“Undressing” distress among cancer patients living in urban, regional, and remote locations in Western Australia

Purpose People diagnosed with cancer from rural and remote locations may experience heightened distress because of distance from cancer treatment and support services. We examined whether remoteness and other factors are associated with psychosocial distress and explored commonly reported problems a...

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Bibliographic Details
Published in:	Supportive care in cancer Vol. 24; no. 5; pp. 1963 - 1973
Main Authors:	Watts, Kaaren J., Good, Louise H., McKiernan, Sandy, Miller, Lisa, O’Connor, Moira, Kane, Robert, Kruger, Deborah J., Adams, Bree R., Musiello, Toni
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2016 Springer Springer Nature B.V
Subjects:	Aged Analysis Cancer Cancer patients Care and treatment Cross-Sectional Studies Emotional disorders Fear Female Health aspects Health Services Accessibility - statistics & numerical data Humans Male Measuring instruments Medical research Medicine Medicine & Public Health Medicine, Experimental Middle Aged Neoplasms - diagnosis Neoplasms - epidemiology Neoplasms - psychology Neoplasms - therapy Nursing Nursing Research Oncology Original Article Pain Medicine Prevalence Rehabilitation Medicine Rural areas Rural Population - statistics & numerical data Social psychology Social Support Statistics as Topic Stress, Psychological - diagnosis Stress, Psychological - epidemiology Stress, Psychological - physiopathology Urban Population - statistics & numerical data Western Australia - epidemiology Western Australia Australia Oncology Psychosocial needs Patients Cancer Distress screening
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Summary:	Purpose People diagnosed with cancer from rural and remote locations may experience heightened distress because of distance from cancer treatment and support services. We examined whether remoteness and other factors are associated with psychosocial distress and explored commonly reported problems among cancer patients in Western Australia (WA). Methods In a cross-sectional study, cancer patients newly referred to a Cancer Council WA Cancer Support Coordinator (CSC) were screened and assessed using the Distress Thermometer (DT) and Problem List (PL) and a standardized form, respectively. The index of remoteness was the Australian Standard Geographical Classification. The association between remoteness, demographic variables, and the frequency of problems endorsed on the PL was analyzed using bivariate analyses and a generalized linear mixed model (GLMM) regression. Results Of 1032 patients referred to a CSC, 466 were screened (45.2 %) with complete data available for 441 patients. Patients from remote areas reported fewer problems than patients from urban and regional locations. Increasing remoteness was not associated with higher distress ( r = −0.04, p = 0.43). Concerns reported differed by remoteness category and included worry, sadness, fears, finances, transportation, and physical symptoms. More emotional problems were independently associated with higher distress ( β = 0.47, p < 0.001), explaining 17.31 % of the variance. Conclusions There is no evidence that increasing remoteness is associated with higher distress. Emotional concerns and physical problems appear to be prevalent among cancer patients irrespective of urban or rural location. Specific concerns detected by distress screening, particularly emotional concerns, may warrant further assessment and targeted referrals.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0941-4355 1433-7339
DOI:	10.1007/s00520-015-2982-4