Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T06:10:50.176Z Has data issue: false hasContentIssue false
  • English
  • Français

On the road again: Patient perspectives on commuting for palliative care

Published online by Cambridge University Press:  23 March 2010

Barbara Pesut ,
Carole A. Robinson ,
Joan L. Bottorff ,
Gillian Fyles  and
Sandra Broughton
Barbara Pesut*
Affiliation:
School of Nursing, University of British Columbia Okanagan, Kelowna British Columbia, Canada
Carole A. Robinson
Affiliation:
School of Nursing, University of British Columbia Okanagan, Kelowna British Columbia, Canada
Joan L. Bottorff
Affiliation:
Centre for Healthy Living and Chronic Disease Prevention, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
Gillian Fyles
Affiliation:
Pain and Symptom Management/Palliative Care Program
Sandra Broughton
Affiliation:
British Columbia Cancer Agency – Centre for the Southern Interior, Kelowna, British Columbia, Canada
*
Address correspondence and reprint requests to: Barbara Pesut, School of Nursing, UBC Okanagan, 3333 University Way, Kelowna BC, V1V 1V7, Canada, P: 250.807.9955 F: 250.807.9865 E-mail: barb.pesut@ubc.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The aim of this research project was to gain an understanding of the experiences of rural cancer patients who commute to an urban cancer center for palliative care.

Method:

The study utilized a mixed method design. Fifteen individuals with a palliative designation participated in semi-structured interviews and filled out the Problems and Needs in Palliative Care Questionnaire.

Results:

Qualitative findings included three major themes: cultures of rural life and care, strategies for commuting, and the effects of commuting. Participants valued their rural lifestyles and gained significant support from their communities. Strategies included preparing for the trip with particular attention to pain management, making the most of time, and maintaining significant relationships. Establishing a routine helped to offset the anxiety of commuting. Commuting was costly but the quality of life and supportive relationships obtained through treatment were significant benefits. Questionnaire data suggested that participants were experiencing a number of problems but few indicated they desired more professional attention to those problems.

Significance of Results:

Rural lifestyles are often an important part of overall well-being and commuting for care is both costly and complex. Health care providers should assist individuals to weigh the relative contributions of staying in their rural locale versus commuting for care to their overall quality of life. Palliative-care individuals in this study indicated a number of ongoing problems but were not inclined to seek further assistance from health care providers in addressing those problems. Clinicians should actively inquire about problems and further research is needed to understand why patients are reluctant to seek help.

