Psychosocial Well-Being and Care Among Advanced Cancer Patients: A Multi-Country Southeast Asia Study

Psychosocial care is an integral part of palliative oncology care, yet little is known about psychosocial well-being and care in Southeast Asia. This study examined psychosocial well-being and its associated factors among advanced cancer patients across the region, and explored psychosocial support services they received.

This cross-sectional, multi-country study recruited 1198 adults diagnosed with stage IV solid cancer who were receiving oncology care in Indonesia, Myanmar, the Philippines, Singapore, Thailand and Vietnam.

Using the Functional Assessment of Cancer Therapy-General, the mean emotional and social well-being scores were 17.22 (SD = 5.30) and 20.59 (SD = 4.48) respectively, with larger cross-country variation in emotional than social well-being. Greater symptom burden and financial difficulties were associated with poorer emotional well-being $\beta$  = -0.34 (95% CI: -0.39, -0.29), -0.36 (-0.53, -0.20) and social well-being -0.13 (-0.17, -0.08), -0.44 (-0.62 to -0.27), respectively. Being 45 years and younger -0.84 (-1.52, -0.16) and knowledge of one's advanced-disease -1.33 (-2.17, -0.49) were associated with poorer emotional well-being, while having less years of education 0.09 (0.02-0.16) and being assessed during an outpatient visit 0.89 (0.20, 1.58) were associated with poorer social well-being. Among those who completed depression screeners, 21% met the threshold scores for depression. Despite this, only 3% of the overall sample received psychosocial support services, though 42% of those who did not indicated openness to a referral.

There is a vital unmet need for psychosocial oncology support services in Southeast Asia. Efforts to systematically screen for distress and develop psychosocial support services are warranted.