AN ASSESSMENT OF THE PSYCHOSOCIAL NEEDS OF RURAL CANCER PATIENTS LIVING IN THE ADIRONDACK REGION OF NORTHERN NY

1. AN ASSESSMENT OF THE PSYCHOSOCIAL NEEDS OF RURAL CANCER PATIENTS LIVING IN THE ADIRONDACK REGION OF NORTHERN NY Alison Riley-Clark MSN RN & Barbara Pieper PhD RN The Sage Colleges SHS Graduate Nursing Program

2. RURAL AREAS: RECURRING THEMES • Unique demographics and needs • Have shortages of health care providers and cancer specialists • (Hughes, Ingleton, Noble & Clark, 2004) • “Although 20 % of Americans live in rural areas only 9% of MD’s practice there” (AHRQ, 2004) • Medicare reimbursements are lower for rural hospitals for the same services. • (Ricketts, 2000) • Higher percentage of residents >65, more patients on Medicare, less revenues • Population has lower income and education levels • (National Rural Health Association, 2008) • Transportation difficulties • Isolated communities • Lack of hospitals & home health services • (Baltic,Whedon, Ahles & Funciullo, 2002) • Limited Internet and cell phone access

5. Adirondack Medical Center, Franklin Co. • 97 beds, cancer clinic with visiting • oncologist 2 days per week • Elizabethtown Hospital, Essex Co. • 15 beds, just added chemotx services • Alice Hyde Medical Center, Franklin Co. • 76 beds. Cancer clinic, oncologist • and radiation therapy services • HAMILTON COUNTY HAS NO HOSPITAL HOSPITALS IN THE ADIRONDACK PARK

6. Residents Over 65 Years by County Essex County – 16.7% Franklin County – 13.2% Hamilton County – 21.5% New York State – 13.2% US Census, 2000

7. PURPOSE OF THE STUDY • Describe the self reported psychosocial needs of • rural cancer patients living in the Adk region. • Identify barriers that prevent rural cancer patients • from accessing available services. • Data will be used to plan new programs for Adirondack cancer patients by local and state cancer providers. • Add to the literature on the needs of rural • cancer patients

8. RESEARCH QUESTIONS • What are the self-reported psychosocial needs of rural Adirondack cancer patients? • Do these patients have access to cancer services and if not, what are the barriers to obtaining quality care and services? • What services do patients want to have available? • What percent of patients have access to computers & online services? • What methods do patients prefer to get more information about their disease ?

9. SURVEY TOOL • Designed by researchers • Brief, only 3-5 minutes to complete • 7 Demographic questions • 8 Likert scale questions • Checklist of preferred services • Checklist for info delivery methods • Comment section

10. METHODS *Survey Distribution Adirondack Medical Center Oncology Center Local ENT Physician Office Cancer Support Group Meetings *Staff gave patients survey, a pen and an envelope. *Respondents placed the completed survey in the envelope and then in a locked collection box. *Study approved by IRB at The Sage Colleges

13. Characteristics (n=46) • 97.9% never had missed an appointment • due to difficulty getting a ride, buying gas or • car problems. • 81% have Internet access • 19% have no Internet access • 13% never use Internet for information • 47% had attended a support group. • 72% expressed some interest to very interested in attending a support group. • 47% felt scared, anxious, sad or worried several times a month, weekly or daily.

15. Services patients preferred to help deal with their cancer.

17. RECOMMENDATIONS • Explore providing laptop computers/epads with Internet access during treatments. • Locate and apply for additional grant funding for yoga/guided imagery/massage sessions • Expand availability of counseling and education specific to coping with cancer & stress. • Expand support group services and explore strategies to connect patients to each other. • Continue to provide written educational materials as well as print-outs/computer discs from cancer websites for those without access • Explore using ebooks and enlarging patient lending library.

18. QUESTIONS? Contact Information Alison Riley-Clark 518-523-2212 arclark59@gmail.com

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