An Exploration of Rural–Urban Residence on Self-Reported Health Status with UK Cancer Survivors Following Treatment: A Brief Report
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Setting
2.3. Questionnaire Design
2.3.1. Demographics
2.3.2. Health Status
2.3.3. Rural–Urban Residence
2.4. Participant Eligibility
2.5. Sample Size Calculation
2.6. Recruitment
2.7. Consent
2.8. Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- International Agency for Research on Cancer. All Cancers Fact Sheet: World Health Organisation. 2020. Available online: https://gco.iarc.fr/today/data/factsheets/cancers/39-All-cancers-fact-sheet.pdf (accessed on 22 May 2022).
- World Health Organisation. Cancer Fact Sheet. 2022. Available online: https://www.who.int/news-room/fact-sheets/detail/cancer (accessed on 22 May 2022).
- Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2019, 5, 1749–1768. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Adams, N.; Gisiger-Camata, S.; Hardy, C.M.; Thomas, T.F.; Jukkala, A.; Meneses, K. Evaluating Survivorship Experiences and Needs Among Rural African American Breast Cancer Survivors. J. Cancer Educ. 2017, 32, 264–271. [Google Scholar] [CrossRef] [PubMed]
- Gisiger-Camata, S.; Adams, N.; Nolan, T.S.; Meneses, K. Multi-Level Assessment to Reach Out to Rural Breast Cancer Survivors. Womens Health 2016, 12, 513–522. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gunn, K.M.; Berry, N.M.; Meng, X.; Wilson, C.J.; Dollman, J.; Woodman, R.J.; Clark, R.A.; Koczwara, B. Differences in the health, mental health and health-promoting behaviours of rural versus urban cancer survivors in Australia. Support. Care Cancer 2020, 28, 633–643. [Google Scholar] [CrossRef]
- Lally, R.M.; Eisenhauer, C.; Buckland, S.; Kupzyk, K. Feasibility of Synchronous Online Focus Groups of Rural Breast Cancer Survivors on Web-Based Distress Self-Management. Oncol. Nurs. Forum. 2018, 45, E111–E124. [Google Scholar] [CrossRef]
- Weaver, K.E.; Palmer, N.; Lu, L.; Case, L.D.; Geiger, A.M. Rural–urban differences in health behaviors and implications for health status among US cancer survivors. Cancer Causes Control. 2013, 24, 1481–1490. [Google Scholar] [CrossRef] [Green Version]
- Weaver, K.E.; Geiger, A.M.; Lu, M.L.; Case, L.D. Rural-urban disparities in health status among US cancer survivors. Cancer 2013, 119, 1050–1057. [Google Scholar] [CrossRef] [Green Version]
- McNulty, J.A.; Nail, L. Cancer Survivorship in Rural and Urban Adults: A Descriptive and Mixed Methods Study. J. Rural Health 2015, 31, 282–291. [Google Scholar] [CrossRef]
- Glasser, M.; Nielsen, K.; Smith, S.N.; Gray, C. Psychosocial needs of rural survivors of cancer and their partners. J. Psychosoc. Oncol. 2013, 31, 319–333. [Google Scholar] [CrossRef]
- Loudon, A.; Barnett, T.; Williams, A. Yoga, breast cancer-related lymphoedema and well-being: A descriptive report of women’s participation in a clinical trial. J. Clin. Nurs. 2017, 26, 4685–4695. [Google Scholar] [CrossRef]
- Burris, J.L.; Andrykowski, M. Disparities in mental health between rural and nonrural cancer survivors: A preliminary study. Psychooncology 2010, 19, 637–645. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ratnapradipa, K.L.; Ranta, J.; Napit, K.; Luma, L.B.; Robinson, T.; Dinkel, D.; Schabloske, L.; Watanabe-Galloway, S. Qualitative analysis of cancer care experiences among rural cancer survivors and caregivers. J. Rural Health 2022, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Anbari, A.B.; Wanchai, A.; Graves, R. Breast cancer survivorship in rural settings: A systematic review. Support. Care Cancer 2020, 28, 3517–3531. [Google Scholar] [CrossRef] [PubMed]
