The mediating role of unmet needs in the relationship between displacement and psychological adjustment: A study of cancer survivors from a Portuguese island region

The present study aims to explore whether the association between previous displacement to mainland Portugal to perform cancer therapy and current psychological adaptation is mediated by cancer survivors’ unmet needs in terms of their emotional experience, financial concerns, access and continuity of care, and relations with others. This cross-sectional study included a sample of 173 cancer survivors from the Azores archipelago (Portugal) recruited from a local oncological health unit. Participants completed a sociodemographic and clinical questionnaire and self-report measures assessing their unmet needs and psychological adaptation. Two parallel multiple mediation models were tested. Azorean cancer survivors live with unmet needs, especially emotional needs (M = 16.68, SD = 10.78). Displacement was indirectly associated with both anxious (indirect effect = 0.58, SE = 0.27, 95% Bias Corrected and accelerated Confidence Interval = [0.05, 1.15]) and depressive symptomatology (indirect effect = 0.36, SE = 0.17, 95% Bias Corrected and accelerated Confidence Interval = [0.03, 0.84]) through unmet emotional needs. Previous displacements seem to play an important role in the way cancer survivors adapt to survivorship by contributing to higher levels of unmet emotional needs. These findings can provide a scientific and clinical contribution to other isolated or island regions in the world where survivors face similar constraints. •This study aimed to explore whether the association between previous displacement to perform cancer therapy and current psychological adaptation is mediated by suvivors' unmet needs.•The previous displacement of Azorean survivors is connected with their psychological adjustment through higher levels of unmet emotional needs.•The early identification of survivors with emotional issues and find strategies to promote their help-seeking behaviors is of major importance.•These findings can provide a scientific and clinical contribution to other isolated regions where survivors face similar constraints.