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Supportive Care in Cancer

, Volume 21, Issue 9, pp 2547–2555 | Cite as

Psychosocial service use: a qualitative exploration from the perspective of rural Australian cancer patients

  • Kate GunnEmail author
  • Deborah Turnbull
  • J. Lindsay McWha
  • Matthew Davies
  • Ian Olver
Original Article
First Online:

Abstract

Purpose

This study aims to identify key issues associated with the provision of psychosocial care from the perspective of rural Australian cancer patients and determine culturally appropriate methods that may reduce barriers to service use.

Method

Seventeen purposively sampled adult South Australians who lived outside metropolitan Adelaide, had a diagnosis of cancer and various demographic and medical histories participated in semi-structured, face-to-face interviews. Participants also completed a demographic questionnaire. Qualitative data were analysed using thematic analysis.

Results

Five key themes were identified: (1) psychosocial support is highly valued by those who have accessed it, (2) having access to both lay and professional psychosocial support is vitally important, (3) accessing psychosocial services is made difficult by several barriers (lack of information about services, initial beliefs they are unnecessary, feeling overwhelmed and concerns about stigma and dual relationships), (4) medical staff located in metropolitan treatment centres are not sufficiently aware of the unique needs of rural patients and (5) patients require better access to psychosocial services post-treatment. Methods through which rural patients believe access to psychosocial services could be improved include: (1) providing more rural-specific information on psychosocial care, (2) improving communication between health care providers and referral to psychosocial services and (3) making psychosocial services a standard part of care.

Conclusions

Rural cancer patients want their unique needs to be recognised and to be treated differently to their urban counterparts. There is a need for more targeted and rurally relevant information for rural cancer patients, both to inform them of, and change their attitudes towards, psychosocial services. Other practical recommendations are also discussed.

Keywords

Cancer Oncology Rural Psychosocial Support Barrier (6) 
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Notes

Acknowledgments

The authors gratefully acknowledge the assistance provided by participants, the Spencer Gulf Rural Health School (Primary Health Care Research Evaluation and Development Bursary) (now UniSA) and Cancer Council SA.

Conflict of interest

No conflicts of interest to declare. The authors have full control of the data and if requested, are willing to make it available to Supportive Care in Cancer.

