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Cancer care in regional Australia from the health professional’s perspective

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Abstract

Purpose

This study aimed to identify the factors which health professionals believe influence clinical care and outcomes for people with cancer in regional areas of Australia.

Methods

Twelve semi-structured interviews were conducted with a variety of health professionals. Interview questions explored health professional’s perspectives on barriers to cancer care for patients, factors which influence clinical care, and access to support in regional areas. Data were interpreted using an inductive thematic analysis approach.

Results

Two global themes were identified: rural culture and the health system. Within these global themes, health professionals discussed barriers to cancer care in regional areas, predominantly associated with travel, limited workforce, and poor communication within the health system. Participants also noted many positive aspects of cancer care in regional areas, including more personalised care for the patients and faster career progression for professionals.

Conclusions

Despite several strategies to improve rural cancer care in recent times, including innovative models of care and increased infrastructure, health professionals still perceive many barriers to cancer care in regional Australia. These are predominantly associated with patient demographics, travel difficulties, and inadequate governance. However, there are also many notable benefits to receiving care in regional areas which have been absent from previous literature. These positive factors should be incorporated in efforts to enhance regional cancer care through the recruitment of health professionals to regional areas and development of regional community support networks.

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References

  1. Australian Institute of Health and Welfare (2017) Cancer in Australia 2017. Cancer series, vol no. 101. AIHW, Canberra

    Google Scholar 

  2. Grunfeld E, Whelan TJ, Zitzelsberger L, Willan AR, Montesanto B, Evans WK (2000) Cancer care workers in Ontario: prevalence of burnout, job stress and job satisfaction. Can Med Assoc J 163(2):166–169

    CAS  Google Scholar 

  3. Delvaux N, Razavi D, Farvacques C (1988) Cancer care—a stress for health professionals. Soc Sci Med 27(2):159–166. https://doi.org/10.1016/0277-9536(88)90324-3

    Article  PubMed  CAS  Google Scholar 

  4. Isikhan V, Comez T, Zafer Danis M (2004) Job stress and coping strategies in health care professionals working with cancer patients. Eur J Oncol Nurs 8(3):234–244. https://doi.org/10.1016/j.ejon.2003.11.004

    Article  PubMed  Google Scholar 

  5. Skolarus T, Holmes-Rovner M, Northouse L, Fagerlin A, Garlinghouse C, Demers R, Rovner D, Darwish-Yassine M, Wei J (2013) Primary care perspectives on prostate cancer survivorship: implications for improving quality of care. Urol Oncol 31(6):727–732. https://doi.org/10.1016/j.urolonc.2011.06.002

    Article  PubMed  Google Scholar 

  6. Mohan S, Wilkes LM, Ogunsiji O, Walker A (2005) Caring for patients with cancer in non-specialist wards: the nurse experience. Eur J Cancer Care 14(3):256–263. https://doi.org/10.1111/j.1365-2354.2005.00566.x

    Article  CAS  Google Scholar 

  7. Amgen Australia Pty Ltd (2011) Access to cancer treatment in non-metropolitan areas of Australia. Deloitte Access Economics. https://www.deloitteaccesseconomics.com.au/uploads/File/Amgen%20final%20report_270112.pdf. Accessed 04/08/2016 2016

  8. Australian Institute of Health and Welfare (2009) Health and community services labour force. National health labour force series, vol Cat. no. HWL 43. AIHW, Canberra

    Google Scholar 

  9. Australian Bureau Statistics (2013) The ‘average’ Australian. 41020—Australian social trends. Canberra, Australian Bureau Statistics

    Google Scholar 

  10. Australian Bureau Statistics (2008) 4819.0 Selected health occupations: Australia, 2006. Australian bureau statistics. Canberra, ACT

    Google Scholar 

  11. Struber JC (2004) Recruiting and retaining allied health professionals in rural Australia: why is it so difficult? Internet J Allied Health Sci Pract 2(2)

  12. Underhill C, Bartel R, Goldstein D, Snodgrass H, Begbie S, Yates P, White K, Jong K, Grogan P (2009) Mapping oncology services in regional and rural Australia. Aust J Rural Health 17(6):321–329. https://doi.org/10.1111/j.1440-1584.2009.01106.x

    Article  PubMed  Google Scholar 

  13. Morgan GW, Barton M, Atkinson C, Millar J, Kumar Gogna N, Yeoh E (2010) ‘GAP’ in radiotherapy services in Australia and New Zealand in 2009. J Med Imaging Radiat Oncol 54(3):287–297. https://doi.org/10.1111/j.1754-9485.2010.02172.x

    Article  PubMed  CAS  Google Scholar 

  14. Drury VB, Inma C (2010) Exploring patient experiences of cancer services in regional Australia. Cancer Nurs 33(1):E25–E31. https://doi.org/10.1097/NCC.0b013e3181af5675

