A recent qualitative study sheds light on the complex factors that shape rural cancer survivors’ engagement in symptom self-management, offering critical insights for oncology clinicians supporting patients in geographically and socioeconomically disadvantaged areas.

The study involved a purposive sample of 10 rural cancer survivors who participated in a series of 8 virtual focus groups over 6 months. All participants lived in areas characterized by limited healthcare capacity, low insurance coverage, and economic hardship. Researchers analyzed transcripts using content analysis to identify key influences on self-management behaviors.

Researchers identified 6 distinct categories as core factors shaping the use of symptom self-management strategies:

1. Credibility—Participants emphasized the importance of trusting the source of information. “Credibility was described as important and based on personal experiences and testimonials from other patients, friends, and neighbors,” the study noted.
2. Symptom Experiences—Severity and type of symptoms played a key role in determining whether individuals pursued self-management options.
3. Perceived Outcomes—Survivors weighed both symptom relief and broader quality-of-life improvements, as well as concerns about safety.
4. Accessibility—A prominent barrier for rural patients. Internet and broadband limitations, transportation challenges, and geographic isolation were frequently cited. “Rural-specific responses were concentrated in the category of accessibility,” the authors observed.
5. Consistency with Personal Preferences—Individual attitudes such as a desire for autonomy or discomfort with receiving help significantly influenced engagement.
6. Motivational Supports—Social support systems and accountability mechanisms helped sustain use of strategies over time.

These findings carry actionable implications for clinical practice. Oncology providers serving rural populations should prioritize interventions that directly address accessibility—particularly broadband and transportation limitations—and consider local infrastructure when recommending resources. Providers should also assess individual preferences and existing social supports when developing symptom management plans.

Tailoring messages to enhance credibility and match patient symptom profiles may further improve uptake. As the authors concluded, “Intervention components should also highlight credible messaging, target specific symptom types and severity, set accurate outcome expectations, tailor recommendations based on personal preferences, and include motivational support.”

This study underscores the need for nuanced, context-aware approaches in survivorship care planning, particularly for rural populations that remain at elevated risk of poor symptom control and associated disparities in quality of life.

Source:

Kwekkeboom K, Eo Y, Hawn R, Phelps K, Stevens J. Factors Influencing Rural Cancer Survivors’ Use of Symptom Self-Management Strategies. Presented at the 50^th Annual ONS Congress; April 9-12, 2025. Denver, CO.