References

  1. 1.
    Fallowfield L (1995) Psychosocial interventions in cancer: should be part of every patient's management plan. Br Med J 311(7016):1316–1317CrossRefGoogle Scholar
  2. 2.
    National Breast Cancer Centre and National Cancer Control Initiative (2003) Clinical practice guidelines for the psychosocial care of adults with cancer. National Breast Cancer Centre, CamperdownGoogle Scholar
  3. 3.
    Butow PN et al (2012) Psychosocial well-being and supportive care needs of cancer patients living in urban and rural/regional areas: a systematic review. Support Care Cancer 20(1):1–22CrossRefGoogle Scholar
  4. 4.
    Baldwin AE, Usher K (2008) Going the distance–experiences of women with gynaecological cancer residing in rural remote north Queensland. Int J Nurs Pract 14(4):322–328CrossRefGoogle Scholar
  5. 5.
    Bettencourt BA et al (2008) Rural and urban breast cancer patients: health locus of control and psychological adjustment. Psycho-Oncology 17(9):932–939CrossRefGoogle Scholar
  6. 6.
    Burris JL, Andrykowski M (2010) Disparities in mental health between rural and nonrural cancer survivors: a preliminary study. Psychooncology 19(6):637–645CrossRefGoogle Scholar
  7. 7.
    Wilson SE, Andersen MR, Meischke H (2000) Meeting the needs of rural breast cancer survivors: what still needs to be done? J Women’s Health Gend-Based Med 9(6):667–677CrossRefGoogle Scholar
  8. 8.
    Girgis A et al (2000) Perceived needs of women diagnosed with breast cancer: rural versus urban location. Aust NZ J Public Health 24(2):166–173CrossRefGoogle Scholar
  9. 9.
    Lyons MA, Shelton MM (2004) Psychosocial impact of cancer in low-income rural/urban women: phase II. Online J Rural Nurs Health Care 4(2):6–23Google Scholar
  10. 10.
    Jong KE et al (2004) Remoteness of residence and survival from cancer in New South Wales. Med J Aust 180(12):618–622PubMedGoogle Scholar
  11. 11.
    Beesley V et al (2008) Unmet needs of gynaecological cancer survivors: implications for developing community support services. Psycho-Oncology 17(4):392–400CrossRefGoogle Scholar
  12. 12.
    Harrison JD et al (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17(8):1117–1128CrossRefGoogle Scholar
  13. 13.
    Bettencourt BA et al (2007) The breast cancer experience of rural women: a literature review. Psycho-Oncology 16(10):875–887CrossRefGoogle Scholar
  14. 14.
    Davis C et al (2003) Assessing the practical and psychosocial needs of rural women with early breast cancer in Australia. Soc Work Health Care 36(3):25–36CrossRefGoogle Scholar
  15. 15.
    McGrath P et al (1999) A study of postdiagnosis breast cancer concerns for women living in rural and remote Queensland. Part II: support issues. Aust J Rural Heal 7(1):43–52CrossRefGoogle Scholar
  16. 16.
    Rogers-Clark C (2002) Living with breast cancer: the influence of rurality on women's suffering and resilience. A postmodern feminist inquiry. Aust J Adv Nurs 20(2):34–39PubMedGoogle Scholar
  17. 17.
    Meneses K et al (2009) Preliminary evaluation of psychoeducational support interventions on quality of life in rural breast cancer survivors after primary treatment. Cancer Nurs 32(5):385–397CrossRefGoogle Scholar
  18. 18.
    Hutchison SD, Steginga SK, Dunn J (2006) The tiered model of psychosocial intervention in cancer: a community based approach. Psycho-Oncology 15(6):541–546CrossRefGoogle Scholar
  19. 19.
    Koopman C et al (2001) Distress, coping, and social support among rural women recently diagnosed with primary breast cancer. Breast J 7(1):25–33CrossRefGoogle Scholar
  20. 20.
    Kenny A et al (2007) Emotional toil: psychosocial care in rural settings for patients with cancer. J Adv Nurs 60(6):663–672CrossRefGoogle Scholar
  21. 21.
    Australian Institute of Health and Welfare, Cancer Australia & Australasian Association of Cancer Registries 2008. Cancer survival and prevalence in Australia: cancers diagnosed from 1982 to 2004. Cancer Series no. 42. Cat. no. CAN 38. Canberra: AIHWGoogle Scholar
  22. 22.
    Australian Institute of Health and Welfare (2004) Rural, regional and remote health: a guide to remoteness classifications, in Rural Health Series. Australian Institute Health and Welfare, CanberraGoogle Scholar
  23. 23.
    Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRefGoogle Scholar
  24. 24.
    Osborn RL, Demoncada AC, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 36(1):13–34CrossRefGoogle Scholar
  25. 25.
    Rehse B, Pukrop R (2003) Effects of psychosocial interventions on quality of life in adult cancer patients: meta analysis of 37 published controlled outcome studies. Patient Educ Couns 50(2):179–186CrossRefGoogle Scholar
  26. 26.
    Ross L et al (2002) Mind and cancer: does psychosocial intervention improve survival and psychological well-being? Eur J Cancer 38(11):1447–1457CrossRefGoogle Scholar
  27. 27.
    McGrath P (2001) Returning home after specialist treatment for hematological malignancies: an Australian study. Fam Commun Health 24(2):36–48CrossRefGoogle Scholar
  28. 28.
    Sullivan T, Weinert C, Cudney S (2003) Management of chronic illness: voices of rural women. J Adv Nurs 44(6):566–574CrossRefGoogle Scholar
  29. 29.
    Neumann M et al (2010) Barriers to using psycho-oncology services: a qualitative research into the perspectives of users, their relatives, non-users, physicians, and nurses. Support Care Cancer 18(9):1147–1156CrossRefGoogle Scholar
  30. 30.
    Hewitt M, Breen N, Devesa S (1999) Cancer prevalence and survivorship issues: analyses of the 1992 national health interview survey. J Nat Cancer Inst 91(17):1480–1486CrossRefGoogle Scholar
  31. 31.
    Carlson LE et al (2004) High levels of untreated distress and fatigue in cancer patients. Br J Cancer 90(12):2297–2304CrossRefGoogle Scholar
  32. 32.
    Jameson JP, Blank MB (2007) The role of clinical psychology in rural mental health services: defining problems and developing solutions. Clin Psychol Sci Pract 14(3):283–298CrossRefGoogle Scholar
  33. 33.
    Hewitt M, Rowland JH (2002) Mental health service use among adult cancer survivors: analyses of the National Health Interview Survey. J Clin Oncol 20(23):4581–4590CrossRefGoogle Scholar
  34. 34.
    Holland JC (2002) History of psycho-oncology: overcoming attitudinal and conceptual barriers. Psychosoma Med 64(2):206–221CrossRefGoogle Scholar
  35. 35.
    Elliott-Schmidt R, Strong J (1997) The concept of well-being in a rural setting: understanding health and illness. Aust J Rural Heal 5(2):59–63CrossRefGoogle Scholar
  36. 36.
    Corboy D, McLaren S, McDonald J (2011) Predictors of support service use by rural and regional men with cancer. Aust J Rural Heal 19(4):185–190CrossRefGoogle Scholar
  37. 37.
    Sareen J et al (2007) Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatr Serv 58(3):357–364CrossRefGoogle Scholar
  38. 38.
    Lee J (2007) Health workers' perceptions of psychosocial support services for cancer patients in rural Victoria. Cancer Forum 31(2):94–98Google Scholar
  39. 39.
    Lawler S et al (2011) Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women. Support Care Cancer 19(12):1975–1982CrossRefGoogle Scholar
  40. 40.
    Steginga SK et al (2006) Translating psychosocial care: guidelines into action. Cancer Forum 30(1):28–31Google Scholar
  41. 41.
    Hughes KL, Sargeant H, Hawkes AL (2011) Acceptability of the distress thermometer and problem list to community-based telephone cancer helpline operators, and to cancer patients and carers. BMC Cancer 11Google Scholar
  42. 42.
    Thewes B, Butow P, Stuart-Harris R (2009) Does routine psychological screening of newly diagnosed rural cancer patients lead to better patient outcomes? Results of a pilot study. Aust J Rural Heal 17(6):298–304CrossRefGoogle Scholar
  43. 43.
    Steginga SK et al (2008) Socio-demographic, psychosocial and attitudinal predictors of help seeking after cancer diagnosis. Psycho-Oncology 17(10):997–1005CrossRefGoogle Scholar
  44. 44.
    Helgeson VS et al (2000) Group support interventions for women with breast cancer: who benefits from what? Heal Psychol 19(2):107–114CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Kate Gunn
    • 1
    Email author
  • Deborah Turnbull
    • 1
  • J. Lindsay McWha
    • 1
  • Matthew Davies
    • 1
  • Ian Olver
    • 2
  1. 1.School of PsychologyThe University of AdelaideAdelaideAustralia
  2. 2.Cancer Council AustraliaSydneyAustralia

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