A more integrated approach can support multidisciplinary teams with the capacity to maximize effective and safe C&D in health care.

It is necessary to understand the impact of factors on distress so that heightened levels can be predicted and targeted by interventions initiated at the first mention of the possibility of the presence of malignancy.

The core qualities could serve as target areas for the development of interventions aimed at modifying provider behaviours so that trust can be established, maintained or improved. Future prospective longitudinal research studies are needed that enhance understanding of trust with multiple primary care provider types.

The significant increase in the number of older adults in the USA, particularly in rural areas, has signaled the need for more research to address the health care needs of this complex, heterogeneous, and vulnerable population. However, accessing older adults in rural areas presents an especially difficult challenge for gerontological researchers. Barriers can include the normal physiological changes that accompany aging, prevalence of chronic illness and medication use, lower literacy rates, transportation issues, and a distrust of 'outsiders' and research in general. Specific strategies that may facilitate participation include the use of gatekeepers to gain entry, increased personal contact by researchers sensitive to the unique needs of older adults, and other media approaches tailored to the rural community. Understanding the characteristics of rural older adults, along with careful planning of recruitment strategies, is crucial to obtaining adequate participation and the acceptance of future research efforts.

No abstract