- Klemp, J.R.; Knight, C.J.; Lowry, B.; Long, T.; Bush, C.; Alsman, K.; Krebill, H.; Peereboom, D.; Overholser, L.; Greiner, K.A. Informing the delivery of cancer survivorship care in rural primary care practice. J. Cancer Surviv. 2022, 16, 4–12. [Google Scholar] [CrossRef]
- Gunn, K.; Olver, I.; Ross, X.S.; Harrison, N.; Livingston, P.; Wilson, C. Improving Survivors’ Quality of Life Post-Treatment: The Perspectives of Rural Australian Cancer Survivors and Their Carers. Cancers 2021, 13, 1600. [Google Scholar] [CrossRef] [PubMed]
- Levit, L.A.; Byatt, L.; Lyss, A.P.; Paskett, E.D.; Levit, K.; Kirkwood, K.; Schenkel, C.; Schilsky, R.L. Closing the Rural Cancer Care Gap: Three Institutional Approaches. JCO Oncol. Pract. 2020, 16, 422–430. [Google Scholar] [CrossRef] [PubMed]
- Afshar, N.; English, D.R.; Milne, R.L. Rural–urban residence and cancer survival in high-income countries: A systematic review. Cancer 2019, 125, 2172–2184. [Google Scholar] [CrossRef] [Green Version]
- van der Kruk, S.R.; Butow, P.; Mesters, I.; Boyle, T.; Olver, I.; White, K.; Sabesan, S.; Zielinski, R.; Chan, B.A.; Spronk, K.; et al. Psychosocial well-being and supportive care needs of cancer patients and survivors living in rural or regional areas: A systematic review from 2010 to 2021. Support. Care Cancer 2022, 30, 1021–1064. [Google Scholar] [CrossRef]
- Butow, P.N.; Phillips, F.; Schweder, J.; White, K.; Underhill, C.; Goldstein, D. Psychosocial well-being and supportive care needs of cancer patients living in urban and rural/regional areas: A systematic review. Support. Care Cancer 2012, 20, 1–22. [Google Scholar] [CrossRef]
- Harrison, J.D.; Young, J.M.; Price, M.A.; Butow, P.N.; Solomon, M. What are the unmet supportive care needs of people with cancer? A systematic review. Support. Care Cancer 2009, 17, 1117–1128. [Google Scholar] [CrossRef]
- Palmer, N.R.; Avis, N.E.; Fino, N.F.; Tooze, J.A.; Weaver, K.E. Rural cancer survivors’ health information needs post-treatment. Patient Educ. Couns. 2020, 103, 1606–1614. [Google Scholar] [CrossRef] [PubMed]
- Reid-Arndt, S.A.; Cox, C.R. Does rurality affect quality of life following treatment for breast cancer? J. Rural Health 2010, 26, 402–405. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- van den Berg, M.; Wendel-Vos, W.; van Poppel, M.; Kemper, H.; van Mechelen, W.; Maas, J. Health benefits of green spaces in the living environment: A systematic review of epidemiological studies. Urban For. Urban Green. 2015, 14, 806–816. [Google Scholar] [CrossRef]
- Bjorklund, R.W.; Pippard, J.L. The mental health consumer movement: Implications for rural practice. Community Ment Health J. 1999, 35, 347–359. [Google Scholar] [CrossRef] [PubMed]
- Kane, C.F.; Ennis, J.M. Health care reform and rural mental health: Severe mental illness. Community Ment. Health J. 1996, 32, 445–462. [Google Scholar] [CrossRef]
- Nelson, D.; Law, G.R.; McGonagle, I.; Turner, P.; Jackson, C.; Kane, R. The Effect of Rural Residence on Cancer-Related Self-Efficacy With UK Cancer Survivors Following Treatment. J. Rural Health 2022, 38, 28–33. [Google Scholar] [CrossRef]
- Nelson, D.; McGonagle, I.; Jackson, C.; Kane, R. What is known about the role of rural-urban residency in relation to self-management in people affected by cancer who have completed primary treatment? A scoping review. Support. Care Cancer 2021, 29, 67–78. [Google Scholar] [CrossRef]
- Clark, D. Urban and Rural Population of the United Kingdom from 1960–2020 Statista 2022. Available online: https://www.statista.com/statistics/984702/urban-and-rural-population-of-the-uk/ (accessed on 22 May 2022).
