Path analysis of survivorship care needs, symptom experience, and quality of life among multiethnic cancer survivors



Cancer survivors continue to experience issues that persist across the survivorship trajectory. This study aims to explore the relationship among survivorship care need, symptom experience, and quality of life (QoL) of multiethnic cancer survivors by using path analytic methods.


Participants were recruited from an academic medical center in Singapore that provides inpatient and outpatient oncology and hematology service. The Cancer Survivor Unmet Needs measure, physical effects subscale of the Cancer Survivors’ Survey of Needs tool, and a Global QoL 10-point Likert scale were used to identify survivorship care needs, symptom experience, and QoL. Descriptive statistics were used to compute sociodemographic information, total survivorship needs, symptom experienced, and quality of life scores. The symptom experience model was used as the hypothetical model. The Analysis of Moment Structure was used to conduct the path analysis to evaluate the relationship between survivorship care needs, symptom experience, and quality of life.


Older cancer survivors were more likely to have spent a longer duration having cancer. Males were unlikely to suffer from solid tumor malignancies. Survivors with solid tumor malignancies were less likely to require supportive care. Survivors who require more supportive care were more likely to have a greater symptom burden. Cancer survivors with more symptoms have poorer QoL. The findings from this study partially supported the symptom experience model.


Our findings reveal that cancer survivors continue to experience symptoms across the survivorship trajectory. The results provide information for nurses during the planning and execution of survivorship care.

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The authors would like to thank all survivors for participating in this study. The authors would also like to thank Professor Alex Molasiotis of Hong Kong Polytechnic University and Professor Raymond Chan of Queensland University of Technology for their inclusion into the STEP study.

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Corresponding author

Correspondence to Ying Lau.

Ethics declarations

Ethical approval was obtained from the Singapore National Healthcare Group-Domain Specific Review Board (2016-01023). All participants received study information and provided verbal and written consent.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Ang, W.H.D., Lau, Y., Ngo, L.P.E. et al. Path analysis of survivorship care needs, symptom experience, and quality of life among multiethnic cancer survivors. Support Care Cancer 29, 1433–1441 (2021).

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  • Cancer survivorship
  • Survivorship care needs
  • Symptom experience
  • Quality of life
  • Path analysis
  • Oncology nursing