 21:901\u0026ndash;906. https://doi.org/10.1007/S00520-012-1685-3\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Breast cancer survivor, women, survivorship, unmet needs, breast cancer","lastPublishedDoi":"10.21203/rs.3.rs-5379884/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5379884/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eIt is essential to identify the met and unmet needs of breast cancer survivors. Furthermore, the sociodemographic and disease related characteristics of survivors can influence their needs. The aim of this study is to investigate the unmet needs of breast cancer survivors and the related factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The study was conducted as a cross-sectional study. The population of this study consisted of 442 breast cancer survivors in Senology Institute Breast Clinic in Istanbul. The data of the study were collected by Breast Cancer Survivor Evaluation Form and The Cancer Survivors’ Unmet Needs (CaSUN) Scale between January 2021 and January 2023. \u003cstrong\u003eResults:\u003c/strong\u003e The mean ages of the was 47.88±9.26. The womens' met needs score of CaSUN was 7.52±8.58. The unmet needs score of CaSUN was 9.37±9.82, and the total needs score was 16.93±10.74. Among the 258 women who had children, there was a statistically significant, positive correlation between the number of children and the unmet needs scores (r=.184; p=.004), negative correlation between the met needs scores of the women (r=-.129; p=.044). There was a statistically significant difference in the unmet needs scores among women based on their marital status (t=2.04; p=.042).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The study with breast cancer survivors in Turkey identified specific unmet needs focussing on psychosocial and information-related domains. Furthermore, certain sociodemographic characteristics such as being married, having children, and employment status have been found to influence the unmet needs of survivors.\u003c/p\u003e","manuscriptTitle":"Unmet Needs of Breast Cancer Survivors and Related Factors: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-15 15:16:18","doi":"10.21203/rs.3.rs-5379884/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6b01501a-ce1b-4433-ad4a-505bd35063e7","owner":[],"postedDate":"November 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-10T06:24:00+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-15 15:16:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5379884","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5379884","identity":"rs-5379884","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}