Patient-reported outcome measures for the identification of supportive care needs in people with lung cancer: are we there yet?

BACKGROUND: The use of patient-reported outcome measures is a method of identifying and addressing supportive care needs (SCN) of people with lung cancer, which are often overlooked. OBJECTIVE: The objectives of this study were to identify and evaluate existing SCN tools previously used in studies with patients with lung cancer and to establish their suitability for use in research and clinical practice. METHODS: A systematic search was carried out in the MEDLINE, CINAHL, EMBASE, PsychINFO, and British Nursing Index databases to locate studies conducted between January 2000 and November 2010 that made use of validated self-report SCN tools with patients with lung cancer. RESULTS: Twelve articles introducing 8 instruments met prespecified selection criteria. All tools were appraised for their content, comprehensiveness, appropriateness, psychometric properties, and feasibility and acceptability. Only 1 lung cancer-specific SCN tool was identified. Whereas the majority of tools had acceptable psychometric properties, only 1 tool had gone through a systematic development process specifically in the context of lung cancer. Therefore, it is questionable whether existing tools can adequately identify healthcare needs that people with lung cancer consider most important. CONCLUSIONS: To ensure that SCNs of people with lung cancer are adequately and promptly identified, rigorous development and systematic testing of content-specific SCN tools are warranted. IMPLICATIONS FOR PRACTICE: Collaborative work between patients with lung cancer, health professionals, and tool developers is required for an SCN tool not only to be content-specific but also to take into consideration the reality of clinical practice in providing supportive care to people with lung cancer.

A systematic review of supportive care needs of people living with lung cancer.

BACKGROUND AND PURPOSE: Supportive care for people living with a diagnosis of lung cancer is paramount. The purpose of this systematic review was to determine the supportive care needs of people with lung cancer, and explore trends and gaps in the assessment of these needs emerging from this literature. METHODS: Through use of a wide range "free text" terms, a systematic search of five electronic databases (Medline, CINAHL, EMBASE, PsychINFO and BNI) was carried out for the period between January 2000 and September 2012. Two validated scoring systems were used to appraise eligible studies for methodological quality and level of evidence. RESULTS: Based on pre-specified selection criteria, 59 articles (25 of quantitative methodology; 34 of qualitative methodology) reporting on 53 studies were retrieved and considered for further analysis. Overall, studies were of acceptable methodological quality. A wide spectrum of health care needs was evident among people with lung cancer. These needs were classified into nine domains: physical; daily living; psychological/emotional; spiritual/existential; informational; practical; patient-clinician communication; social and family-related; and cognitive. Daily living, practical, and cognitive needs were given less attention in this literature. CONCLUSIONS: People with lung cancer have a complex array of supportive care needs that impact on various life aspects. Yet, our knowledge still remains fragmentary. Embarking on new longitudinal exploratory studies and well-designed clinical trials is therefore strongly encouraged. The use of patient reported outcome measures as a clinical intervention tool may be viewed as a means of identifying and managing unmet needs in this patient population.