Gaining a better understanding of the needs of rural cancer patients requiring in-home palliative and end-of-life care and nursing care and services.

Abstract

Access to in-home palliative and end-of-life care (PELC), qualified professionals, and high-quality nursing care and services in rural areas is limited and unequal, thus leading to an increase in unmet needs across the care trajectory of cancer patients. A qualitative descriptive study was carried out to gain a better understanding of the needs of rural cancer patients receiving in-home PELC and to describe the nursing care and services available to them. Five rural cancer patients requiring PELC reported a variety of needs, especially those arising from limited information resources and multiple time- and energy-consuming back-and-forth trips to urban centres. Seven nurses who provide in-home care and services to rural inhabitants outlined the challenges they face in addressing these needs. These are related primarily to the long distances they are called upon to travel, the limited number of specialized professional resources available, transfers to emergency departments, the dearth of PELC training and the lack of a dedicated PELC team. These findings helped gain a better understanding of the specific needs of rural cancer patients requiring in-home PELC, as well as the challenges that nurses must confront to help their patients remain in their own homes.