    Article  PubMed  Google Scholar 

  15. Emery JD, Walter FM, Gray V, Sinclair C, Howting D, Bulsara M, Bulsara C, Webster A, Auret K, Saunders C, Nowak A, Holman DA (2013) Diagnosing cancer in the bush: a mixed methods study of GP and specialist diagnostic intervals in rural Western Australia. Fam Pract 30(5):541–550. https://doi.org/10.1093/fampra/cmt016

    Article  PubMed  Google Scholar 

  16. Clavarino AM, Lowe JB, Carmont SA, Balanda K (2002) The needs of cancer patients and their families from rural and remote areas of Queensland. Aust J Rural Health 10(4):188–195

    Article  PubMed  Google Scholar 

  17. Grimison P, Phillips F, Butow P, White K, Yip D, Sardelic F, Underhill C, Tse R, Simes R, Turley K, Raymond C, Goldstein D (2013) Are visiting oncologists enough? A qualitative study of the needs of Australian rural and regional cancer patients, carers and health professionals. Asia Pac J Clin Oncol 9(3):226–238. https://doi.org/10.1111/ajco.12014

    Article  PubMed  Google Scholar 

  18. Lawler S, Spathonis K, Masters J, Adams J, Eakin E (2011) Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women. Support Care Cancer 19(12):1975–1982. https://doi.org/10.1007/s00520-010-1041-4

    Article  PubMed  Google Scholar 

  19. Ireland MJ, March S, Crawford-Williams F, Cassimatis M, Aitken JF, Hyde MK, Chambers SK, Sun J, Dunn J (2017) A systematic review of geographical differences in management and outcomes for colorectal cancer in Australia. BMC Cancer 17(1):95. https://doi.org/10.1186/s12885-017-3067-1

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dunn J, Garvey G, Valery PC, Ball D, Fong KM, Vinod S, O’Connell DL, Chambers SK (2017) Barriers to lung cancer care: health professionals’ perspectives. Support Care Cancer 25(2):497–504. https://doi.org/10.1007/s00520-016-3428-3

    Article  PubMed  CAS  Google Scholar 

  21. QSR International Pty Ltd. (2012) NVivo qualitative data analysis software. Version 10 edn

  22. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101

    Article  Google Scholar 

  23. Australian Government (2009) Budget 2009–10. Australian Government,. http://www.budget.gov.au/2009-10/content/bp2/html/bp2_expense-16.htm. Accessed Feb 2018 2018

  24. Sabesan S, Larkins S, Evans R, Varma S, Andrews A, Beuttner P, Brennan S, Young M (2012) Telemedicine for rural cancer care in North Queensland: bringing cancer care home. Aust J Rural Health 20(5):259–264. https://doi.org/10.1111/j.1440-1584.2012.01299.x

    Article  PubMed  Google Scholar 

  25. Platt V, O’Connor K, Coleman R (2015) Improving regional and rural cancer services in Western Australia. Aust J Rural Health 23(1):32–39. https://doi.org/10.1111/ajr.12171

    Article  PubMed  Google Scholar 

  26. Palkhivala A (2011) Canada develops models of teleoncology. JNCI: J Natl Cancer Inst 103(21):1566–1568. https://doi.org/10.1093/jnci/djr449

    Article  PubMed  Google Scholar 

  27. Doolittle GC, Spaulding AO (2006) Providing access to oncology care for rural patients via telemedicine. J Oncol Pract 2(5):228–230

    Article  PubMed  PubMed Central  Google Scholar 

  28. Brigden M, Minty A, Pilatzke S, Della Vidova L, Sherrington L, McPhail K (2008) A survey of recipient client physician satisfaction with teleoncology services originating from thunder bay regional health sciences centre. Telemed J E Health: Off J Am Telemed Assoc 14(3):250–254. https://doi.org/10.1089/tmj.2007.0048

    Article  Google Scholar 

  29. Jhaveri D, Larkins S, Kelly J, Sabesan S (2016) Remote chemotherapy supervision model for rural cancer care: perspectives of health professionals. Eur J Cancer Care (Engl) 25(1):93–98. https://doi.org/10.1111/ecc.12309

    Article  CAS  Google Scholar 

  30. Kenny A, Endacott R, Botti M, Watts R (2007) Emotional toil: psychosocial care in rural settings for patients with cancer. J Adv Nurs 60(6):663–672. https://doi.org/10.1111/j.1365-2648.2007.04453.x

    Article  PubMed  Google Scholar 

  31. Cameron M, Ray R, Sabesan S (2015) Remote supervision of medical training via videoconference in northern Australia: a qualitative study of the perspectives of supervisors and trainees. BMJ Open 5(3):e006444. https://doi.org/10.1136/bmjopen-2014-006444

