Self-Management Following Cancer Treatment: A mixed methods study of rural and urban populations in the East Midlands of England.

Introduction: The needs and challenges of People Living with and Beyond Cancer (PLWABC) are well documented but there is a lack of research examining the influence of rural-urban residence on the ability to self-manage the consequences of cancer. The aim of this study was to identify and compare self-management behaviours and practices in a sample of PLWABC who were post-treatment from rural and urban areas. Methods: This mixed methods study used a cross-sectional self-completion postal questionnaire to collect data on demographics, rural-urban residence and a range of items related to self-management behaviours. Mean scores were calculated and a higher score was indicative of confidence to self-manage. Independent samples t Tests compared mean scores between rural and urban participants. The questionnaire also included a free text option for additional responses. These responses were independently analysed using thematic analysis. Results: 227 participants returned a questionnaire. The mean age was 66.86±11.22 (range 26-90). 52% of participants were female, 48% male, 45% resided in rural areas and 53% in urban areas. Rural participants (7.86±1.70) reported significantly (p<.01) higher cancer-related self-management behaviour compared to urban participants (7.09±1.96). 56% (n=128) of the total sample (n=227) completed the free text response. The overarching theme was of the participants “moving on” from cancer and developing a meaningful life for themselves. This involved significant life adjustments. Other themes emerged relating to making adjustments to health behaviours and the importance of clinical and non-clinical support. Conclusions: The findings of this large-scale study offer valuable insights into the self-management experiences of people post cancer treatment. 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 in the transition to survivorship. Implications for international nursing practice will be discussed in the presentation.