Supportive care needs among patients with breast and cervical cancer at a tertiary cancer treatment center in ethiopia: a cross-sectional study

Abstract

The rising incidence of cancer diagnoses alongside improving survival rates in low- and middle-income countries (LMICs) has substantially increased the demand for comprehensive supportive care. This study aimed to assess the supportive care needs of patients diagnosed with breast or cervical cancer at Hawassa University Comprehensive Specialized Hospital Cancer Treatment Center, Ethiopia. A hospital-based cross-sectional study was conducted among 349 patients with breast or cervical cancer between December 2023 and May 2024. Data were collected using three validated instruments: the Supportive Care Needs Survey Short Form (SCNS-SF34), the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being scale (FACIT-Sp-12), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). All instruments were scored according to their respective guidelines. Multivariable linear regression was performed to identify factors independently associated with supportive care needs. Patients were relatively young, with a mean age of 42.5 ± 12 years for breast cancer and 49.5 ± 12 years for cervical cancer. The majority reported cancer-related symptoms, and nearly all patients indicated unmet supportive care needs in at least one domain. Greater supportive care needs were significantly associated with the use of traditional or spiritual healing practices (mean difference [MD] 9.15, 95% CI: 3.51-14.59), lower functional performance status (MD 5.53, 95% CI: 3.11-7.96), higher number of children (MD 1.95, 95% CI: 0.90-3.01), and higher educational attainment (MD 2.58, 95% CI: 1.22-3.94). Conversely, having health insurance was associated with significantly lower supportive care needs (MD - 3.78, 95% CI: -7.36 to - 0.19). Unmet supportive care needs were prevalent across all assessed domains: physical and daily living, psychological, sexual health, patient care, and health information underscoring a substantial gap in comprehensive cancer care in this setting. To address these needs, healthcare systems should prioritize patient-provider communication, strengthen social support networks for high-need patients, integrate spiritual well-being into care planning, and develop context-sensitive, multidisciplinary supportive care strategies.