School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia.
BMJ Open. 2019 Jul 11;9(7):e028315. doi: 10.1136/bmjopen-2018-028315.
To explore the experiences of cancer caregivers who live in rural Australia and travel to a metropolitan cancer health service to access cancer treatment.
A qualitative study using semistructured, audio-recorded interviews conducted between December 2017 and July 2018 with caregivers and social workers. Thematic analysis using interpretative descriptive techniques performed on textual interview data within a critical realist paradigm to develop understanding of rural caregivers' lived experiences.
Participants were from rural areas attending a metropolitan cancer centre in Australia and social workers.
21 caregivers (16 female) of people with cancer living in rural Australia within a minimum distance of 100 km from the metropolitan cancer centre where they access treatment, and five social workers employed at a metropolitan cancer service with experience of working with rural patients and caregivers.
Thematic analysis developed two overarching themes: theme 1: describes the unique circumstance in which caregiving for a person with cancer takes place in the rural setting at considerable distance from the cancer service where the person receives treatment. This is explored in three categories: 'Rural community and culture', 'Life adjustments' and 'Available supports'. Theme 2: captures the multiplicity of tasks and challenges involved in organising and coordinating the journey to access cancer treatment in a metropolitan hospital, which is presented in the following categories: 'Travel', 'Accommodation' and 'Health system navigation'.
Caregivers who live in rural areas face significant challenges when confronting geographic isolation between their rural home environment and the metropolitan setting, where the patient accessed cancer treatment. There is a need for healthcare services to identify this group to develop feasible and sustainable ways to provide interventions that have the best chance of assisting rural caregivers in supporting the patient while maintaining their own health and well-being.
探索居住在澳大利亚农村、前往大都市癌症保健服务机构接受癌症治疗的癌症照顾者的体验。
这是一项定性研究，使用半结构式、录音采访的方法，于 2017 年 12 月至 2018 年 7 月期间对照顾者和社会工作者进行采访。在批判现实主义范式内，使用解释性描述技术对文本采访数据进行主题分析，以发展对农村照顾者生活体验的理解。
参与者来自澳大利亚农村地区，在距离大都市癌症中心最近 100 公里的范围内，他们在那里接受治疗，以及在大都市癌症服务机构工作的五名有农村患者和照顾者工作经验的社会工作者。
21 名居住在澳大利亚农村地区的癌症患者照顾者（16 名女性），他们距离接受治疗的大都市癌症中心最近距离为 100 公里，以及五名在大都市癌症服务机构工作的社会工作者，他们有与农村患者和照顾者合作的经验。
主题分析产生了两个总体主题：主题 1：描述了在远离接受治疗的癌症服务机构的农村环境中照顾癌症患者的独特情况。这在三个类别中进行了探讨：“农村社区和文化”、“生活调整”和“可用支持”。主题 2：捕捉到了在大都市医院接受癌症治疗时，组织和协调旅行所涉及的多项任务和挑战，这些挑战在以下类别中呈现：“旅行”、“住宿”和“医疗系统导航”。
居住在农村地区的照顾者在面对其农村家庭环境与大都市治疗环境之间的地理隔离时，面临着重大挑战。医疗保健服务机构需要确定这一群体，制定可行和可持续的干预措施，以帮助农村照顾者在支持患者的同时保持自己的健康和福祉。
