TY - JOUR
T1 - Cancer Survivorship in Rural and Urban Adults
T2 - A Descriptive and Mixed Methods Study
AU - McNulty, Julie A.
AU - Nail, Lillian
N1 - Publisher Copyright:
© 2015 National Rural Health Association.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Purpose: Rural-dwelling cancer survivors (CSs) are at risk for decrements in health and well-being due to decreased access to health care and support resources. This study compares the impact of cancer in rural- and urban-dwelling adult CSs living in 2 regions of the Pacific Northwest. Methods: A convenience sample of posttreatment adult CSs (N = 132) completed the Impact of Cancer version 2 (IOCv2) and the Memorial Symptom Assessment Scale-short form. High and low scorers on the IOCv2 participated in an in-depth interview (n = 19). Findings: The sample was predominantly middle-aged (mean age 58) and female (84%). Mean time since treatment completion was 6.7 years. Cancer diagnoses represented included breast (56%), gynecologic (9%), lymphoma (8%), head and neck (6%), and colorectal (5%). Comparisons across geographic regions show statistically significant differences in body concerns, worry, negative impact, and employment concerns. Rural-urban differences from interview data include access to health care, care coordination, connecting/community, thinking about death and dying, public/private journey, and advocacy. Conclusion: The insights into the differences and similarities between rural and urban CSs challenge the prevalent assumptions about rural-dwelling CSs and their risk for negative outcomes. A common theme across the study findings was community. Access to health care may not be the driver of the survivorship experience. Findings can influence health care providers and survivorship program development, building on the strengths of both rural and urban living and the engagement of the survivorship community.
AB - Purpose: Rural-dwelling cancer survivors (CSs) are at risk for decrements in health and well-being due to decreased access to health care and support resources. This study compares the impact of cancer in rural- and urban-dwelling adult CSs living in 2 regions of the Pacific Northwest. Methods: A convenience sample of posttreatment adult CSs (N = 132) completed the Impact of Cancer version 2 (IOCv2) and the Memorial Symptom Assessment Scale-short form. High and low scorers on the IOCv2 participated in an in-depth interview (n = 19). Findings: The sample was predominantly middle-aged (mean age 58) and female (84%). Mean time since treatment completion was 6.7 years. Cancer diagnoses represented included breast (56%), gynecologic (9%), lymphoma (8%), head and neck (6%), and colorectal (5%). Comparisons across geographic regions show statistically significant differences in body concerns, worry, negative impact, and employment concerns. Rural-urban differences from interview data include access to health care, care coordination, connecting/community, thinking about death and dying, public/private journey, and advocacy. Conclusion: The insights into the differences and similarities between rural and urban CSs challenge the prevalent assumptions about rural-dwelling CSs and their risk for negative outcomes. A common theme across the study findings was community. Access to health care may not be the driver of the survivorship experience. Findings can influence health care providers and survivorship program development, building on the strengths of both rural and urban living and the engagement of the survivorship community.
KW - Cancer survivorship
KW - Impact of cancer
KW - Late effects
KW - Rural health
KW - Rural-urban cancer survivorship
UR - http://www.scopus.com/inward/record.url?scp=84934434224&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84934434224&partnerID=8YFLogxK
U2 - 10.1111/jrh.12106
DO - 10.1111/jrh.12106
M3 - Article
AN - SCOPUS:84934434224
VL - 31
SP - 282
EP - 291
JO - Journal of Rural Health
JF - Journal of Rural Health
SN - 0890-765X
IS - 3
ER -