Self-management self-efficacy in people living with and beyond cancer (PLWABC) post-treatment: A rural-urban comparison in the East Midlands of England.


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David Nelson1,Ros Kane1,Ian McGonagle1,Paul Turner1,Christine Jackson1,Gianina Postavaru2
1University of Lincoln,2Bishop Grosseteste University

Abstract

Background

The needs and challenges of PLWABC in rural areas are well documented, however, there is a lack of research examining whether rural-urban residence has a significant bearing on self-efficacy (belief to execute behaviour) to self-manage the consequences of cancer following treatment. The aim of this study was to identify and compare self-management self-efficacy in a sample of PLWABC who were post-treatment from rural and urban areas in the East Midlands of England.

Method

The study used a cross-sectional self-completion postal questionnaire that collected data on demographics, rural-urban residence, and self-management self-efficacy. Participants rated their confidence to perform 11 self-management behaviours (1=not at all confident to 10=totally confident). Mean scores were calculated and a higher score was indicative of high self-efficacy. Independent samples t Tests compared mean scores between rural and urban participants.

Results

227 participants completed and returned a questionnaire. The mean age was 66.86±11.22 (range 26-90). The most common cancer sites were breast (32%), urological (23%) and upper and lower GI (18%). 52% of participants were female, 48% male, 45% resided in rural areas and 53% in urban areas. Overall, the mean self-efficacy score was 7.44±1.91 (range 1.73-10.0). Rural participants (7.86±1.70) reported significantly (p<.01) higher cancer-related self-efficacy compared to those in urban areas (7.09±1.96). In terms of confidence to perform specific self-management tasks, rural participants had significantly higher self-efficacy than urban respondents with regards to managing fatigue (p<.05), physical discomfort (p<.01), emotional distress (p<.001), other symptoms or health problems (p<.05), and problems caused by cancer and its treatment (p<.05).

Conclusion

Whilst the active treatment phase can present significant challenges for PLWABC in rural areas the findings suggest that the rural environment has the potential to increase self-management self-efficacy in the transition to survivorship.