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提高癌症幸存者治疗后的生活质量:澳大利亚农村癌症幸存者及其护理人员的观点。

Improving Survivors' Quality of Life Post-Treatment: The Perspectives of Rural Australian Cancer Survivors and Their Carers.

作者信息

Gunn Kate M, Olver Ian, Skrabal Ross Xiomara, Harrison Nathan, Livingston Patricia M, Wilson Carlene

机构信息

Cancer Research Institute, University of South Australia, Adelaide 5001, Australia.

Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide 5001, Australia.

出版信息

Cancers (Basel). 2021 Mar 30;13(7):1600. doi: 10.3390/cancers13071600.

Abstract

The transition from urban centres back to rural and remote communities can be challenging for rural cancer survivors after treatment. This study aimed to (a) provide deeper understanding of the experiences of rural survivors who have completed active cancer treatment and returned to their rural communities, and (b) determine strategies to re-orient existing services or develop new interventions to more appropriately meet rural survivors' service preferences and needs. Semi-structured interviews were conducted with 22 adults (64% female) who lived outside of a metropolitan area and had completed active cancer treatment (n = 13), were the carer for a rural/remote cancer survivor (n = 6), or were both a survivor and carer (n = 3). Thematic analysis was conducted to identify dominant themes in the qualitative data. A range of physical, psychological and practical challenges that impact quality of life among rural survivors post-treatment were found. These challenges appeared to be compounded by a lack of trust in local rural healthcare services and a lack of clear post-treatment pathways to quality of life-enhancing support services. Acceptable strategies to overcome barriers included nurse-led, telephone-based, or face-to-face interventions, initiated and continued by the same service provider, and that included support to manage emotional challenges associated with post-treatment survivorship. The findings will inform the design of interventions to better meet rural cancer survivors' post-treatment support needs.

摘要

对于接受治疗后的农村癌症幸存者而言,从城市中心转回农村及偏远社区可能颇具挑战。本研究旨在:(a)更深入地了解已完成积极癌症治疗并返回农村社区的幸存者的经历;(b)确定重新调整现有服务或开发新干预措施的策略,以更恰当地满足农村幸存者的服务偏好和需求。对22名成年人(64%为女性)进行了半结构化访谈,这些人居住在大都市区以外,已完成积极癌症治疗(n = 13),是农村/偏远地区癌症幸存者的照料者(n = 6),或是幸存者兼照料者(n = 3)。进行了主题分析以确定定性数据中的主要主题。研究发现了一系列影响农村幸存者治疗后生活质量的身体、心理和实际挑战。这些挑战似乎因对当地农村医疗服务缺乏信任以及缺乏明确的治疗后通往提高生活质量支持服务的途径而加剧。克服障碍的可接受策略包括由同一服务提供者发起并持续的护士主导、基于电话或面对面的干预措施,其中包括支持应对与治疗后生存相关的情感挑战。研究结果将为设计干预措施提供参考,以更好地满足农村癌症幸存者的治疗后支持需求。

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