Psychosocial well-being and supportive care needs of cancer patients living in urban and rural/regional areas: a systematic review

Abstract

PurposeTo describe what is known about levels of morbidity and the experience and needs of people with cancer, and their carers, living in rural areas. MethodsA search of online databases for English language papers describing or assessing the prevalence of psychosocial morbidity or needs in a population of rural or regional cancer patients. Excluded: intervention studies, discussion of service delivery, effectiveness of support groups or support via videoconferencing, concentrated on medical outcomes or survival rates, reported differences in the uptake of cancer screening, or concentrated on health attitudes or treatment decision making. ResultsThere were 37 studies included in the review, including 25 quantitative studies (all surveys), 11 of which included a control group of urban patients, and 12 qualitative studies. Until recently, most studies had methodological short-comings. Only two prospective studies were identified, most studies focused on breast cancer and few addressed psychological morbidity. The majority of controlled studies reported worse 3 outcomes for rural patients, who appear to have higher needs in the domains of physical/daily living. This may reflect more limited access to resources, a more selfsufficient lifestyle and personal characteristics, for example, being more stoical and less likely to ask for help. The need to travel for treatment caused many practical, emotional and financial problems for patients and burdened them with additional worry concerning family and work commitments. Some patients reported benefits in sharing experiences with others also forced to stay away from home, but most agreed that staying at home was preferable. ConclusionThis review highlights that whilst we are beginning to get some insight into the needs of people with cancer in rural areas, much is still unknown. Population-based, prospective studies including people with heterogenous cancers from rural and urban settings are needed.

The experience of rural families in the face of cancer

“…The need to travel for treatment caused many practical, emotional, and financial problems for patients, overburdening them with additional concern about family and professional commitments. While sharing experiences with others who are also away from home has been considered beneficial by some people, most agreed that staying at home was preferable (26) . These results are similar to those obtained in this investigation.…”

Impact of Treatments on the Family of Breast, Prostate, Colon and Lung Cancer Patients

“…The need to travel for treatment cause many practical, emotional and financial problems for patients and burden them with additional worry concerning family and work commitments (Butow P. et al 2012). Recent publications highlighted as well travel-related burden for cancer patients (Zucca A. et al, 2011) and financial and social impacts for support persons of cancer survivors (Carey M. et al 2012) as impact of age and distance on the willingness of cancer patients to travel more or further away for a slightly more efficient therapy (Groux P. et al 2014a) and the impact of gender, age and travel time impact on the need for social support of patients to have access to cancer treatment (Groux P. et al 2014b).…”

Are Cancer Patients Willing to Travel More or Further Away for a Slightly More Efficient Therapy?

“…Nevertheless evidence that centralisation of cancer services lead to cost-effective care is incomplete (Ke et al, 2012). The need to travel for treatment cause many practical, emotional and financial problems for patients and burden them with additional worry concerning family and work commitments (Butow et al, 2012). Recent publications highlighted as well the travel-related burden for cancer patients (Zucca et al, 2011) as the financial and social impact for support persons of cancer survivors (Carey et al, 2012).…”