Unmet supportive care needs and characteristics of family caregivers of patients with oral cancer after surgery Shu-Ching Chen 1,6 *, Yeur-Hur Lai 2 , Chun-Ta Liao 3,4,6 , Bing-Shen Huang 4,5,6 , Chien-Yu Lin 4,5,6 , Kang-Hsing Fan 4,5,6 and Joseph Tung-Chien Chang 4,5,6 1 Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan 2 School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan 3 Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan 4 College of Medicine, Chang Gung University, Taoyuan, Taiwan 5 Department of Radiation Oncology, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan 6 Head and Neck Oncology Group, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Taoyuan, Taiwan *Correspondence to: Department of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan. E-mail: shuching@gw. cgust.edu.tw Received: 6 March 2013 Revised: 30 October 2013 Accepted: 1 November 2013 Abstract Objective: The aim of this study was to identify factors associated with unmet supportive care needs in family caregivers of patients with oral cancer after surgery. Methods: In a cross-sectional study, we recruited patient–family caregiver dyads from the otolaryn- gology head and neck surgery wards of a medical center in northern Taiwan. Patients were assessed using a set of structured questionnaires to measure symptom distress, sleep quality, and depression. Social support and supportive care needs of family caregivers were measured. Results: Of the 102 dyads surveyed, needs for supportive care in information domain and healthcare professional/healthcare services domain were highest. Patients with more severe symptoms and family caregivers who received less social support from family were associated with greater overall unmet supportive care needs. Conclusions: Family caregivers report the need for more information and healthcare services after a family member has had oral surgery. Caregiving training programs should be developed for care- givers on the basis of meeting reported needs. Copyright © 2014 John Wiley & Sons, Ltd. Introduction Supportive care is defined as ‘care given to improve the quality of life of patients who have a serious or life-threat- ening disease. The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychologi- cal, social, and spiritual problems related to a disease or its treatment’ [1]. Supportive care given to caregivers is designed to help them cope while caring for a family member with cancer [1]. Many family caregivers experi- ence unmet supportive care needs after a family member has had cancer treatment [2–4]. Cancer is a progressive and chronic disease that pro- foundly impacts the patient’s physical and psychosocial well-being and that of the family. In Taiwan, oral cancer is the fourth leading cause of death among men [5], and 55% of these men have advanced disease at diagnosis [6]. Radical excision and reconstruction are the treatments of choice [7]. Family caregivers often face complex caregiving tasks after their family member’s surgery. Unmet supportive care needs may have negative consequences for caregivers, including emotional distress [8], declines in physical well- being, and reduced quality of life [4], and may interfere with the way family caregivers handle caregiving. Previous studies found that unmet needs in caregivers of patients with cancer could range from 30% to 56% [2–4]. In Taiwan, patients with oral cancer tend to have low educa- tion level, low occupational and social classes, and low in- come [9]. Most patients with oral cancer are men [6] and the primary breadwinners. Family caregivers take on heavy responsibilities after a patient is treated for oral cancer. Unmet supportive care needs of family caregivers of cancer patients are associated with several characteristics. Anxiety and depression among patients are significant predictors of caregivers’ unmet needs [2–4]. Good sup- portive services help caregivers use community services more effectively and manage stress [3]. Family members have fewer unmet needs when caregiving interferes less in their own activities and requires less involvement, and when they are physically healthy and have social support [10]. A qualitative study reported that a caregiver’s lack of patient-care knowledge and limited understanding of the health system were associated with greater supportive care needs [11]. Copyright © 2014 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology 23: 569–577 (2014) Published online 8 January 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3458