University of Virginia School of Nursing, Charlottesville, VA, USA.
University of Virginia Cancer Center, Charlottesville, VA, USA.
J Cancer Surviv. 2020 Oct;14(5):643-652. doi: 10.1007/s11764-020-00874-y. Epub 2020 May 11.
Rural cancer survivors have worse quality of life than their urban counterparts. Telemedicine is a potential solution to connecting rural residents with specialized cancer providers during the survivorship period, but limitations in broadband may stifle the impact. Using data from a feasibility study evaluating a telemedicine intervention aimed at connecting rural Virginia cancer survivors with their care team located at a cancer center associated with an academic medical center, we sought to evaluate the ability of rural survivors to access the intervention and suggest strategies for improving access to rural cancer survivorship care.
We used a descriptive design with geospatial and quantitative methods to understand broadband access, driving time to a satellite telemedicine site, and ability to utilize a borrowed cellular-enabled tablet to participate in the intervention for cancer survivors living in Central Virginia.
Our study participants resided in census tracts where an average of 58% of households have adequate broadband access necessary to support a telemedicine videoconferencing intervention. Average driving time to the nearest telemedicine site was 29.6 min. Those who utilized the borrowed tablet experienced considerable difficulty with utilizing the technology.
Rural cancer populations do not have equal access to a cancer survivorship telemedicine intervention.
Telemedicine interventions aimed at connecting cancer survivors with their academic medical center-based cancer providers may be ineffective if survivors do not have access to either fixed broadband or a satellite clinic. Future research needs to evaluate other sites from which rural survivors can connect, such as rural public libraries.
农村癌症幸存者的生活质量比城市癌症幸存者差。远程医疗是一种将农村居民与专门的癌症提供者在生存期间联系起来的潜在解决方案，但宽带的限制可能会抑制其影响。本研究使用了一项评估远程医疗干预措施的可行性研究的数据，该干预措施旨在将弗吉尼亚州农村癌症幸存者与其位于学术医疗中心相关癌症中心的护理团队联系起来，我们试图评估农村幸存者获得该干预措施的能力，并提出改善农村癌症生存者护理获取途径的策略。
我们使用描述性设计和地理空间及定量方法来了解宽带接入、前往卫星远程医疗站点的驾驶时间，以及居住在弗吉尼亚州中部的癌症幸存者使用借来的支持蜂窝网络的平板电脑参与干预的能力。
我们的研究参与者居住在普查区内，这些普查区中平均有 58%的家庭有足够的宽带接入，以支持远程医疗视频会议干预。前往最近的远程医疗站点的平均驾驶时间为 29.6 分钟。那些使用借来的平板电脑的人在使用技术方面遇到了相当大的困难。
农村癌症患者无法平等获得癌症生存者远程医疗干预措施。
如果癌症幸存者无法获得固定宽带或卫星诊所，旨在将癌症幸存者与其学术医疗中心癌症提供者联系起来的远程医疗干预措施可能无效。未来的研究需要评估农村幸存者可以连接的其他地点，例如农村公共图书馆。
