{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T21:18:31Z","timestamp":1782940711194,"version":"3.54.5"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Patients with cirrhosis have significant physical, psychological, and practical needs. We documented patients\u2019 perceived need for support with these issues and the differences with increasing liver disease severity, etiology, and age. Using the supportive needs assessment tool for cirrhosis (SNAC), we examined the rate of moderate-to-high unmet needs (Poisson regression; incidence rate ratio [IRR]) and the correlation between needs and sociodemographic\/clinical characteristics (multivariable linear regression) in 458 Australians adults with cirrhosis. Primary liver disease etiology was alcohol in 37.6% of patients, chronic viral hepatitis C in 25.5%, and nonalcoholic fatty liver disease (NAFLD)\/nonalcoholic steatohepatitis (NASH) in 23.8%. A total of 64.6% of patients had Child-Pugh class A cirrhosis. Most patients (81.2%) had at least one moderate-to-high unmet need item; more than 25% reported a moderate-to-high need for help with \u201clack of energy,\u201d \u201csleep poorly,\u201d \u201cfeel unwell,\u201d \u201cworry about \u2026 illness getting worse (liver cancer),\u201d \u201chave anxiety\/stress,\u201d and \u201cdifficulty with daily tasks.\u201d Adjusting for key sociodemographic\/clinical factors, patients with Child-Pugh C had a greater rate of \u201cpractical and physical needs\u201d (vs. Child-Pugh A; IRR = 2.94, 95% confidence interval [CI] 2.57-3.37), patients with NAFLD\/NASH had a greater rate of needs with \u201clifestyle changes\u201d (vs. alcohol; IRR = 1.81, 95% CI 1.18-2.77) and \u201cpractical and physical needs\u201d (IRR = 1.43, 95% CI 1.23-1.65), and patients aged \u226565 years had fewer needs overall (vs. 18-64 years; IRR = 0.70, 95% CI 0.64-0.76). Higher overall SNAC scores were associated with Child-Pugh B and C (both <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001), NAFLD\/NASH (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.028), patients with \u201cno partner, do not live alone\u201d (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.004), unemployment (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.039), ascites (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.022), and dyslipidemia (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.024) compared with their counterparts. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Very high levels of needs were reported by patients with cirrhosis. This information is important to tailor patient-centered care and facilitate timely interventions or referral to support services.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep4.1681","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T18:15:04Z","timestamp":1612808104000},"page":"891-905","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":21,"title":["The Patient\u2019s Perspective in Cirrhosis: Unmet Supportive Care Needs Differ by Disease Severity, Etiology, and Age"],"prefix":"10.1097","volume":"5","author":[{"given":"Patricia C.","family":"Valery","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M.","family":"Bernardes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Mckillen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samath","family":"Amarasena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Stuart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunter","family":"Hartel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Skoien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Horsfall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leshni","family":"Pillay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth E.","family":"Powell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Hepatology Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep4.1681","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep4.1681","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1681","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T22:21:51Z","timestamp":1729030911000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1002\/hep4.1681","relation":{},"ISSN":["2471-254X"],"issn-type":[{"value":"2471-254X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}