Pedro Leli W, Schmiege Sarah J
College of Nursing, University of Colorado in Denver.
Department of Biostatistics and Informatics, University of Colorado in Denver.
Oncol Nurs Forum. 2014 May;41(3):E211-9. doi: 10.1188/14.ONF.E211-E219.
PURPOSE/OBJECTIVES: To explore the impact of rurality on health-related quality-of-life (HRQOL) disparities in rural long-term cancer survivors.
Cross-sectional survey.
Rural-Urban Continuum Codes (RUCC) 7, 8, and 9.
91 adults at least five years post-treatment.
Mailed surveys measured HRQOL, self-esteem, and social support. Regression models were estimated to isolate (from self-esteem and social support) the effect of level of rurality on HRQOL.
HRQOL, self-esteem, social support, and rurality.
No differences in demographic characteristics existed among RUCCs. Survivors residing in RUCCs 7 or 8 tended to be similar in several dimensions of HRQOL. Survivors living in RUCC 7 reported significantly lower social function and greater financial difficulty and number of symptoms compared to survivors in RUCC 9 (the most remote). Self-esteem and social support strongly correlated with HRQOL.
The significant impact of rurality on HRQOL beyond self-esteem and social support suggests its role in explaining cancer survivorship disparities and directing practice. Until additional exploration can identify mechanisms behind rurality's impact, consideration of level of rurality as a potential factor in evaluating survivors' HRQOL outcomes is reasonable.
Survivor context (e.g., level of rurality) influences HRQOL outcomes. Context or culture-relevant risk minimization and HRQOL optimization nursing practices are indicated.
目的/目标：探讨乡村环境对农村癌症长期幸存者健康相关生活质量（HRQOL）差异的影响。
横断面调查。
城乡连续体代码（RUCC）7、8和9级地区。
91名治疗后至少五年的成年人。
通过邮寄调查问卷来测量健康相关生活质量、自尊和社会支持。采用回归模型（将自尊和社会支持因素分离）来评估乡村程度对健康相关生活质量的影响。
健康相关生活质量、自尊、社会支持和乡村程度。
不同城乡连续体代码地区的人口统计学特征没有差异。居住在城乡连续体代码7级或8级地区的幸存者在健康相关生活质量的几个维度上情况相似。与居住在城乡连续体代码9级（最偏远地区）的幸存者相比，居住在城乡连续体代码7级的幸存者报告的社会功能显著更低，经济困难更大，症状数量更多。自尊和社会支持与健康相关生活质量密切相关。
乡村环境对健康相关生活质量的显著影响独立于自尊和社会支持，这表明其在解释癌症幸存者差异和指导实践方面的作用。在进一步探究能够确定乡村环境影响背后的机制之前，将乡村程度作为评估幸存者健康相关生活质量结果的一个潜在因素是合理的。
幸存者的背景（如乡村程度）会影响健康相关生活质量结果。需要采取与背景或文化相关的风险最小化和健康相关生活质量优化护理措施。
