Aust. J. Rural Health (2002) 10, 188 –195 Blackwell Science, Ltd Oxford, UK AJR The Australian Journal of Rural Health 1038-5282 2002 Blackwell Science Asia Pty Ltd 10 436 Australian journal of rural health The needs of cancer patients and their families: A. M. CLAVARINO et al. 10.1046/j.1038-5282.2002.00436.x Original Article BEES SGML Original Article THE NEEDS OF CANCER PATIENTS AND THEIR FAMILIES FROM RURAL AND REMOTE AREAS OF QUEENSLAND Alexandra M. Clavarino, John B. Lowe, Sue-Ann Carmont and Kevin Balanda Centre for Health Promotion and Cancer Prevention Research, School of Population Health, University of Queensland Medical School, