Psychosocial outcomes and care utilization among rural and nonrural cancer patients.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 79-79
Author(s):  
Angela E Usher ◽  
Janice Bell ◽  
Laurel A Beckett ◽  
Jill G Joseph ◽  
Brad J. Zebrack ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cancer Patients ◽  
Rural Areas ◽  
Urban Areas ◽  
Psychosocial Care ◽  
Psychosocial Outcomes ◽  
Psychosocial Distress ◽  
Care Utilization ◽  
Lower Odds ◽  
Independent Effects

79 Background: Approximately 20% of people diagnosed with cancer in the U.S. travel from rural areas to urban cancer centers for treatment. Rural cancer patients face unique challenges which may contribute to greater psychosocial distress when compared to urban-dwelling patients. While up to half of all cancer patients screen positive for psychosocial distress, only 25-44% of distressed patients utilize psychosocial care. Patients from rural areas may face greater barriers to utilization of psychosocial care compared to patients from urban areas. To date, few studies have focused on these concerns. Methods: Three-years of data were collected from newly diagnosed patients screened between 2015 and 2017, including the Patient Health Questionnaire-2 and the NCCN Distress Thermometer (n = 4,865). Adjusted multi-variable logistic regression, chi-square, and negative binomial regression were used to assess relationships among psychosocial outcomes and care utilization, rurality, and distance to treatment in driving miles, controlling for socio-demographic and clinical covariates. Distance to treatment based on driving miles computed in ArcGIS v10.5. Stata v15 was used for all statistical analyses, significance set at ≤.05. Results: Higher odds of depressive symptoms were detected among people living in rural areas compared to urban areas. The odds of psychosocial distress were higher in patients from rural areas and further distances from treatment compared to local distance. Patients from rural areas had lower odds of psychosocial care utilization compared to patients in urban areas. Distance to treatment had independent effects, over and above rurality, for lower odds of psychosocial care utilization. Conclusions: Distance to treatment and rurality appear to be risk factors with independent effects on depressive symptoms and psychosocial distress and appear to be associated with lower odds of psychosocial care use among cancer patients with self-reported distress when compared to patients from urban and local areas. Findings support improved detection of and response to patient reported psychosocial outcomes, and further research designed to better understand the mechanisms underlying the reported associations.

scholarly journals Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

2021 ◽  
Vol 18 (6) ◽  
pp. 2818
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Middle School ◽  
Depressive Symptoms ◽  
Rural Areas ◽  
Urban Areas ◽  
Depression Scale ◽  
Wealth Index ◽  
School Level ◽  
Cross Sectional ◽  
Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

scholarly journals Factors Influencing the Willingness of Palliative Care Utilization among the Older Population with Active Cancers: A Case Study in Mandalay, Myanmar

2021 ◽  
Vol 18 (15) ◽  
pp. 7887
Author(s):  
Aye Tinzar Myint ◽  
Sariyamon Tiraphat ◽  
Isareethika Jayasvasti ◽  
Seo Ah Hong ◽  
Vijj Kasemsup
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Rural Areas ◽  
Psychosocial Support ◽  
Care Utilization ◽  
Severe Illness ◽  
Cross Sectional Survey ◽  
Care Services ◽  
Palliative Care Services ◽  
Older Cancer Patients

Palliative care is an effective, multidisciplinary healthcare service to alleviate severe illness patients from physical, psychological, and spiritual pain. However, global palliative care has been underutilized, especially in developing countries. This cross-sectional survey aimed to examine the factors associated with older cancer patients’ willingness to utilize palliative care services in Myanmar. The final sample was composed of 141 older adults, 50-years of age and above who suffered from cancers at any stage. Simple random sampling was applied to choose the participants by purposively selecting three oncology clinics with daycare chemotherapy centers in Mandalay. We collected data using structured questionnaires composed of five sections. The sections include the participant’s socio-economic information, disease status, knowledge of palliative care, psychosocial and spiritual need, practical need, and willingness to utilize palliative care services. The study found that approximately 85% of older cancer patients are willing to receive palliative care services. The significant predictors of willingness to utilize palliative care services include place of living, better palliative care knowledge, more need for spiritual and psychosocial support, and practical support. This study can guide health policymakers in increasing the rate of palliative care utilization. The suggested policies include developing community-level palliative care services in Myanmar, especially in rural areas, promoting palliative care knowledge, applying appropriate religious and spiritual traditions at palliative treatment, and developing suitable medicines for the critically ill.

scholarly journals Can interactive parental education impact health care utilization in pediatric asthma: A study in rural Texas

