Quality of care: Distress, health care use and needs of women with breast cancer

The aims of this thesis were to: (1) examine enduring distress and its predictors in women with breast cancer; (2) determine the extent to which distress-related problems are portrayed in a graphic novel about breast cancer; (3) examine health care use and additional needs (with regard to medical, paramedical, psychosocial, supplementary, CAM, and dental care services), and predictors of health care use in women with breast cancer; and (4) examine predictors of unmet care needs of women with breast cancer after treatment. Practitioners may use the findings to provide tailored care to those women with the highest needs. Also, the results may be used to guide the direction of future, effective interventions.
More specifically, developers of distress interventions are advised to target fatigue and lack of physical strength as well as life-satisfaction and cancer worry in their program. Furthermore, addressing needs in the psychological, and health system and informational domains should take priority. Women with breast cancer especially want more self-help information, help for coping with fear of disease recurrence or spread, and help for coping with uncertainty about the future. Finally, early targeting of distress can possibly prevent higher use and unmet needs across domains.