2. Important things for urban-based health professionals to consider when treating rural patients
Many find coming to the city and finding their way around very stressful.
Staff in small rural hospitals are often familiar with their patients; these patients can find the anonymity of large urban hospitals overwhelming, impersonal and, at least initially, distressing and difficult to navigate.
Being away from family, friends and support networks during treatment adds to levels of distress.
Most rural patients appreciate the acknowledgement that they have travelled from their rural homes for the appointment.
As travelling is tiring and difficult, having appointments scheduled together and not changed at the last minute is essential.
Ask “What do I need to know about you that will help me to help you?” This helps build rapport and gives them an opportunity to raise preferences about how treatment can be structured to accommodate work and family commitments.
Where possible, suggest making arrangements for tests (e.g. blood tests prior to chemotherapy) to be done close to the patient’s home to minimise the amount of time spent away from home. If possible, check that this will not cost the patient extra.
Stigma and rural values (e.g. reluctance to complain or to ask for help) can make it difficult for rural patients to access support services and reluctant to report difficulties such as side effects or negative emotions. An explanation that psychosocial care is recommended as a standard part of treatment for allcancer patients is helpful. A direct question on what sorts of difficulties they have experienced may help them broach this subject.
Clear communication between rural GPs and urban specialists is a necessity. Rural patients may experience anxiety upon leaving urban-based treatment facilities, particularly if these patients are concerned that their local GP does not have a good understanding of their medical situation.
Discharge planning is very important. Be familiar with exactly what services are available to support patients on their return home to rural communities.
Make a referral to psychosocial services in metropolitan treatment centres and/or inform rural patients about relevant support services in their local area. This will increase the likelihood that services are accessed.
To help identify relevant support services in rural areas, use the service directory section of this website.
Try to employ simple, lay language wherever possible.
Encourage patients and their supporters to take notes, ask questions and report side effects.
Try to demonstrate a personal interest in the person beyond their illness.
Ask patients if they understand why they are having a particular treatment, taking a particular medication etc.