Factors affecting provision of care services for patients with cancer living in the rural area: an integrative review

Abstract

This paper explored individual-and system-level factors affecting the provision of care services for rural patients. An integrated literature review across four databases identified 22 studies from six countries. A focus on health and wellbeing and the influence of rurality was explored. Findings indicate physical and functional health in rural cancer patients is lower in comparison with urban areas. Influencing factors were socio-economic status, age, income, health literacy, control and self-efficacy. Enhancing the strengths and education of caregivers and their inclusion in service decision-making are paramount for rural cancer patients and for the wellbeing of the caregivers. Disparities in rural areas need to be explored with longitudinal research to understand the clinical, social and cultural characteristics in relation to remoteness. The use of innovative technologies has been recommended as an option to enhance the health access and enable quality care provision across rural areas. Knowledge translation• The facilitation of access to innovative health care to balance the disparities of rural people (telehealth, online support groups, follow-up phone calls, enticement for specialist care in rural areas).• A holistic approach with education and support provided to the family is particularly important for rural patients as the family is a key source of social, emotional and informational support over the journey.Although there has been increasing research regarding the needs of cancer patients (health care, community, social care needs), there has been little focus on the care needs of patients in rural areas 2 . The number of rural patients is under-examined in the Keywords Rural cancer patients, cancer caregiver, health resources, literature review.

Cancer‐related help‐seeking in cancer survivors living in regional and remote Australia

“… Abbreviations: Edu., Education level 1‐4 ; OR, Odds Ratio; SES, socio‐economic status percentile; Rel.,Relationship Status (0 = no partner, 1 = partner). …”

“…People living in regional and remote areas in Australia experience poorer cancer outcomes than those in metropolitan areas 1,2 . Those living outside major cities show lower 5‐year survival rates for many cancers 1 and are more likely to report poor physical and mental health, lower quality of life and unmet supportive care needs 2,3 than those living in metropolitan areas. Several studies show that, compared to those living in major cities, people living in regional and remote areas tend to be 5%–10% less likely to participate in cancer screening 4–6 and approximately 20% less likely to utilise primary medical care services 7 .…”

“…The reasons for geographical disparities in cancer outcomes are not well‐understood, but are likely to include socio‐demographic factors and challenges in accessing timely and appropriate health services and support in regional and remote areas 3 . In addition, it has been suggested that those living in regional and remote areas tend to exhibit attitudes that reduce the likelihood that they will seek support and medical attention when required 2,10–14 .…”

Disparity in cancer survivorship care: A cross-sectional study of telehealth use among cancer nurses in Australia

“…Significant barriers limit delivery of care to the growing number of cancer survivors in Australia who live outside metropolitan areas and who need and desire survivorship care. Key barriers include geographical distances to metropolitan-based specialist cancer centres, health workforce shortages, and lack of diagnostic and treatment services in rural and remote locations ( Australian Institute of Health and Welfare, 2017 ;Australian Medical Association, 2017 ;Gunn et al, 2020 ;Salehi et al, 2019 ). Given that telehealth technologies have the potential to address many of these barriers ( Chan, Button, Thomas, Gates, & Yates, 2018 ), this study was designed with the aim of understanding cancer nurses' preparedness and use of telehealth as a key tool to help bridge this gap.…”

The experience and challenges of rural persons with cancer and their families

“…Disparities exist access to health care for people living in rural and remote areas, particularly screening for cancer and chronic disease, mental health support, palliative, paediatric care and specialist health services [services which focus on one aspect of health care provision] (Ding, Saunders, Cook, & Johnson, 2019;Gunn et al, 2019;Salehi, Frommolt, & Coyne, 2019). Barriers to the availability of services are often in relation to the ability of the health service to provide practitioners to work in rural and remote areas (Brown et al, 2017;Orda, Orda, Sen Gupta, & Knight, 2017).…”