    Article  PubMed  PubMed Central  Google Scholar 

  32. Byrom L, Lucas L, Sheedy V, Madison K, McIver L, Castrisos G, Alfonzo C, Chiu F, Muir J (2016) Tele-Derm national: a decade of teledermatology in rural and remote Australia. Aust J Rural Health 24(3):193–199

    Article  PubMed  Google Scholar 

  33. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB (2016) Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One 11(7):e0159015. https://doi.org/10.1371/journal.pone.0159015

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. McGrath P, Patterson C, Yates P, Treloar S, Oldenburg B, Loos C (1999) A study of postdiagnosis breast cancer concerns for women living in rural and remote Queensland. Part II: support issues. Aust J Rural Health 7(1):43–52

    Article  PubMed  CAS  Google Scholar 

  35. Doyle C, Lennox L, Bell D (2013) A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 3(1):e001570. https://doi.org/10.1136/bmjopen-2012-001570

    Article  PubMed  PubMed Central  Google Scholar 

  36. Murphy C, Sabesan S, Steer C, Yates P, Booms A, Jones V, Simpson A, Clarke K, Eek R, Ashley D, Goldstein D, Packer C, Tuthill F, Boyce A, Underhill C (2015) Oncology service initiatives and research in regional Australia. Aust J Rural Health 23(1):40–48. https://doi.org/10.1111/ajr.12173

    Article  PubMed  Google Scholar 

  37. Australian Institute of Health and Welfare (2016) Australia’s health 2016. Australia’s health series, vol Cat. no. AUS 199. AIHW, Canberra

    Google Scholar 

  38. Australian Institute of Health and Welfare (2005) Rural, regional, and remote health: indicators of health. vol cat. no. PHE 59. AIHW, Canberra

    Google Scholar 

  39. Australian Bureau Statistics (2011) Health outside major cities. Australian Social Trends, vol 4102.0. ABS, Canberra

    Google Scholar 

  40. Howat A, Veitch C, Cairns W (2006) A descriptive study comparing health attitudes of urban and rural oncology patients. Rural and Remote Health 6 ((internet)):563

  41. McColl L (2007) The influence of bush identity on attitudes to mental health in a Queensland community. Rural Soc 17(2):107–124. https://doi.org/10.5172/rsj.351.17.2.107

    Article  Google Scholar 

  42. Emery JD, Walter FM, Gray V, Sinclair C, Howting D, Bulsara M, Bulsara C, Webster A, Auret K, Saunders C, Nowak A, Holman CDA (2013) Diagnosing cancer in the bush: a mixed-methods study of symptom appraisal and help-seeking behaviour in people with cancer from rural Western Australia. Fam Pract 30(3):294–301. https://doi.org/10.1093/fampra/cms087

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank the health professionals who participated in the study for their valuable contributions and acknowledge the support of the Clinical Oncological Society of Australia. The authors would like to acknowledge the assistance of Arlen Rowe in transcribing the interviews.

Author information

Authors and Affiliations

  1. Institute for Resilient Regions, University of Southern Queensland, LPO BOX 4393, Raceview, Queensland, 4305, Australia

    Fiona Crawford-Williams, Belinda Goodwin, Sonja March, Michael J. Ireland, Suzanne K. Chambers, Joanne F. Aitken & Jeff Dunn

  2. School of Psychology and Counselling, University of Southern Queensland, Ipswich, Queensland, 4305, Australia

    Sonja March & Michael J. Ireland

  3. Cancer Council Queensland, Fortitude Valley, Queensland, 4006, Australia

    Melissa K. Hyde, Suzanne K. Chambers, Joanne F. Aitken & Jeff Dunn

  4. Menzies Health Institute Queensland, Griffith University, Southport, Queensland, 4222, Australia

    Melissa K. Hyde, Suzanne K. Chambers & Joanne F. Aitken

  5. Prostate Cancer Foundation of Australia, St Leonards, New South Wales, 2065, Australia

    Suzanne K. Chambers

  6. Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, 6027, Australia

    Suzanne K. Chambers

  7. School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, 4000, Australia

    Joanne F. Aitken

  8. School of Social Science, University of Queensland, St Lucia, Queensland, 4072, Australia

    Jeff Dunn

  9. School of Medicine (research), Griffith University, Nathan, Queensland, 4111, Australia

    Jeff Dunn

Authors
  1. Fiona Crawford-Williams
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  2. Belinda Goodwin
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  3. Sonja March
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  4. Michael J. Ireland
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  8. Jeff Dunn
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Corresponding author

Correspondence to Fiona Crawford-Williams.

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The authors declare that they have no conflict of interest.

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Crawford-Williams, F., Goodwin, B., March, S. et al. Cancer care in regional Australia from the health professional’s perspective. Support Care Cancer 26, 3507–3515 (2018). https://doi.org/10.1007/s00520-018-4218-x

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  • DOI: https://doi.org/10.1007/s00520-018-4218-x

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