Unmet Needs and Care Delivery Gaps Among Rural Cancer Survivors

Nicole L Stout; Dannell Boatman; Madeline Rice; Emelia Branham; Meadow Miller; Rachel Salyer

doi:10.1177/23743735241239865

Unmet Needs and Care Delivery Gaps Among Rural Cancer Survivors

J Patient Exp. 2024 Mar 18:11:23743735241239865. doi: 10.1177/23743735241239865. eCollection 2024.

Authors

Nicole L Stout^{1

2}, Dannell Boatman¹, Madeline Rice³, Emelia Branham³, Meadow Miller⁴, Rachel Salyer⁵

Affiliations

¹ Department of Cancer Prevention and Control, School of Medicine, West Virginia University, Morgantown, WV, USA.
² Department of Health Policy, Management, and Leadership, School of Public, West Virginia University, Morgantown, WV, USA.
³ Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, USA.
⁴ West Virginia University, Morgantown, WV, USA.
⁵ Department of Internal Medicine, School of Medicine, West Virginia University, Morgantown, WV, USA.

Abstract

Community-based healthcare delivery systems frequently lack cancer-specific survivorship support services. This leads to a burden of unmet needs that is magnified in rural areas. Using sequential mixed methods we assessed unmet needs among rural cancer survivors diagnosed between 2015 and 2021. The Supportive Care Needs Survey (SCNS) assessed 5 domains; Physical and Daily Living, Psychological, Support and Supportive Services, Sexual, and Health Information. Needs were analyzed across domains by cancer type. Survey respondents were recruited for qualitative interviews to identify care gaps. Three hundred and sixty two surveys were analyzed. Participants were 85% White (n = 349) 65% (n = 234) female and averaged 2.03 years beyond cancer diagnosis. Nearly half (49.5%) of respondents reported unmet needs, predominantly in physical, psychological, and health information domains. Needs differed by stage of disease. Eleven interviews identified care gap themes regarding; Finding Support and Supportive Services and Health Information regarding Care Delivery and Continuity of Care. Patients experience persistent unmet needs after a cancer diagnosis across multiple functional domains. Access to community-based support services and health information is lacking. Community based resources are needed to improve access to care for long-term cancer survivors.

Keywords: cancer survivorship; chronic care; mixed methods; rural health.