Holistic needs assessments for teenagers and young adults after cancer treatment in Scotland identified a significant burden of unmet needs


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Angela Edgar1,Nicola Davison1,Simita Kumar1,Bernadine Wilkie1,Jeff White2
1NHS Lothian,2NHS Greater Glasgow and Clyde

Abstract

Background

Psychosocial issues are common amongst Teenagers and young adults (TYA) after cancer treatment and TYA report feeling unsupported. The objective of this study was to determine the burden of needs amongst TYA after cancer treatment and evaluate whether these needs are being met.

Method

Scottish TYA (16-24 years) completing cancer treatment, between April 2016-April 2017, were identified. Treatment Summaries (TS) and Holistic Needs Assessment (HNA) were completed and distributed (TS only) to patients and health professionals. Qualitative analysis identified concerns.

Results

Fifty-one of 83 eligible TYA were recruited (response rate 61%); 26 (51%) males, median (range) age 22 (16 – 25) years with over-representation of germ cell tumours (39%), lymphomas (27%), bone tumours (14%). TS data was available for 51 (100%) and raw HNA data for 26 patients (50%). 45 TYA (88%) reported concerns: 35 (69%) reported 1-5 concerns; 2 (4%) reported 6-10 concerns; 5 (10%) reporting 11-15 concerns; 1 (2%) reported 1 concern and 2 (4%) reported >20 concerns: general appearance, physical fitness and emotional issues, were the most numerous. One third of TYA were referred for psychological support; two-thirds benefitted from third sector support programmes.

Conclusion

Almost 90% of TYA reported at least one concern after cancer treatment, with more than two-thirds of patients reporting five to 10 concerns, and 10% reporting up to 15 concerns. While support services, largely provided by third sector, are in place for many patients, further evaluation of the Health Needs Assessments, exploring relationships to diagnoses, and identification of gaps in services, are required to inform future developments.