Keywords

Advanced cancerPalliative careRural health services
Type
Original Articles
Information
Palliative & Supportive Care , Volume 8 , Issue 2 , June 2010 , pp. 187 - 195
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Athas, W.F., Adams-Cameron, M., Hunt, W.C., et al. (2000). Travel distance to radiation therapy and receipt of radiotherapy following breast-conserving surgery. Journal of the National Cancer Institute, 92, 269–271.CrossRefGoogle ScholarPubMed
Baird, G., Flynn, R., Baxter, G., et al. (2008). Travel time and cancer care: An example of the inverse care law? Rural and remote health, 8, 1003.Google ScholarPubMed
Baldwin, L.M., Cai, Y., Larson, E.H., et al. (2008). Access to cancer services for rural colorectal cancer patients. The Journal of Rural Health : Official journal of the American Rural Health Association and the National Rural Health Care Association, 2,390–399.CrossRefGoogle Scholar
Burge, F., Lawson, B. & Johnston, G. (2005). Where a cancer patient dies: The effect of rural residency. Journal of Rural Health, 21, 233–238.CrossRefGoogle ScholarPubMed
Celaya, M.O., Rees, J.R., Gibson, J.J., et al. (2006). Travel distance and season of diagnosis affect treatment choices for women with early-stage breast cancer in a predominantly rural population (United States). Cancer Causes & Control: CCC, 17, 851–856.CrossRefGoogle Scholar
Cinnamon, J., Schuurman, N. & Crooks, V.A. (2008). A method to determine spatial access to specialized palliative care services using GIS. BMC Health Services Research, 8, 140.CrossRefGoogle ScholarPubMed
Craft, P.S., Burns, C.M., Smith, W.T., et al. (2005). Knowledge of treatment intent among patients with advanced cancer: A longitudinal study. European Journal of Cancer Care, 14, 417–425.CrossRefGoogle ScholarPubMed
Crosato, K.E. & Leipert, B. (2006). Rural women caregivers in Canada. Rural & Remote Health, 6, 520.Google ScholarPubMed
Davis, C., Girgis, A., Williams, P., et al. (1998). Needs assessment of rural and remote women travelling to the city for breast cancer treatment. Australian & New Zealand Journal of Public Health, 22, 525–527.CrossRefGoogle Scholar
Fitch, M.I., Gray, R.E., McGowan, T., et al. (2003). Travelling for radiation cancer treatment: patient perspectives. Psycho-oncology, 12, 664–674.CrossRefGoogle ScholarPubMed
Fitch, M.I., Gray, R.E., McGowan, T., et al. (2005). Travelling for radiation cancer treatment: Patient satisfaction. Canadian Oncology Nursing Journal Revue Canadienne de Nursing Oncologique, 15, 107–119.CrossRefGoogle ScholarPubMed
Glaser, B.G. & Strauss, A.L. (1967). The Discovery of Grounded theory: Strategies for Qualitative Research. Chicago: Aldine Publishing Company.Google Scholar
Gray, R.E., James, P., Manthorne, J., et al. (2004). A consultation with Canadian rural women with breast cancer. Health expectations: An International Journal of Public Participation in Health Care and Health Policy, 7, 40–50.CrossRefGoogle ScholarPubMed
Hall, S.E., Holman, C.D.J., Threlfall, T., et al. (2008). Lung cancer: An exploration of patient and general practitioner perspectives on the realities of care in rural Western Australia. Australian Journal of Rural Health, 16, 355–362.CrossRefGoogle ScholarPubMed
Hegney, D., Pearce, S., Rogers-Clark, C., et al. (2005). Close, but still too far. The experience of Australian people with cancer commuting from a regional to a capital city for radiotherapy treatment. European Journal of Cancer Care, 14, 75–82.CrossRefGoogle ScholarPubMed
Hughes, P.M., Ingleton, M.C., Noble, B., et al. (2004). Providing cancer and palliative care in rural areas: A review of patient and carer needs. Journal of Palliative Care, 20(1), 44–49.CrossRefGoogle Scholar
Interior Health Authority. (2008). P.E.O.P.L.E. 33 Population Projections. Retrieved June 22, 2009, from http://www.interiorhealth.ca/uploadedFiles/Information/Reports/Population_Profiles/001IH_P32PopProj_maps.pdfGoogle Scholar
Lockie, S.J., Bottorff, J., Robinson, C.A., et al. (2010). Experience of rural family caregivers who assist with commuting for palliative care. Canadian journal of Nursing Research (In press).Google ScholarPubMed
Longo, C.J., Deber, R., Fitch, M., et al. (2007). An examination of cancer patients' monthly ‘out-of-pocket’ costs in Ontario, Canada. European Journal of Cancer Care, 16, 500–507.CrossRefGoogle ScholarPubMed
Martin-McDonald, K., Rogers-Clark, C., Hegney, D., et al. (2003). Experiences of regional and rural people with cancer being treated with radiotherapy in a metropolitan centre. International Journal of Nursing Practice, 9, 176–182.CrossRefGoogle Scholar
McGrath, P. (2001). Returning home after specialist treatment for hematological malignancies: An Australian study. Family & Community Health, 24, 36–48.CrossRefGoogle ScholarPubMed
Osse, B.H., Vernooij, M.J., Schade, E., et al. (2004). Towards a new clinical tool for needs assessment in the palliative care of cancer patients: The PNPC instrument. Journal of Pain and Symptom Management, 28, 329–341.CrossRefGoogle Scholar
Osse, B.H.J., Vernooij-Dassen, M.J.F.J., Schade, E., et al. (2005). The problems experienced by patients with cancer and their need for palliative care. Supportive Care Cancer, 13, 722–732.CrossRefGoogle ScholarPubMed
Parry, J., Mathers, J., Laburn-Peart, C., et al. (2007). Improving health in deprived communities: What can residents teach us? Critical Public Health, 17, 123–136.CrossRefGoogle Scholar
Payne, S., Jarrett, N., Jeffs, D., et al. (2001). Implications of social isolation during cancer treatment. The implications of residence away from home during cancer treatment on patients' experiences: A comparative study. Health & Place, 7, 273–282.CrossRefGoogle ScholarPubMed
Reif, S., Golin, C.E. & Smith, S.R. (2005). Barriers to accessing HIV/AIDS care in North Carolina: Rural and urban differences. AIDS Care, 17, 558–565.CrossRefGoogle ScholarPubMed
Robinson, C., Pesut, B., Bottorff, J.L., et al. (2009). Rural palliative care: A comprehensive review. Journal of Palliative Medicine, 12, 253–258.CrossRefGoogle Scholar
White, N.J., Given, B.A. & Devoss, D.N. (1996). The advanced practice nurse: Meeting the information needs of the rural cancer patient. Journal of Cancer Education: The Official Journal of the American Association for Cancer Education, 11, 203–209.Google ScholarPubMed
Wilkes, L., White, K. & O'Riordan, L. (2000). Empowerment through information: Supporting rural families of oncology patients in palliative care. Australian Journal of Rural Health, 8, 41–46.CrossRefGoogle ScholarPubMed
Wilkes, L.M., White, K., Mohan, S., et al. (2006). Accessing metropolitan cancer care services: practical needs of rural families. Journal of Psychosocial Oncology, 24, 85–101.CrossRefGoogle ScholarPubMed