2018 ◽  
Vol 46 (8) ◽  
pp. 3172-3182 ◽  
Author(s):  
Vijay Agusala ◽  
Priyanka Vij ◽  
Veena Agusala ◽  
Vivekanand Dasari ◽  
Bhargavi Kola
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Parental Education ◽  
Pediatric Patients ◽  
Hospital Admissions ◽  
Care Utilization ◽  
Asthma Education ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Objective It is well known that parent/patient education helps to reduce the burden of asthma in urban areas, but data are scarce for rural areas. This study explored the impact of asthma education in Ector County, a rural part of Health Services Region 9 in Texas, which has one of the highest prevalence rates of asthma in the state. Methods This prospective study investigated an interactive asthma education intervention in pediatric patients aged 2–18 years and their caregivers. Change in parental/caregiver knowledge about their child’s asthma along with frequency of missed school days, emergency department (ED) visits and hospital admissions was obtained via telephone surveys before and after the educational intervention was delivered. Results The study enrolled 102 pediatric patients and their parents/caregivers. Asthma education was associated with significantly fewer school absences, ED visits and hospitalizations. Parents/caregivers reported feeling better educated, knowing what triggers an asthma exacerbation, identifying the signs of a severe asthma attack in their child, feeling confident about managing asthma and feeling that the asthma was under control. Conclusion Asthma education of caregivers and children was associated with better symptom management and fewer acute exacerbations, pointing to the relevance and importance of asthma education among pediatric patients in rural areas.

The Commission on Cancer Psychosocial Distress Screening Standard: The first year in review.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 198-198 ◽  
Author(s):  
Nina S. Miller ◽  
Ryan M. McCabe ◽  
Allison Knutson
Keyword(s):  
Cancer Patients ◽  
Treatment Plan ◽  
Psychosocial Care ◽  
Psychosocial Distress ◽  
Screening Tools ◽  
Institute Of Medicine ◽  
Distress Screening ◽  
Patient Centered ◽  
Screening Process ◽  
Cancer Program

198 Background: In response to recommendations from the 2007 Institute of Medicine report, Cancer Care for the Whole Patient, the American College of Surgeons’ Commission on Cancer developed a set of Continuum of Care standards, including a patient-centered standard regarding the delivery of psychosocial distress screening to all cancer patients. According to Cancer Program Standards 2012: Ensuring Patient-Centered Care, the accredited cancer program must implement a process to integrate and monitor on-site psychosocial distress screening and referral for the provision of psychosocial care. Patients experience psychological, social, financial, and behavioral issues that can interfere with their treatment plan and adversely affect outcomes. Screening processes result in the identification of distressed cancer patients and assessment and referral pathways to ensure appropriate psychosocial care provision can be obtained. The standard was established in 2012 with a 2015 implementation period allowing programs time to develop a screening, assessment, and referral process tailored to their patient population. Methods: Programs submit documentation to describe their process for delivery of care through an electronic activity report. Documentation of this standard includes the timing for delivery of the psychosocial distress screening tool; methodology; the specific tools selected with preference to validated and reliable screening tools; and a process for assessment, referral and documentation. This presentation will summarize the program submissions for 2015 and include an analysis of the details of the standard compliance as reported by accredited programs. Results: This analysis will include responses from all Commission on Cancer accredited programs reporting on this standard. The analysis will provide information about the trends in the timing, methods, and tools used by programs implementing a psychosocial distress screening process. Conclusions: This analysis will inform future decisions about standardization of a screening process and the feasibility of pooling data across centers.

Psychosocial distress screening in cancer care.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 187-187 ◽  
Author(s):  
N Mullai
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Trigger Point ◽  
Emotional Experience ◽  
Psychosocial Care ◽  
Specific Area ◽  
Psychosocial Distress ◽  
Medical Visit ◽  
Distress Screening ◽  
Distress Level

187 Background: Distress is a multifactorial, emotional experience that may interfere with patients’ ability to cope with cancer and its treatment. Recognizing and managing distress may benefit patients. The Commission on Cancer requires implementation of Standard 3.2, Psychosocial Distress Screening in 2015 and integrating distress intervention in cancer care. This study evaluates patients’ perception on benefits in this regard. Methods: Patients were screened at least once at a pivotal medical visit using a questionnaire that included various aspects of stress. NCCN’s Psychosocial Distress Screening Tool was used to measure seriousness of distress. Patients marked their distress level on a scale of 1 to 10. A threshold of 5 was set as a trigger point to start addressing distress. Results: Answers from 311 cancer patients (male 61%; female 39%) were evaluated since January 2015. A majority of patients had breast cancer (29%), followed by lung (18%), GI (18%), and hematological (12%) malignancies. The mean distress score was 3.72 (male 3.14; female 3.97). 131 patients had a score above five. Age group, 40-49 years had a higher distress (4.79) compared to others. Esophageal cancer (1%) had the highest mean score 7.33 followed by head & neck cancer (4%) with 5.67. In most patients, anxiety about cancer and its treatment was the cause of distress. However, they did not want any additional psychosocial intervention except for talking to their oncologist and primary physician. The distress of some patients was family related and they were unsure of the help needed. Two patients refused screening stating the questions were intrusive. Conclusions: Coordinated psychosocial care may benefit cancer patients with significant distress. NCCN tool helps to assess the severity of patients’ distress and to determine the need for intervention. The results (mean score of 3.72) suggest most cancer patients need no major intervention or special psychosocial counseling other than discussing with their physician and family, which is done routinely in most oncology practices. However, when stress is expressed, this tool does help the treating physicians to determine the specific area and degree of stress, to focus on the type of help needed for the patient, and to channel resources appropriately.

