Rural Resilience in Cancer Survivors: Conceptual Analysis of a Global Phenomenon

Abstract

Aim: The aims of this analysis are to (1) identify the concept of rural resiliency in cancer survivors in the nursing literature and (2) propose a conceptual framework that may help nurses leverage rural resilience to improve survivorship care.
 Background: Rural cancer survivors demonstrate rural resiliency by utilizing aspects of rural culture to improve their psychosocial distress. However, resiliency in rural cancer survivors is poorly understood.
 Design: We used Walker & Avants’ concept analysis approach to direct article selection, review, and analysis.
 Review methods: We identified a definition, antecedents, consequences, attributes, empirical referents, and related terms, and provide model, contrary, and borderline case examples.
 Results: We identified 29 articles that met inclusion criteria. We propose a conceptual model of rural resiliency that is grounded in three domains of rural culture: spirituality, cultural norms, and social capital. Attributes of rural culture within these domains impact a cancer survivor’s psychosocial health, leading to either negative or positive psychosocial outcomes.
 Conclusion: A better understanding of how rural resiliency impacts cancer survivors can help clinicians and researchers provide culturally-targeted post-treatment interventions. Our proposed conceptual framework may guide nurse researchers to develop measurement tools that evaluate rural resilience and its impact on health outcomes.
 Keywords: rural, cancer survivor, resilience, concept analysis, conceptual frameworkDOI: https://doi.org/10.14574/ojrnhc.v21i1.676

Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study

“…Current approaches toward improving access to care have been developed in the context of an urban health care delivery system [ 54 ]. For example, rather than viewing aspects of rural culture through a deficit lens (ie, stigma and self-reliance as barriers to access), we should strive to develop culturally appropriate interventions that leverage the considerable strengths of the rural setting (ie, resilience, strong community networks) to design effective interventions that connect rural survivors with care [ 55 ].…”

Barriers and facilitators to resilience for rural cancer survivors during COVID‐19

“…Participants in this study stated access to spiritual/faith-inclusive cancer care would strengthen their resilience, which in turn improves QoL (Bernacchi et al, 2021). Previous studies suggest cancer patients'…”

“…. In fact, rural survivors may prefer to seek care from informal family caregivers and community networks instead of healthcare providers (Bernacchi et al, 2021).…”

The Rural Profile

“…Self-reliance, as a construct, is related to hardiness, independence, resilience and individualism (Bacsu et al, 2017;Bernacchi et al, 2021;Collins et al 2009, Keller & Owens, Online Journal of Rural Nursing and Health Care, 22(2) https://doi.org/10.14574/ojrnhc.v22i2.716 70 2020; Kuntz et al, 2018;Wagnild & Torma, 2018). Numerous studies have explored the concept of self-reliance in rural communities and have identified it as one of the factors that contributes to the differences in health seeking behaviors between rural and urban populations (DeGuzman et al, 2022;Starcher et al, 2017), particularly mental health seeking behaviors (Fennell et al, 2018).…”

“…Consequences are the outcomes of the concept (Walker & Avant, 2019). If a person has a strong rural profile that person typically has substantial social capital (Brown & Schafft, 2019;Mayer & Buttler-Nelson, 2018;Phillips & McLeroy, 2004) as well as substantial mistrust or distrust of outsiders and newcomers (Bernacchi et al, 2021;Bonnie et al, 2020, Brown & Schaftt, 2019Lee et al, 2018). Both of these consequences are related to the traditional "deficit discourse" of rurality.…”