Concerns across the survivorship trajectory: results from a survey of cancer survivors.

PURPOSE/OBJECTIVES To evaluate the most prevalent physical, social, emotional, and spiritual concerns of cancer survivors. DESIGN Descriptive, cross-sectional study. SETTING A matrix (multisite) cancer center in three urban centers in the United States. SAMPLE 337 cancer survivors representing nine diagnostic groups in a broad spectrum of time since diagnosis. METHODS Participants completed a survey designed to evaluate the self-reported concerns of cancer survivors. Demographic information and questions using Likert scales were used to measure concerns and quality of life. Descriptive statistics and regression analyses were used to evaluate data. MAIN RESEARCH VARIABLES Cancer diagnosis; time since diagnosis; and physical, social, emotional, and spiritual concerns. FINDINGS Overall, quality of life was reported as a mean of 8.44 on a scale of 0-10. The top five concerns identified were fear of recurrence, fatigue, living with uncertainty, managing stress, and sleep disturbance. Prevalence and severity of concerns differed by cancer diagnosis and time since diagnosis. Patients reporting extreme concerns related to fatigue were associated with lower quality-of-life scores. CONCLUSIONS The research indicated that fatigue and fear of recurrence are lasting concerns across the survivorship trajectory and that age, cancer diagnosis, and time since diagnosis will have an effect on the survivor's experience. IMPLICATIONS FOR NURSING Nurses should take a proactive role in assessing the physical, social, emotional, and spiritual needs of all cancer survivors, regardless of cancer type and time since diagnosis. Future research and support programs for cancer survivors should focus on the major concerns of fatigue and fear of recurrence. KNOWLEDGE TRANSLATION The results of this research confirmed the importance of designing programs to support cancer survivors in an integrative manner from initial diagnosis into the period of long-term survivorship. Specific attention should be placed on the concerns related to fear of recurrence, fatigue, financial burden, and the long-term effects of cancer treatment.