University of Utah School of Medicine Salt Lake City, UT
S. B. Seifert1, M. J. Stephens2, A. Ariotti2, A. King2, M. Watt2, and G. Suneja3; 1University of Utah School of Medicine, Salt Lake City, UT, United States, 2University of Utah, Salt Lake City, UT, 3Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
Purpose/Objective(s): People living in rural communities experience disparities in accessing cancer treatment, yet little is known about the challenges rural patients experience when undergoing radiotherapy. In this study, we aimed to describe how rural cancer patients (a) experience their diagnosis and radiation journey and (b) employ coping mechanisms during radiotherapy at a facility far from home. Materials/
Methods: Adults living in rural areas—defined by census classifications that were cross referenced with rural-urban classification codes—who were beginning radiotherapy at a tertiary cancer center were invited to participate. Using a qualitative, photo-elicitation method, participants took photographs documenting their experiences during radiation treatment in response to the prompt, “Over the course of your treatment, take photos that you feel capture your experience of radiation therapy.” Following the completion of radiotherapy, participants uploaded 10 photographs of their choosing to a protected shared drive and completed individual in-depth interviews. The interviewer probed to understand how participants’ experience as a rural resident contributed to challenges they faced and informed their coping mechanisms. The interviews were transcribed and coded with qualitative data analysis software using the practical thematic analysis approach. Results: Participants (N=7) included 4 females and 3 males with an age range of 32-69 years, and cancers of the breast, esophageal, skin, and brain. Participants lived an average of 175 miles from the treatment center with travel times ranging from 1 to 6 hours. In qualitative interviews, three themes emerged related to the impact of receiving radiation therapy far from home: (1) isolation, sadness, & apprehension; (2) changes to day-to-day life and routines, with corresponding financial burden; and (3) interpersonal burdens related to relationships and family. Three strategies emerged related to coping mechanisms: (1) mental (e.g., reframing the situation, self-reflection); (2) physical (e.g., exercise); and (3) social (e.g., harnessing support from their family or community, local resources such as housing). Conclusion: This study demonstrated that traveling from a rural to a metropolitan area to receive radiotherapy treatment results in emotional, financial, and social effects that may compound the adverse effects of undergoing cancer treatment. The photo-elicitation method allowed rural participants to express and conceptualize their experiences receiving cancer treatment far from home with a patient-focused lens that more traditional approaches (e.g., surveys) are unable to elucidate. Future work should consider how to improve the experiences of rural cancer patients.
