Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
J Rural Health. 2024 Sep;40(4):634-644. doi: 10.1111/jrh.12842. Epub 2024 May 16.
While limited resources can make high-quality, comprehensive, coordinated cancer care provision challenging in rural settings, rural cancer patients often rely on local hospitals for care. To develop resources and strategies to support high-quality local cancer care, it is critical to understand the current experiences of rural cancer care physicians, including perceived strengths and challenges of providing cancer care in rural areas. METHODS: Semi-structured interviews were conducted with 13 cancer providers associated with all 12 non-metropolitan/rural Iowa hospitals that diagnose or treat >100 cancer patients annually. Iterative thematic analysis was conducted to develop domains.
Participants identified geographic proximity and sense of community as strengths of local care. They described decision-making processes and challenges related to referring patients to larger centers for complex procedures, including a lack of dedicated navigators to facilitate and track transfers between institutions and occasional lack of respect from academic physicians. Participants reported a desire for strengthening collaborations with larger urban/academic cancer centers, including access to educational opportunities, shared resources and strategies to collect and monitor data on quality, and clinical trials.
Rural cancer care providers are dedicated to providing high-quality care close to home for their patients and would welcome opportunities to increase collaboration with larger centers to improve coordination and comprehensiveness of care, collect and monitor data on quality of care, and access continuing education opportunities. Further research is needed to develop implementation approaches that will extend resources, services, and expertise to rural providers to facilitate high-quality cancer care for all cancer patients.
尽管有限的资源可能使农村地区难以提供高质量、全面、协调的癌症护理，但农村癌症患者通常依赖当地医院进行治疗。为了开发资源和策略来支持高质量的当地癌症护理，了解农村癌症护理医生的当前经验至关重要，包括在农村地区提供癌症护理的感知优势和挑战。方法：对与每年诊断或治疗>100 名癌症患者的所有 12 家非大都市/农村爱荷华州医院相关的 13 名癌症提供者进行了半结构化访谈。采用迭代主题分析来开发领域。
参与者认为地理位置接近和社区意识是当地护理的优势。他们描述了与将患者转介到大中心进行复杂手术相关的决策过程和挑战，包括缺乏专门的导航员来促进和跟踪机构之间的转移，以及偶尔缺乏学术医生的尊重。参与者表示希望加强与更大的城市/学术癌症中心的合作，包括获得教育机会、共享资源和策略来收集和监测质量数据，以及临床试验。
农村癌症护理提供者致力于为患者提供高质量的家庭护理，并欢迎有机会增加与更大中心的合作，以改善护理的协调性和全面性，收集和监测护理质量数据，并获得继续教育机会。需要进一步研究制定实施方法，将资源、服务和专业知识扩展到农村提供者，以促进所有癌症患者的高质量癌症护理。
