The Role of Primary Care Providers in Transitioning Rural Cancer Survivors and Family Caregivers to Extended Survivorship

Abstract

1.<h3>Context:</h3> Rural cancer survivors and their family caregivers have poor quality of life as survivors transition from active cancer treatment to extended survivorship. This outcome is related to poor access to specialty care and survivorship services, such as support groups. Primary care providers (PCPs) are critical to supporting rural survivors and their family caregivers’ during the transition to survivorship. 2.<h3>Objective:</h3> To describe the role of PCPs in transitioning rural cancer survivors and their family caregivers from active cancer treatment to extended survivorship 3.<h3>Study design and analysis:</h3> This was a secondary analysis of a qualitative descriptive study. 60-90 minute interviews were recorded, transcribed, and verified in qualitative software (n=6 rural cancer survivors, 4 caregivers, and one survivor who was also a caregiver; 100% women). Data were analyzed using an inductive coding strategy, and thematic analysis was used to develop key themes. 4.<h3>Setting:</h3> Southwest Virginia, a geographically isolated region that is part of Central Appalachia. 5.<h3>Population studied:</h3> Rural cancer survivors who were 1-5 years posttreatment living in and unpaid family or friend caregivers who assisted with medical care, activities of daily living, or finances. 6.<h3>Intervention/Instrument:</h3> A 14-item semi-structured interview guide was informed by Bernacchi’s conceptual framework of rural resilience and the current rural survivorship literature. 7.<h3>Outcome measures:</h3> We developed three key themes from the data. 8.<h3>Results:</h3> The three themes were 1) family caregivers are willing to accept a mental healthcare referral from a PCP, 2) rural cancer survivors build trust with their PCPs through spiritual care, and 3) rural cancer survivors and their family caregivers need increased follow-up from PCPs while transitioning from active treatment to extended survivorship. 9.<h3>Conclusions:</h3> Rural cancer survivors and their family caregivers trust PCPs to coordinate posttreatment care and to provide culturally-appropriate care. Rural cancer survivors prefer a family-based approach to primary care, in which PCPs actively engage family caregivers in survivorship care and provide resources and referrals as needed. Future research is needed to develop and test family-based interventions that PCPs can deliver to support rural survivors and their family caregivers during the transition to extended survivorship.