Abstract

Background: There is a lack of research examining whether rural-urban residence has a significant impact on confidence to self-manage the consequences of cancer following treatment. The aim of this study was to compare confidence to self-manage in a sample of people affected by cancer who were post treatment from rural and urban settings in the East Midlands of England.

Methods: The study used a cross-sectional self-completion questionnaire that collected data on demographics, rural-urban residence, and confidence to self-manage using the Cancer Survivors Self-Efficacy Scale (Foster et al, 2013). Participants rated their confidence to perform 11 self-management behaviours (1 = not at all confident to 10 = totally confident). Independent samples t Tests and Mann Whitney U Tests were conducted.

Results: 227 participants completed a questionnaire (27% response rate). The mean age was 66.86 ± 11.22 (range 26–90). 52% of participants were female and 48% male. With regards to residence, 45% resided in rural areas and 53% in urban areas. Overall, rural participants (7.86 ± 1.70) reported significantly (p < 0.01) 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 confidence to manage fatigue (p < 0.05), physical discomfort (p < 0.01), emotional distress (p < 0.001), other symptoms or health problems (p < 0.05), and to deal with problems caused by cancer by themselves (p < 0.05).

Conclusions: Whilst the active treatment phase presents considerable challenges for individuals in rural areas the findings suggest that the rural environment has the potential to positively influence confidence to self-manage in the transition to survivorship.