Enhancing psychosocial care for people with cancer in rural communities: what can remote counselling offer?

Abstract

Rural cancer patients are often disadvantaged in access to psychological services. We reviewed remote counselling research for psychological support using telephone, videoconferencing, and the Internet as a potential solution. Telephone counselling is the most extensively researched, while there are encouraging findings in emerging research about videoconferencing and Internetbased psychological care. Where no face-to-face psychological service exists, these technologies are promising, yet unproven. Less variable methods are needed to better assess the technology and therapeutic approach for stronger evidence.

“Receptivity”: An Important Factor Affecting Supportive Care Provision

“…The findings from this study indicate that if research is to be useful for those developing supportive care services, there needs to be a shift in perspective that moves from broad categories of access to that of individual receptivity that is respectful of the multitude of factors that affect any and every individual. By way of example, these findings do acknowledge the extensive literature that indicates living in regional, rural, and remote areas can be a barrier to availability and engagement with supportive care services (Collie et al, 2007;Jones et al, 2008;O'Brien et al, 2008;Shepherd , 2008). However, this is only part of the story.…”

“…For example, although working in the area of malignant brain tumors, Arber et al (2010) recommended that a focus on uptake and response to supportive care services should be documented throughout the illness trajectory. There is an increasing body of research that explores the range of new and technologybased modes of communication used to reach people isolated by distance and unable to access person-to-person contact such as videoconferencing and online support groups (Collie et al, 2007;Shepherd et al, 2008;van Uden-Kraan et al, 2009). The linking of such research with an exploration of receptivity promises an effective and productive new direction of responding to psychosocial need.…”

“…The available literature implies that dominant variables such as gender (Manii & Ammerman, 2008), geographical location (Collie et al, 2007;Jones et al, 2008;O'Brien et al, 2008;Shepherd et al, 2008), and type of cancer (Couture et al, 2008) determine the behavior of each individual. Perhaps this framework is driven by the focus on access to treatment and the restriction of the research to clinical health services.…”

“…The notion of access has some relevance to this challenge. Although predominantly focused on clinical treatment and screening services (Baker & Schwartz, 2005;Couture, Nguyen, Alvarado, Velasquez, & Zunzunegui, 2008;Facione, 1999;Facione & Facione, 1997;Greiner, Engelman, Hall, & Ellerbeck, 2004;Haran, 2003;Jones et al, 2008;Mele, Archer, & Pusch, 2005;Reid & Porter, 2011;Shahid, Finn, Bessarab, & Thompson, 2011;Shepherd, Goldstein, Olver, & Parle, 2008;Wolff & Ellis, 2009), the research on access is predicated on the democratic principle that all should have equal access to service provision. However it is only recently that research focused on access issues has included the psychosocial aspects of care (Arber, Faithful, Plaskota, Lucas, & de Vries, 2010;O'Brien, Harris, King, & O'Brien, 2008;Whittier, Scharlach, & Dal Santo, 2005).…”

Survivors at Higher Risk for Adverse Late Outcomes Due to Psychosocial and Behavioral Risk Factors

“…Thus, employing interventions that can be widely disseminated is critical to advancing science and providing equal access for disparate populations. Technology, such as the telephone, Internet, smart phones, and videoconferencing, allows for remote counseling/interventions and thus more widespread dissemination of psychosocial and behavioral programs (150). Although research on the development of costeffective and easily disseminated programs for improving the QOL of cancer survivors progresses, change in the health care system is needed to integrate these programs into cancer treatment plans.…”