“Double whammy”: a rapid review of rural vs urban psychosocial cancer experiences and telehealth service in five countries during the COVID-19 pandemic

Abstract

Background Cancer is a long-term condition with biopsychosocial components. People with cancer living in rural areas can have poorer treatment outcomes and higher rates of unmet psychosocial needs than those in urban areas. Cancer, as opposed to other chronic conditions, poses a unique challenge in this current COVID-19 pandemic context, given immunocompromised states of patients and long-term survivor treatment effects. The disaggregated impact of psychosocial issues potentiated by the pandemic on rural vs. urban cancer populations is yet to be quantified. This rapid review investigates whether (i) people with cancer are experiencing pandemic-related psychosocial impacts, (ii) these impacts are equivalent in urban and rural locations, and (iii) whether the rapid uptake of telehealth mitigates or reinforces any identified impacts. Method A rapid review was conducted for literature published between December 2019 and 13 August 2021. Results Fifteen papers were included, incorporating evidence from five countries. The available literature suggests people affected by cancer living in rural areas are evidencing disproportionate psychosocial impacts of COVID-19, compounding cancer experiences. Despite its widespread and necessary use during the pandemic, telehealth was identified as an additional challenge for rural people with cancer. Conclusions Clinicians working with rural people affected by cancer should ensure recognition of the greater risks of psychosocial concerns in their rural patients, and reduced access to health services. Whilst telehealth and other remote technologies are useful and necessary in this pandemic era, clinicians should consider whether its use benefits their rural clients or reinforces existing disparities.

Exploring the Impact of the COVID-19 Pandemic on Cancer-Related Distress Among Thoracic Oncology Patients at a Rural Cancer Center

“…These ndings are consistent with results from a rapid review of 15 articles, which observed disproportionate psychosocial consequences of COVID-19 among individuals treated for cancer in rural regions [23]. Our results also align with previous studies demonstrating the adverse impact of the COVID-19 pandemic on health-related quality of life among rural cancer survivors [25,33]. Conversely, a study comparing urban and rural cancer populations in Utah did not observe any signi cant differences in psychosocial distress indicators of social interactions, loneliness, nancial strain, or accumulating di culties after the onset of COVID-19 [24].…”

“…Conversely, a study comparing urban and rural cancer populations in Utah did not observe any signi cant differences in psychosocial distress indicators of social interactions, loneliness, nancial strain, or accumulating di culties after the onset of COVID-19 [24]. Moreover, no signi cant changes in psychosocial distress were observed after the onset of COVID-19 among individuals treated for breast cancer at an urban hospital in Germany [25,34]. Discrepancies in ndings across studies may be due to differences in access barriers across geographical locations [25], and/or differences in cancer site, and social determinants of health, which could differentially impact experienced distress and quality of life measures [9,11,29,35].…”

“…Growing evidence indicates that CRD has also increased since the onset of the pandemic [22,23], and this may have more adversely affected individuals in rural areas with limited access to supportive services. Yet, the potential impact of the COVID-19 pandemic on CRD among rural cancer patients remains uncertain, with prior studies demonstrating varied results [24,25].…”

Supportive Care in Pediatric Oncology: Opportunities and Future Directions

“…Assessing and addressing the psychosocial needs of patients with cancer is crucial for coping, adjustment, and overall well-being [16]. Effective intervention requires the systematic identification of risk factors, symptoms, and associated impacts on medical care to anticipate challenges and mobilize supportive care resources before concerns escalate [17][18][19]. Many centers have begun to integrate psychosocial screening and routine check-ins using PROs into care models to assess patients before, during, and after treatment in accordance with practice standards [20][21][22].…”

Social influence, performance expectancy, and price value as determinants of telemedicine services acceptance in Chile

“…Traditional healthcare services have evolved to online care services to patients called telemedicine [8] , a beneficial service for online people. As the work of [9] describes, telemedicine can be a healthcare solution for people in countryside areas. However, this leaves 2.7 billion people offline [7] , [10] .…”