AN ASSESSMENT OF THE PSYCHOSOCIAL NEEDS OF RURAL CANCER PATIENTS

AN ASSESSMENT OF THE PSYCHOSOCIAL
NEEDS OF RURAL CANCER PATIENTS
LIVING IN THE
ADIRONDACK REGION OF NORTHERN NY
Alison Riley-Clark MSN RN & Barbara Pieper PhD RN
The Sage Colleges
SHS
Graduate Nursing Program
RURAL AREAS: RECURRING THEMES
Unique demographics and needs
Have shortages of health care providers and cancer specialists
(Hughes, Ingleton, Noble & Clark, 2004)
“Although 20 % of Americans live in rural areas only 9% of MD’s practice there”
(AHRQ, 2004)
Medicare reimbursements are lower for rural hospitals for the same services.
(Ricketts, 2000)
Higher percentage of residents >65, more patients on Medicare, less revenues
Population has lower income and education levels
(National Rural Health Association, 2008)
Transportation difficulties
Isolated communities
Lack of hospitals & home health services
(Baltic,Whedon, Ahles & Funciullo, 2002)
Limited Internet and cell phone access
HOSPITALS IN THE ADIRONDACK PARK
Adirondack Medical Center, Franklin Co.
97 beds, cancer clinic with visiting
oncologist 2 days per week
 Elizabethtown Hospital, Essex Co.
15 beds, just added chemotx services
 Alice Hyde Medical Center, Franklin Co.
76 beds. Cancer clinic, oncologist
and radiation therapy services
HAMILTON COUNTY HAS NO HOSPITAL
Residents Over 65 Years by County
Essex County – 16.7%
Franklin County – 13.2%
Hamilton County – 21.5%
New York State – 13.2%
US Census, 2000
PURPOSE OF THE STUDY
Describe the self reported psychosocial needs of
rural cancer patients living in the Adk region.
Identify barriers that prevent rural cancer patients
from accessing available services.
Data will be used to plan new programs for
Adirondack cancer patients by local and state
cancer providers.
Add to the literature on the needs of rural
cancer patients
RESEARCH QUESTIONS
What are the self-reported psychosocial needs of rural
Adirondack cancer patients?
Do these patients have access to cancer services and if not,
what are the barriers to obtaining quality care and
services?
What services do patients want to have available?
What percent of patients have access to computers &
online services?
What methods do patients prefer to get more information
about their disease ?
SURVEY TOOL
Designed by researchers
Brief, only 3-5 minutes to complete
7 Demographic questions
8 Likert scale questions
Checklist of preferred services
Checklist for info delivery methods
Comment section
METHODS
*Survey Distribution
Adirondack Medical Center Oncology Center
Local ENT Physician Office
Cancer Support Group Meetings
*Staff gave patients survey, a pen and an envelope.
*Respondents placed the completed survey in the envelope
and then in a locked collection box.
*Study approved by IRB at The Sage Colleges
Demographic
Variables
32
Percent
19
28
40.4%
59.6%
Live in the Adirondack Park
46
97.9%
Race - White (as identified by respondent)
Type of Cancer
46
97.9%
Breast
13
27.7%
Colon
3
6.4%
Lung
2
4.3%
Other or multiple types
19
40.4%
Currently Receiving Cancer Treatment
68.1%
Gender
Male
Female
Table 2 Travel Time to Medical Services in Minutes.
Family Doctor
N
47
Mean
13.11
SD
12.64
Range
0-60.00
Cancer Doctor
47
60.32
105.77
0-480.00
Chemotherapy
47
20.11
35.91
0-150.00
Radiation Therapy
47
27.87
37.98
0-150.00
Characteristics (n=46)
97.9% never had missed an appointment
due to difficulty getting a ride, buying gas or
car problems.
81% have Internet access
19% have no Internet access
13% never use Internet for information
47% had attended a support group.
72% expressed some interest to very interested in
attending a support group.
47% felt scared, anxious, sad or worried several
times a month, weekly or daily.
SURVEY QUESTION
1
NEVER/NOT AT
ALL
How often do you feel
Scared, anxious, sad or
worried?
10.6% (n=5) 42.6% 21.3% 12.8%
(n=20) (n=10) (n=6)
12.8%
(n=6)
4.3% (n=2) 6.4%
(n=3)
12.8% 12.8%
(n=6) (n=6)
61.7% (
n=29)
8.5% 27.7%
(n=4) (n=13)
2.1%
(n=1)
How often do you get
support from family
and friends
How often do you get
help from your church
or any community
organization?
2
3
WKLY/VERY
INTERESTED
53.2%
(n=25)
6.4%
(n=3)
Have you ever been
interested in talking
with a counselor about
coping with cancer?
42.6%
(n=20)
21.3% 25.5% 8.5% (n=4)
(n=10) (n=12)
How interested are you
in trying yoga or
relaxation classes?
36.2%
(n=17)
12.8%
(n=6)
17% 31.9%
(n=17) (n=15)
5
DAILY
Services patients preferred to help deal with their cancer.
Respondent’s Preferred Methods For Cancer
Information
70
59.6
60
48.9
50
Percentage
40.4
40
30
20
14.9
10
0
Method
17
12.8
10.6
RECOMMENDATIONS
Explore providing laptop computers/epads with Internet
access during treatments.
Locate and apply for additional grant funding for
yoga/guided imagery/massage sessions
 Expand availability of counseling and education
specific to coping with cancer & stress.
Expand support group services and explore strategies to
connect patients to each other.
Continue to provide written educational materials as
well as print-outs/computer discs from cancer
websites for those without access
Explore using ebooks and enlarging patient lending
library.
QUESTIONS?
Contact Information
Alison Riley-Clark
518-523-2212
[email protected]
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