"‘I used to say, ‘I am OK’”: The unspoken realities of supportive care needs in Asian American metastatic cancer survivorship.
Bibliographic record
Abstract
338 Background: With advances in treatments, more individuals are living with metastatic cancer. Supportive care improves quality of life and reduces costs, but supportive care needs (SCNs) of Asian Americans with metastatic cancer are understudied. This convergent mixed-methods study examined the SCNs of Chinese, Vietnamese, and Korean (CVK) American adults with metastatic solid tumors. Methods: Language-matched interviewers conducted semi-structured interviews. English-translated transcripts were analyzed using reflexive thematic analysis to answer the question, “What are the supportive care needs of Asian Americans with metastatic cancer?” Quantitative surveys were completed following the interview, including the SCNS-ST9, to assess five domains of SCNs (health system/information, patient care/support, physical/daily living, psychological/emotional, sexuality). Results: Participants (n = 69; M a ge = 52.03, SD = 21.18) identified as Chinese (52.17%), Vietnamese (30.43%), or Korean (17.39%). Most were female (66.67%), foreign-born (88.41%), and reported low acculturation (71.01%). Five preliminary themes were developed: 1) Greater healthcare access and education; 2) Pervasive but hidden mental health gaps; 3) Harmonized care coordination; 4) Preparing ahead for all possibilities; and 5) Addressing the needs of the collective unit. Across themes, patients conveyed that existing infrastructure was insufficient, and supplementing with external care was vital (e.g., acupuncture (Chinese), religious services (Vietnamese/Korean)). Expressing SCNs to the healthcare team varied by age and acculturation. Quantitative findings diverged from interviews, with most participants describing low need across the five SCNS-ST9 domains (25.70 ± 8.68). Patients ≤50 years old at diagnosis reported more sexuality needs ( p = 0.02) than older patients. More acculturated patients reported greater needs to be emotionally validated by healthcare staff ( p <0.01). Conclusions: Findings highlight both shared and ethnoculturally specific SCNs of CVK American metastatic cancer survivors, underscoring the importance of culture in care coordination. A mixed-methods approach revealed critical gaps that may be overlooked by quantitative data alone, particularly in domains influenced by stigma and cultural values (i.e., patients’ unspoken realities). Ongoing patient engagement and interactive assessments may provide valuable information for clinical service quality improvement.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".