Changes in unmet care needs, social support and distress from initial diagnosis to post-surgery in patients with gynecological cancer: A longitudinal study

Purpose This study aimed to explore the changes in unmet care needs, perceived social support, and levels of anxiety, stress and depression experienced by newly diagnosed Greek patients with gynecological cancer. These outcomes were assessed during the phase after diagnosis and before surgical treatment (T0), and 4 months after surgical treatment at the first postoperative follow-up visit (T1). Methods This was a prospective, longitudinal, descriptive study based on the framework of stress and coping theory. A convenience sample of 86 patients newly diagnosed with gynecological cancer participated in the study between May 2020 and April 2021. Unmet care needs were measured by the Needs Evaluation Questionnaire. Distress levels were measured by the Greek version of the Depression, Anxiety and Stress Scale (DASS-21), and social support was measured by the Greek version of the Multidimensional Scale of Perceived Social Support (MSPSS). Participants’ demographic characteristics and clinical data were also recorded. The Needs Evaluation Questionnaire, Depression, Anxiety and Stress Scale (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS) and a demographic and clinical data questionnaire were distributed to a convenience sample of 86 patients. Results The mean age of the participants was 60.7 years (SD = 10.9 years) and 57.6% were married. The most common diagnosis was endometrial cancer (45.9%) and 40.6% of patients had grade I cancer. Overall, patients’ needs and social support had significantly decreased at T1 compared to T0 (p = 0.005 and p = 0.029, respectively). DASS-21 subscale scores did not change significantly over the follow-up period, whereas anxiety levels were significantly lower at follow up (p = 0.048). Changes in anxiety levels were associated with changes in needs related to family (p < 0.001), need for assistance/care (p = 0.013) and support (p = 0.004), and total needs (p = 0.004). Conclusion The phase following cancer diagnosis and awaiting surgery is a high-risk period for the mental health of women with gynecological cancer, and one that requires special attention from healthcare professionals. By identifying unmet needs, addressing anxiety and providing appropriate social support, they can contribute significantly to improving patients’ quality of life throughout their cancer journey.