McNulty Julie A, Nail Lillian
Arizona State University, College of Nursing and Health Innovation, Phoenix, Arizona.
Oregon Health and Science University, School of Nursing, Portland, Oregon.
J Rural Health. 2015 Summer;31(3):282-91. doi: 10.1111/jrh.12106. Epub 2015 Jan 19.
Rural-dwelling cancer survivors (CSs) are at risk for decrements in health and well-being due to decreased access to health care and support resources. This study compares the impact of cancer in rural- and urban-dwelling adult CSs living in 2 regions of the Pacific Northwest.
A convenience sample of posttreatment adult CSs (N = 132) completed the Impact of Cancer version 2 (IOCv2) and the Memorial Symptom Assessment Scale-short form. High and low scorers on the IOCv2 participated in an in-depth interview (n = 19).
The sample was predominantly middle-aged (mean age 58) and female (84%). Mean time since treatment completion was 6.7 years. Cancer diagnoses represented included breast (56%), gynecologic (9%), lymphoma (8%), head and neck (6%), and colorectal (5%). Comparisons across geographic regions show statistically significant differences in body concerns, worry, negative impact, and employment concerns. Rural-urban differences from interview data include access to health care, care coordination, connecting/community, thinking about death and dying, public/private journey, and advocacy.
The insights into the differences and similarities between rural and urban CSs challenge the prevalent assumptions about rural-dwelling CSs and their risk for negative outcomes. A common theme across the study findings was community. Access to health care may not be the driver of the survivorship experience. Findings can influence health care providers and survivorship program development, building on the strengths of both rural and urban living and the engagement of the survivorship community.
由于获得医疗保健和支持资源的机会减少，农村地区的癌症幸存者面临健康和幸福感下降的风险。本研究比较了生活在太平洋西北部两个地区的农村和城市成年癌症幸存者中癌症的影响。
一个由接受治疗后的成年癌症幸存者组成的便利样本（N = 132）完成了癌症影响量表第2版（IOCv2）和纪念症状评估量表简表。IOCv2得分高和低的参与者参加了深入访谈（n = 19）。
样本主要为中年（平均年龄58岁）女性（84%）。自治疗结束后的平均时间为6.7年。癌症诊断类型包括乳腺癌（56%）、妇科癌症（9%）、淋巴瘤（8%）、头颈癌（6%）和结直肠癌（5%）。跨地理区域的比较显示，在身体担忧、焦虑、负面影响和就业担忧方面存在统计学上的显著差异。访谈数据中的城乡差异包括获得医疗保健、护理协调、联系/社区、思考死亡和临终、公共/私人历程以及宣传。
对农村和城市癌症幸存者之间异同的洞察挑战了关于农村癌症幸存者及其负面结果风险的普遍假设。研究结果的一个共同主题是社区。获得医疗保健可能不是生存体验的驱动因素。研究结果可以影响医疗保健提供者和生存计划的制定，基于农村和城市生活的优势以及生存社区的参与。
