When a person living with cancer turns to complementary therapies, what needs are they seeking to address? The search for greater well-being may be accompanied by a desire to better understand their treatment, communicate more effectively with healthcare professionals, or feel more actively involved in their care.
This question guided our study, “Complementary needs behind complementary therapies in cancer patients,” published in 2015 in Psycho-Oncology. Using the Needs Evaluation Questionnaire (NEQ), we examined the associations between the use of complementary therapies and specific unmet needs among cancer patients.
Our aim was to better understand the experiences of people using complementary therapies and identify aspects of cancer care that might require greater attention.
What Are Complementary Therapies?
In our study, the term complementary therapies referred to practices and products used alongside conventional cancer treatments. This was a broad and heterogeneous category, including mind–body approaches, herbal preparations, dietary supplements, nutritional interventions, and other practices.
The term “complementary” emphasizes their use alongside conventional medical care, distinguishing them from “alternative” approaches, which are used instead of conventional treatments.
This classification describes how these practices are used; it does not imply that all the approaches considered have the same effectiveness or safety profile.
The study focused on patients’ needs, not on evaluating the effectiveness of complementary therapies.
The Study: Understanding Patients’ Needs Through the NEQ
The research was conducted across six oncology facilities in Tuscany, Italy, involving patients with different cancer sites and at various stages of their disease and care pathways.
Of the 980 patients invited to participate, 803 agreed to take part. The analyses reported in the article included 783 patients with sufficiently complete NEQ data.
Participants were interviewed about their use of complementary therapies and completed the questionnaire, consisting of 23 YES/NO items addressing informational, care-related, relational, psycho-emotional, and practical needs.
At the time of data collection, 300 patients, representing 38.3% of the analyzed sample, were using one or more complementary therapies.
This percentage describes the study sample and should not be interpreted as a current estimate of the prevalence of complementary therapy use among cancer patients in Italy.
Which Needs Were Most Frequently Reported?
In the initial comparison between the two groups, three needs were significantly more frequent among patients using complementary therapies:
| Need identified through the NEQ | Complementary therapy users | Non-users |
|---|---|---|
| Greater involvement in treatment decisions | 40.0% | 31.7% |
| Better communication with clinicians | 44.4% | 37.2% |
| More information about financial and insurance matters related to the illness | 46.1% | 36.4% |
These findings highlight three concrete aspects of cancer care: participating in decisions, communicating with healthcare professionals, and navigating the practical consequences of illness.
However, the two groups also differed in their personal and clinical characteristics. We therefore conducted additional statistical analyses to account for potential confounding factors.
What Emerges When Differences Between Patients Are Taken Into Account?
In the multivariable analyses, which accounted for the sociodemographic and clinical characteristics considered in the study, significant associations remained for:
- The need for better communication with clinicians.
- The need for more information about financial and insurance matters.
Significant associations also emerged for three additional needs:
- Receiving more detailed explanations about treatments.
- Receiving clearer and more understandable information from doctors and nurses.
- Receiving greater attention from nursing staff.
By contrast, the association with the desire for greater involvement in treatment decisions was no longer statistically significant after adjustment.
This distinction is important: direct comparisons of percentages and analyses that account for differences between groups provide complementary information, but they do not always lead to the same findings.
Information, Communication, and Participation in Care
A substantial proportion of the needs associated with complementary therapy use concerned communication with healthcare professionals.
Requesting more detailed explanations about treatments or clearer information may reflect a desire to better understand what is happening and navigate treatment decisions.
Seeking better communication may indicate a need to ask questions, share concerns, or discuss aspects of one’s experience that may not receive sufficient attention during clinical consultations.
In discussing our findings, we proposed one possible interpretation: for some patients, the use of complementary therapies may be associated with a search for a more active role and a greater sense of control over their experience of illness.
These findings nevertheless highlight the importance of the quality of communication—not only the information provided, but also patients’ opportunities to understand and discuss it.
Among the associations identified, the need for financial and insurance-related information deserves particular attention.
Within the NEQ, this need concerns matters such as healthcare co-payments, disability benefits, and other practical issues related to illness. It is distinct from the need to receive direct financial assistance.
The study therefore identified a greater demand for information and practical guidance, without demonstrating that complementary therapy users necessarily experienced greater financial hardship.
What Do We Mean by “Complementary Needs”?
The title of the study introduces a deliberately meaningful expression: “complementary needs” behind complementary therapies.
Some needs may appear secondary to the primary objectives of cancer treatment, such as controlling the disease, prolonging survival, or relieving symptoms.
For patients, however, understanding a treatment, feeling heard, or receiving guidance about the practical consequences of illness may be highly important.
From this perspective, “complementary” does not mean unimportant. Rather, it refers to needs that may receive less attention despite contributing significantly to the overall experience of care.
The NEQ helps bring these needs to the attention of the healthcare team by giving patients a direct voice.
For clinical practice, the study’s main contribution lies in encouraging healthcare professionals to better understand what patients feel is missing from their conventional care and what may lead them to seek answers through complementary therapies.
Open, non-judgmental communication can help patients and healthcare professionals discuss not only the practices being used, but also the expectations, concerns, and needs associated with them.
The NEQ can support this dialogue by identifying areas in which patients would welcome greater attention.
Making these needs visible may help guide improvements in communication, information provision, and supportive care, thereby strengthening the relationship between patients and their oncology teams.
Reference
Bonacchi A, Toccafondi A, Mambrini A, Cantore M, Muraca MG, Focardi F, Lippi D, Miccinesi G. Complementary needs behind complementary therapies in cancer patients. Psycho-Oncology. 2015;24(9):1124–1130. doi: 10.1002/pon.3773.
For further information or inquiries: andreabonacchi@centrosynthesis.it
