ArticleJMIR formative research2022
Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study.
Article in JMIR formative research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Effects of Remote Web-Based Interventions on the Physiological and Psychological States of Patients With Cancer: Systematic Review With Meta-Analysis.JMIR mHealth and uHealth · 2025Pooled it
- Navigating rural challenges and promoting posttraumatic growth via expressive writing: a qualitative study among rural breast cancer survivors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Uncharted stigma: a descriptive report exploring HIV- and cancer-related stigma among cancer survivors living with HIV.AIDS research and therapy · 2026Article
- Barriers and Facilitators to Timely Adjuvant Therapy for Head and Neck Cancer in Rural Care.JAMA otolaryngology-- head & neck surgery · 2026Article
- Navigating rural challenges and promoting posttraumatic growth via expressive writing: A qualitative study among rural breast cancer survivors.Research square · 2026Article
- Functional disability and multidimensional hardship among cancer survivors in the USA: a nationally representative study.Journal of cancer survivorship : research and practice · 2026Article
- "Just give it to us straight!": a qualitative analysis of midwestern rural lung cancer survivors and caregivers about survivorship care experiences.Journal of cancer survivorship : research and practice · 2025Article
- Getting back on track after treatment of cancer: A qualitative interview study of cancer survivors' experiences.PloS one · 2025Article
- Rural comprehensive cancer care: Qualitative analysis of current challenges and opportunities.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- The relationship between felt stigma and non-fatal overdose among rural people who use drugs.Harm reduction journal · 2024Article
- Similarities and differences across the underlying dimensions of social functioning in rural and nonrural cancer survivors: A mixed-methods study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Cancer Survivors' Experiences of Navigating the Australian Health Care System for Physical and Mental Health Care Needs.International journal of environmental research and public health · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEven when technology allows rural cancer survivors to connect with supportive care providers from a distance, uptake of psychosocial referrals is low. Fewer than one-third of participants in a telemedicine intervention for identifying rural survivors with high distress and connecting them with care accepted psychosocial referral.
objectiveThe purpose of this research was to examine the reasons for which rural cancer survivors did not accept a psychosocial referral.
methodsWe utilized a qualitative design to address the research purpose. We interviewed participants who had been offered psychosocial referral. Semistructured interviews were conducted 6 weeks later (n=14), and structured interviews were conducted 9 months later (n=6). Data were analyzed descriptively using an inductive approach.
resultsUltimately, none of the rural cancer survivors (0/14, 0%) engaged with a psychosocial care provider, including those who had originally accepted referrals (0/4, 0%) for further psychosocial care. When explaining their decisions, survivors minimized their distress, emphasizing their self-reliance and the need to handle distress on their own. They expressed a preference for dealing with distress via informal support networks, which was often limited to close family members. No survivors endorsed public stigma as a barrier to accepting psychosocial help, but several suggested that self-stigma associated with not being able to handle their own distress was a reason for not seeking care.
conclusionsRural cancer survivors' willingness to accept a psychosocial referral may be mediated by the rural cultural norm of self-reliance and by self-stigma. Interventions to address referral uptake may benefit from further illumination of these relationships as well as a strength-based approach that emphasizes positive aspects of the rural community and individual self-affirmation.
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