Patient needs in the context of gynecologic oncology and breast cancer : a validation study

Abstract

Medical advancements and therapeutic innovations are progressing rapidly, necessitating corresponding adaptations in the delivery of patient-centered care. This study explores the needs of women diagnosed with gynecologic and breast cancers, using the frameworks of the National Academy of Medicine and the Picker Institute as reflective lenses. We conducted a qualitative, single-center study employing grounded theory methodology. Semi-structured interviews were carried out with 20 patients undergoing treatment for gynecologic malignancies and breast cancer at a university medical center. Interviews covered multiple phases of illness, including treatment initiation, adaptation, abstention, and future-oriented decisions. Data were analyzed inductively using constant comparative methods. Findings largely affirmed the relevance of the eight established domains of patient-centered care - personal values, clear information and education, emotional support, involvement of family and friends, physical comfort, coordinated care, continuity, and access to treatment. Three additional insights emerged: needs vary according to illness phase and tend to taper over time; they are grounded in ethical dimensions, including social identity, epistemic agency, and moral distress; and they are interdependent, requiring holistic rather than isolated responses. These results highlight that effective patient-centered care must account not only for the content of care but also for its timing, context and ethical significance, warranting integration into standard oncological practice.