Barriers to accessing cancer services for adults with physical disabilities in England and Wales: an interview-based study

Abstract

ObjectivesThe aim of this study was to explore the barriers to accessing cancer services faced by adults with pre-existing physical disabilities.DesignCross-sectional, exploratory qualitative study. Data were collected by semistructured interviews and analysed thematically.SettingParticipants were recruited through statutory and third sector organisations in England and Wales between October 2017 and October 2018.Participants18 people with a diagnosis of cancer and a pre-existing physical disability.ResultsThe findings illustrate that people with physical disabilities in England and Wales face a variety of barriers to accessing cancer services. The overall theme that emerged was that participants experienced a lack of attitudinal and institutional preparation both from healthcare professionals and healthcare facilities. This overall theme is illustrated through three subthemes: lack of acknowledgment of disability, unseeing disability and physical inaccessibility.ConclusionsAs the population ages and increasing numbers of people live with cancer and disability, it is important to develop knowledge to respond to the needs of this population. The mere existence of services does not guarantee their usability. Services need to be relevant, flexible, and accessible and offered in a respectful manner. It is important that healthcare professionals work towards inclusive healthcare provision, enabling the utilisation of services by all. Necessary steps to be taken include better communication between the various professionals and across the different teams involved in patients’ care, raising awareness of how physical disability can affect or interact with cancer-related treatment and creating more accessible physical environments.

Exploring attitudes about developing cancer among patients with pre‐existing mobility disability

“…Informational support from other people with disability can help patients identify accessible medical facilities for both preventive screening and treatment, as well as identify healthcare providers equipped to manage cancer care in the context of underlying disability. Previous studies highlighted physical access barriers to cancer treatment for people with disability, notably inaccessible medical equipment, 10–13 requiring that people with disability plan ahead in anticipation of such challenges to avoid delays in care. Arranging other forms of support (i.e., identifying caregivers who could provide physical assistance with ADLs over the course of treatment) is also critical, as cancer can exacerbate mobility impairments and reduce independence with ADLs 11 …”

“…They also experience cancer care disparities, notably lower likelihoods of receiving potentially life‐saving surgery 7 , 8 or other standard treatments 9 . Research interviews with people with disability have identified barriers to screening services and cancer care, including physical access barriers, 10‐13 inadequate preparedness among clinicians and facilities for accommodating disability, 12 , 13 and challenges navigating health promotion services for cancer survivors 14 …”

An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial

“…The availability of cancer-related counseling for patients may be limited ( Haun et al, 2018 ), e.g. by lack of transportation, living in a rural area, suffering from physical disabilities, or information deficits, which prevent cancer patients from taking advantage of face-to-face support ( Zimmermann-Schlegel et al, 2017 ; Sakellariou et al, 2019 ; Neumann et al, 2010 ). In addition, barriers on the side of psychotherapists refer to uncertainties in the treatment of somatically ill patients, organizational problems, or lack of expertise, which are reflected in low proportions of patients in psychotherapeutic practices ( Schwarz et al, 2006 ).…”

Perspectives of Patients with Pre-existing Mobility Disability on the Process of Diagnosing Their Cancer

“…[4][5][6] However, few studies have explored in-depth the experiences of patients with mobility disability with the process of cancer diagnosis. [7][8][9][10][11] One such study from the United Kingdom identified broad factors within their healthcare delivery system that might affect the process of diagnosing cancer among people with mobility disability, including physical access barriers, lack of recognition of disability-related needs, and lack of consideration of aspects of living with disability that may affect cancer care (e.g., various required accommodations). 9 Thus, little information is available about important aspects of cancer care for a population that, despite relatively high rates of cancer, 3 nonetheless experiences disparities in screening and barriers to accessing care.…”

“…[7][8][9][10][11] One such study from the United Kingdom identified broad factors within their healthcare delivery system that might affect the process of diagnosing cancer among people with mobility disability, including physical access barriers, lack of recognition of disability-related needs, and lack of consideration of aspects of living with disability that may affect cancer care (e.g., various required accommodations). 9 Thus, little information is available about important aspects of cancer care for a population that, despite relatively high rates of cancer, 3 nonetheless experiences disparities in screening and barriers to accessing care. 4,12 To explore aspects of cancer care contributing to disability disparities, we framed our study around the model of disability adopted by the World Health Organization (WHO) in 2001.…”