Keimweiss Samuel, Gurolnick Anna, Grant Shakira, Burris Jessica, Studts Jamie, Lewis-Thames Marquita
Northwestern University, Chicago, IL, United States.
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Cancer Surviv. 2025 Feb;19(1):21-34. doi: 10.1007/s11764-023-01445-7. Epub 2023 Aug 26.
We assessed the experiences of rural lung cancer survivors and caregivers to understand and identify barriers to posttreatment survivorship care management.
From May 2021 to June 2022, we conducted semi-structured interviews with a purposively sampled cohort. Participants were either posttreatment lung cancer survivors (within 5 years of their last active treatment) or caregivers of a lung cancer survivor. Interviews probed participants regarding survivorship care knowledge, implementation, and navigation. Two analysts inductively coded verbatim transcripts and conducted a thematic analysis.
We interviewed N = 21 participants: lung cancer survivors (76%) and caregivers (24%). Participants self-identified as Non-Hispanic White (100%), were at least 65 years old (77%), identified as male (62%), and previously smoked ≥ 5 packs over the lifetime (71%). The perspectives of survivors and caregivers were similar; thus, we analyzed them together. Themes related to survivorship care included (1) frustrations and uncertainty regarding unexpected barriers, (2) strategies to improve the delivery of posttreatment information, (3) strategies to remain positive and respond to emotional concerns of survivorship care, and (4) the impact of engaging and patient-centered care teams.
Given the limited access to lung cancer care resources in rural communities, our findings reveal that following a survivorship care program or plan requires a high level of individual resilience and community/interpersonal networking.
This study's findings can be applied to improve practice-based care for rural posttreatment lung cancer survivors and provide an impetus for developing tools to assist patient navigation toward community-based supportive care and care management resources.
我们评估了农村肺癌幸存者及其护理人员的经历，以了解和确定治疗后生存护理管理的障碍。
2021年5月至2022年6月，我们对一个有目的抽样的队列进行了半结构化访谈。参与者为治疗后的肺癌幸存者（在其最后一次积极治疗的5年内）或肺癌幸存者的护理人员。访谈探讨了参与者关于生存护理知识、实施和导航的情况。两名分析人员对逐字记录进行归纳编码并进行了主题分析。
我们采访了N = 21名参与者：肺癌幸存者（76%）和护理人员（24%）。参与者自我认定为非西班牙裔白人（100%），年龄至少65岁（77%），男性（62%），且一生中吸烟≥5包（71%）。幸存者和护理人员的观点相似；因此，我们将他们一起分析。与生存护理相关的主题包括：（1）对意外障碍的挫败感和不确定性；（2）改善治疗后信息传递的策略；（3）保持积极态度并应对生存护理情感问题的策略；（4）参与性和以患者为中心的护理团队的影响。
鉴于农村社区肺癌护理资源有限，我们的研究结果表明，遵循生存护理计划需要高度的个人适应能力和社区/人际网络。
本研究结果可应用于改善农村治疗后肺癌幸存者基于实践的护理，并为开发工具提供动力，以帮助患者找到社区支持性护理和护理管理资源。
