Head and Neck Cancer in a Rural U.S. Population: Quality of Life, Coping, Health Care Literacy, and Access to Services

Abstract

Purpose The aim of this study was to explore the beliefs, access, and motivations of individuals with head and neck cancer (HNC) living in a rural community in the United States, regarding their speech and swallowing deficits. Method A convenience sample of nine patient participants with HNC and nine caregiver participants completed in-depth, semistructured interviews regarding their experiences with HNC diagnosis and treatment. The researchers utilized a thematic networks approach to analyze the qualitative data obtained. Results Primary results of the study were a set of common themes emerging from 735 units for analysis, arranged into 34 basic themes, nine organizing themes, and four global themes. The resulting networks centered around quality of life impact, coping, health literacy, and access. Direct quotes from the participants are utilized to illustrate response categories. Conclusions Individuals with HNC and their caregivers living in rural communities in the United States appear to represent a unique subset of the HNC population. While they present similarly in most areas, they display unique tendencies in the areas of psychological coping, health literacy, and access. Provision of practical, pertinent information that can be accessed by patients and caregivers alike outside the hospital is suggested to better serve this community.

The health care experiences of people with head and neck cancer: A scoping review

“…Factors such as payment/costs of treatment and services, cultural identity, socioeconomic status, education level, marital status/family support, or distance from treatment center, can not only shape a person's experience of health care but also impact their HNC outcomes 68–70 . For example, people in rural areas experience more difficulties in accessing specialist care (e.g., speech pathology) than their metropolitan counterparts 69,71 . In addition to limitations in the reporting of personal characteristics, many studies did not report crucial oncological information such as staging, disease site specifics and disease histology which makes interpretation and understanding of health care experiences challenging.…”

“…[68][69][70] For example, people in rural areas experience more difficulties in accessing specialist care (e.g., speech pathology) than their metropolitan counterparts. 69,71 In addition to limitations in the reporting of personal characteristics, many studies did not report crucial oncological information such as staging, disease site specifics and disease histology which makes interpretation and understanding of health care experiences challenging. Future studies should include oncological data to enable readers to better understand the population studied.…”

Retention in rural speech and language therapy: The impact of rural tertiary education in Australia

“…Within the speech and language therapy profession, international researchers have found that people living outside of metropolitan regions face a number of barriers to service availability and accessibility (Lowe & Nobriga, 2021;O'Callaghan et al, 2005;Verdon et al, 2011;Wilson et al, 2002). Specifically in Ireland, longer waiting times have been significantly associated with decreased speech and language therapy service utilisation (Curran, et al, 2015).…”