In research, there's a tendency to always study interventions in the people who are worst off. They usual have a lot to gain, and this makes an intervention look good. While there is certainly a good logic to helping those who need it most, I also think it's unfair to discriminate against the people who are doing "not terrible."
On a related note, there's a lot of work done on figuring out how to identify those who need the help most. One common idea is to look for those who score the lowest on a quality of life (QOL) measure. However, I just read an article, published in 2007, that suggests anxiety would be a better screening tool.
They concluded that anxiety predicted QOL and how many unmet needs breast cancer survivors would have. They also found that time from diagnosis did not predict QOL or unmet needs when anxiety was included, and they were looking at survivors 2-10 years post diagnosis. To find evidence that even a decade isn't enough time for people to get over their anxiety (assuming without professional help) shows how important this issue is, and how powerful it may be as a screening tool to identify who may need supportive care the most.
Hodgkinson 2007 Breast cancer survivors’ supportive care needs
2–10 years after diagnosis; Support Care Cancer (2007) 15: 515–523
DOI 10.1007/s00520-006-0170-2
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