Responding to the Needs of Rural Cancer Survivors: Learning to LiveWell with Chronic Conditions

Abstract

Background: Rural Saskatchewan cancer survivors have reported a lack of support once their cancer treatments have been completed. This problem is more acute the further away one lives from Saskatoon and Regina. A chronic disease self-management program titled LiveWell with Chronic Conditions (LWCC) is available to all people with any chronic condition in rural areas across Saskatchewan. This program addresses key areas of concern to survivors; however, participation is low for cancer survivors.

Purpose: To determine how LWCC can reach and respond to the needs of rural cancer survivors in Saskatchewan.

Objectives: 1. To gain an understanding of how the program responds to the needs of rural cancer survivors from the perspective of program leaders and cancer survivors. 2. To explore how the existing LWCC program could be enhanced in terms of content, format, delivery and marketing strategy. 3. Based on results, develop recommendations in coordination with agencies and institutions that provide services to cancer survivors.

Methods: A mixed-methods case study approach was adopted. Needs questionnaires were completed by cancer survivors who participated in the LWCC program offered in rural health regions across the province (n=4). Consenting survivors who attended the program and several program facilitators, some of whom were cancer survivors themselves, were interviewed in order to provide their opinion regarding content, format, and other relevant feedback that would improve the fit of the program with the needs of rural cancer survivors (n=10).

Results: Results indicate the material covered in the program is appropriate for cancer survivors who have finished acute treatment and are making the transition to life after cancer. Program benefits include improved self-efficacy and being able to manage emotional and physical issues from cancer including fatigue and pain. Rural survivors would like access to additional information to address issues specific to cancer survivorship including dealing with the fear of cancer recurrence, lymphedema and sexuality. A cancer specific rural health program would not be very feasible due to small populations. Cancer survivors felt comfortable in a group among people with other chronic conditions although support of another person with cancer participating in the LWCC group would be preferred.

Knowledge Translation: A think tank was held with key stakeholders who provide services to cancer survivors to review these findings and form recommendations for improving rural cancer survivor care. These recommendations are: 1) to promote LWCC to rural cancer survivors who have finished acute cancer treatment, 2) to broaden the awareness of the program among cancer care providers, and 3) to refer cancer survivors to an existing cancer survivorship single day workshop after participation in LWCC. This workshop is available in up to 10 communities outside of Regina and Saskatoon.

Conclusion: The Live Well with Chronic Conditions program is appropriate and beneficial for cancer survivors who have completed acute cancer treatments. As more cancer care providers make referrals to this program and an online version of the program becomes available, uptake will likely improve among rural cancer survivors in Saskatchewan.