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Care Needs and Symptoms Burden of Breast Cancer Patients in Jordan: A Cross-Sectional Study

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Omar Shamieh, Ghadeer Alarjeh, Houshen Li, Mahmoud Abu Naser, Fadi Abu Farsakh, Rashid Abdel-Razeq, Adib Edilbi, Ruba Al-Ani, Richard Harding, Ping Guo

Original languageEnglish
Article number10787
JournalInternational Journal of Environmental Research and Public Health
Issue number17
PublishedSep 2022

King's Authors


Breast cancer is the most common malignancy in Jordan. Rigorous needs assessment for breast cancer patients can prioritize both cancer care and palliative care to propose the appropriate services effectively. We conducted a cross-sectional study of breast cancer patients in a cancer center in Jordan. We assessed symptom burden, comorbidities, and performance using the Edmonton Symptom Assessment System (ESAS), the Charlson Comorbidity Index (CCI), and the Australia-modified Karnofsky performance scale (AKPS). Descriptive analysis and regression models to predict the highest symptom burden were used. A total of 233 participants were enrolled: curative vs. palliative intent groups (147 (63%) vs. 86 (37%) patients), respectively. Tiredness was the most reported symptom in 189 patients (81%), while nausea was the least in 61 patients (26.2%). A relationship between the AKPS score and total ESAS was seen (correlation coefficient of −0.487; p < 0.0001). The prevalence of anxiety (p = 0.014), lack of appetite (p = 0.002), poor well-being (p < 0.001), and sleep disorder (p = 0.035) was higher in the palliative care intent group than in the curative one. We identified unmet needs in breast cancer patients. Both groups showed a prevalence of distressing symptoms suggesting that even those with non-palliative intent have high needs and should receive integrated palliative care.

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