- Vandenbroucke, J.P.; von Elm, E.; Altman, D.G.; Gøtzsche, P.C.; Mulrow, C.D.; Pocock, S.J.; Poole, C.; Schlesselman, J.J.; Egger, M.; Strobe Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. PLoS Med. 2007, 4, e297. [Google Scholar] [CrossRef] [Green Version]
- Moore, H.E.; Siriwardena, A.N.; Gussy, M.; Tanser, F.; Hill, B.; Spaight, R. Mental health emergencies and COVID-19: The impact of ‘lockdown’ in the East Midlands of the UK. BJPsych Open 2021, 7, e139. [Google Scholar] [CrossRef]
- Office for National Statistics. General Health in England and Wales: 2011 and Comparison with 2001. 2013. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandwellbeing/articles/generalhealthinenglandandwales/2013-01-30 (accessed on 22 June 2022).
- Office for National Statistics. 2011 Rural/Urban Classification 2016. Available online: https://www.ons.gov.uk/methodology/geography/geographicalproducts/ruralurbanclassifications/2011ruralurbanclassification (accessed on 22 June 2022).
- Department for Environment. Food & Rural Affairs. Defining Rural Areas. 2017. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/597751/Defining_rural_areas__Mar_2017_.pdf (accessed on 22 June 2022).
- Ministry of Housing. Communities & Local Government. The English Indices of Deprivation: Statistical Release. 2019. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/835115/IoD2019_Statistical_Release.pdf (accessed on 22 June 2022).
- Shneerson, C.; Taskila, T.; Holder, R.; Greenfield, S.; Tolosa, I.; Damery, S.; Gale, N. Patterns of self-management practices undertaken by cancer survivors: Variations in demographic factors. Eur J. Cancer Care 2015, 24, 683–694. [Google Scholar] [CrossRef]
- Shneerson, C.; Taskila, T.; Greenfield, S.; Gale, N. A survey investigating the associations between self-management practices and quality of life in cancer survivors. Support. Care Cancer 2015, 23, 2655–2662. [Google Scholar] [CrossRef] [PubMed]
- Thomas, A.A.; Timmons, A.; Molcho, M.; Pearce, A.; Gallagher, P.; Butow, P.; O’Sullivan, E.; Gooberman-Hill, R.; O’Neill, C.; Sharp, L. Quality of life in urban and rural settings: A study of head and neck cancer survivors. Oral Oncol. 2014, 50, 676–682. [Google Scholar] [CrossRef] [PubMed]
Characteristic | Rural Total n = 103 | Urban Total n = 120 | |
---|---|---|---|
n (%) | n (%) | ||
Age | 25–44 | 3 (2.9) | 4 (3.3) |
45–54 | 12 (11.7) | 15 (12.5) | |
55–64 | 24 (23.3) | 26 (21.7) | |
65–74 | 42 (40.8) | 48 (40.0) | |
Over 75 | 22 (21.4) | 27 (22.5) | |
Gender | Female | 62 (60.2) | 57 (47.5) |
Male | 41 (39.8) | 63 (52.5) | |
Living arrangements | Partner/Spouse/Family/Friends/Nursing home | 92 (89.3) | 90 (75.0) |
Alone | 9 (8.7) | 30 (25.0) | |
Marital status | Married or living with partner | 89 (86.4) | 82 (68.3) |
Single/Divorced/Separated/Widowed | 13 (12.7) | 38 (31.7) | |
Employment status | Employed | 21 (20.4) | 30 (25.0) |
Not Employed | 3 (2.9) | 9 (7.5) | |
Retired | 69 (67.0) | 75 (62.5) | |
Other | 9 (8.7) | 6 (5.0) | |