scholarly journals Socio-economic and rural-urban differences in healthcare and catastrophic health expenditures among cancer patients in China: analysis of the China Health and Retirement Longitudinal Study

2021 ◽  
Author(s):  
Yang Zhao ◽  
Shenglan Tang ◽  
Wenhui Mao ◽  
Tomi F Akinyemiju
Keyword(s):  
Longitudinal Study ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Service Utilization ◽  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Service ◽  
Service Use ◽  
Increased Risk ◽  
Chinese Cancer Patients

Abstract Background In China, cancer deaths account for one-fifth of all deaths and exert a heavy toll on patients, families, healthcare systems, and society as a whole. This study aims to examine socio-economic and rural-urban differences in treatment, healthcare service utilization and catastrophic health expenditure (CHE) among Chinese cancer patients, and to investigate the relationship between different treatment types and healthcare service use as well as incidence of CHE. Methods We analyzed a nationally representative sample from the China Health and Retirement Longitudinal Study including 17,224 participants in 2011 and 19,569 participants in 2015. Multivariable regression models were performed to investigate the association of cancer treatments with healthcare service utilization and CHE. Results The age-adjusted prevalence of cancer is 1.37% for 2011 and 1.84% for 2015. Approximately half of the cancer patients utilized treatment for their disease, with a higher proportion of urban residents (54%) than rural residents (46%) receiving cancer treatment in 2015. CHE declined by 22% in urban areas (25% in 2011 and 19% in 2015) but increased by 31% in rural areas (25% in 2011 to 33% in 2015). There was a positive relationship between cancer treatment and outpatient visit (OR = 2.098, 95% CI = 1.453, 3.029), admission to hospital (OR = 1.961, 95% CI = 1.346, 2.857) and CHE (OR = 1.796, 95% CI = 1.231, 2.620). Chemotherapy and surgery were each associated with a 2-fold increased risk of CHE. Conclusions Meaningful changes to improve health insurance benefit packages are needed to ensure universal, affordable and patient-centered health coverage for the Chinese cancer patients.

scholarly journals Measures of psychosocial care utilization in a national sample of cancer patients.

2019 ◽  
Vol 87 (3) ◽  
pp. 234-245 ◽  
Author(s):  
Miryam Yusufov ◽  
Joseph S. Rossi ◽  
Lawrence Grebstein ◽  
Colleen A. Redding ◽  
Ginette G. Ferszt ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Psychosocial Care ◽  
National Sample ◽  
Care Utilization

scholarly journals Determinants of Households’ Access to Improved Drinking Water Sources: A Secondary Analysis of Eswatini 2010 and 2014 Multiple Indicator Cluster Surveys

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Maswati S. Simelane ◽  
Mduduzi Colani Shongwe ◽  
Kerry Vermaak ◽  
Eugene Zwane
Keyword(s):  
Drinking Water ◽  
Rural Areas ◽  
Urban Areas ◽  
Household Head ◽  
Wealth Index ◽  
Water Sources ◽  
Lower Odds ◽  
Drinking Water Sources ◽  
Multiple Indicator ◽  
The Government

Worldwide, millions of people still die from diseases associated with inadequate water supply, sanitation, and hygiene, despite the fact that the United Nations recognized access to clean drinking water and sanitation as a human right nearly a decade ago. The objective of this study was to describe the determinants of access to improved drinking water sources in Eswatini in 2010 and 2014. Using the Eswatini Multiple Indicator Cluster Surveys (EMICSs), data for 4,819 households in 2010 and 4,843 in 2014 were analyzed. Bivariate and multivariate complementary log-log regression analyses were conducted to identify the determinants of households’ access to improved drinking water sources. The study found that households’ access to improved drinking water sources significantly improved from 73.1% in 2010 to 77.7% in 2014 (p<0.0001). In 2010, households whose heads were aged 35–54 and 55 years had lower odds of having access to improved drinking water sources than those with younger ones. In 2014, female-headed households had lower odds, while, in 2010, sex of the household head was not associated with access to improved drinking water sources. In both years, an increase in the number of household members was negatively associated with access to improved drinking water sources compared to those with fewer members. In both years, the odds of access to improved drinking water sources increased with an increase in the wealth index of the household, and households located in urban areas had higher odds of access to improved drinking water sources compared to those in rural settings. In both years, households from the Shiselweni and Lubombo regions had lower odds of access to improved drinking water sources. The government and its partners should continue to upscale efforts aimed at increasing access to improved drinking water, especially in rural areas, to reduce the disparity that exists between urban and rural households.

scholarly journals Depressive Symptoms and Healthy Behavior Frequency in Polish Postmenopausal Women from Urban and Rural Areas

2021 ◽  
Vol 18 (6) ◽  
pp. 2967
Author(s):  
Mariusz Gujski ◽  
Dorota Raczkiewicz ◽  
Ewa Humeniuk ◽  
Beata Sarecka-Hujar ◽  
Artur Wdowiak ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Postmenopausal Women ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Never Married ◽  
Healthy Behaviors ◽  
Rural Settings ◽  
Urban And Rural Areas ◽  
Behavior Frequency

The objective of this study was to determine whether the severity of depressive symptoms was linked to healthy behaviors in Polish postmenopausal women and whether the strength of the link differed between women living in urban versus rural settings. The study was conducted in 2018 in the Lublin region of Poland and included 396 postmenopausal women (239 living in rural areas and 157 in urban areas). The severity of depressive symptoms was evaluated by the Beck Depression Inventory (BDI) and the frequency of healthy behaviors was assessed using the Inventory of Healthy Behaviors. Postmenopausal women living in rural areas underwent menopause significantly earlier, were more often widowed, more often obese, more often less educated, and less likely to have never married when compared to those living in urban areas. Importantly, rural postmenopausal women endorsed more depressive symptoms (p = 0.049). There was a negative correlation between the severity of depressive symptoms and age in urban postmenopausal women (r = −0.174, p = 0.029), but this was not evident in rural women (r = −0.034, p = 0.600). The frequency of healthy behaviors was significantly lower in rural postmenopausal women, especially with respect to nutritional habits. A positive correlation was found between the frequency of healthy behaviors and the level of education in both sets of women (p = 0.034 and p = 0.045, respectively). To summarize, we found a significant link between healthy behaviors and depressive symptoms in postmenopausal women. We also found that this link was more evident in rural than in urban women.

scholarly journals Prevalence of Psychological Distress in Suriname In Urban and Rural Areas: The Suriname Health Study

2017 ◽  
Vol 1 (1) ◽  
pp. 8-17
Author(s):  
PW Gunther ◽  
M Sanches ◽  
CCF Smits ◽  
ISK Krishnadath
Keyword(s):  
Psychological Distress ◽  
Rural Areas ◽  
Urban Areas ◽  
Mental Distress ◽  
Female Gender ◽  
Health Study ◽  
Lower Odds ◽  
Psychological Distress Scale ◽  
Urban And Rural Areas ◽  
Distress Scale

Objective: To describe the presence of mental distress in a representative sample of the Surinamese ethnic groups in the population, across urban and rural areas. Design and Methods: The Kessler Psychological Distress Scale was applied to data from the Suriname Health Study (n=5,434 (15 to 65 years)) designed according to WHO Steps guidelines,to determine prevalences for mental distress in all living areas. Calculations were made in subgroups of sex, age, ethnicity, education, income, marital and employment status. The Odds Ratio (OR) for Sex and Ethnicity was estimated for mild-moderate and severe mental distress. Results: An overall prevalence of 3.8% (95%CI, 3.3-4.4) was observed for severe mental distress, 4.9% (95%CI, 4.4-5.5) for moderate mental distress and 10.8% (95%CI,10.0-11.6) for mild mental distress. The OR for mild-moderate and severe mental distress was 0.7 and 0.5 for men compared to women and higher prevalence of all categories of mental distress were found in women compared to men. Respondents with lower education and lower income showed higher prevalence of all categories of mental distress. Prevalence was also higher among respondents living in urban versus rural coastal areas, among singles versus people living with a partner and in unemployed versus employed. Maroons had higher Odds for mild-moderate and severe mental distress compared to Hindustani. Amerindian and Javanese had lower Odds for mild-moderate mental distress and Creole had lower Odds for Severe mental distress compared to Hindustani. Conclusions: Overall 19.5% of respondents reported mental distress. The main risk factors were female gender, Maroon ethnicity, low level of education and income, living in urban areas, unemployment and being single.

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