Qualifications ** | Professional | 30 (29.1) | 30 (25.0) |
Qualification | 19 (18.4) | 20 (16.7) | |
Degree or Higher Degree | 24 (23.3) | 26 (21.7) | |
A level or equivalent GCSE/O Levels or equivalent | 35 (34.0) | 43 (35.8) | |
No qualifications | 8 (7.8) | 30 (25.0) | |
Annual household income | £0–14,999 | 23 (22.3) | 31 (25.8) |
£15–24,999 | 19 (18.4) | 36 (30.0) | |
£25–49,999 | 36 (35.0) | 35 (29.2) | |
Over £50,000 | 12 (11.7) | 8 (6.6) | |
Primary Cancer Type | Breast | 39 (37.9) | 34 (28.6) |
Urological | 22 (21.4) | 30 (25.2) | |
Skin | 8 (7.8) | 10 (8.4) | |
Head and Neck | 7 (6.8) | 6 (5.0) | |
Gynecological | 6 (5.8) | 4 (3.4) | |
Lower Gastrointestinal | 13 (12.6) | 16 (13.4) | |
Hematological | 4 (3.9) | 6 (5.0) | |
Upper Gastrointestinal | 3 (2.9) | 8 (6.7) | |
Other | 1 (1.0) | 5 (4.2) | |
Health Status | Very Good or Good | 82 (79.6) | 73 (60.9) |
Fair | 17 (16.5) | 35 (29.1) | |
Poor or Very Poor | 4 (3.9) | 12 (10.0) |
Health Status | |||||
---|---|---|---|---|---|
Model 1 | B | SE B | β | t | p |
Constant | 3.701 (3.541, 3.860) | 0.081 | 45.752 | 0.000 | |
Rural–Urban | 0.430 (0.195, 0.666) | 0.119 | 0.239 | 3.603 | 0.000 |
Adjusted R2 | 0.053 | ||||
Model 2 | |||||
Constant | 3.427 (3.179, 3.675) | 0.126 | 27.254 | 0.000 | |
Rural–Urban | 0.356 (0.119, 0.594) | 0.121 | 0.198 | 2.958 | 0.009 |
Marital Status | 0.400 (0.119, 0.681) | 0.142 | 0.188 | 2.810 | 0.013 |
Adjusted R2 | 0.082 | ||||
Model 3 | |||||
Constant | 3.125 (2.766, 3.474) | 0.177 | 17.671 | 0.000 | |
Rural–Urban | 0.318 (0.081, 0.555) | 0.120 | 0.177 | 2.643 | 0.009 |
Marital Status | 0.357 (0.077, 0.637) | 0.142 | 0.168 | 2.515 | 0.013 |
Deprivation | 0.057 (0.010, 0.103) | 0.024 | 0.159 | 2.405 | 0.017 |
Adjusted R2 | 0.103 | ||||
Model 4 | |||||
Constant | 3.271 (2.900, 3.643) | 0.189 | 17.349 | 0.000 | |
Rural–Urban | 0.329 (0.094, 0.564) | 0.119 | 0.183 | 2.755 | 0.006 |
Marital Status | 0.806 (0.304, 1.308) | 0.255 | 0.379 | 3.166 | 0.002 |
Deprivation | 0.055 (0.009, 0.101) | 0.023 | 0.155 | 2.369 | 0.019 |
Living Arrangement | −0.593 (−1.145, −0.041) | 0.280 | −0.252 | −2.116 | 0.035 |
Adjusted R2 | 0.117 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Nelson, D.; McGonagle, I.; Jackson, C.; Kane, R. An Exploration of Rural–Urban Residence on Self-Reported Health Status with UK Cancer Survivors Following Treatment: A Brief Report. Nurs. Rep. 2022, 12, 574-582. https://doi.org/10.3390/nursrep12030056
Nelson D, McGonagle I, Jackson C, Kane R. An Exploration of Rural–Urban Residence on Self-Reported Health Status with UK Cancer Survivors Following Treatment: A Brief Report. Nursing Reports. 2022; 12(3):574-582. https://doi.org/10.3390/nursrep12030056
Chicago/Turabian StyleNelson, David, Ian McGonagle, Christine Jackson, and Ros Kane. 2022. "An Exploration of Rural–Urban Residence on Self-Reported Health Status with UK Cancer Survivors Following Treatment: A Brief Report" Nursing Reports 12, no. 3: 574-582. https://doi.org/10.3390/nursrep12030056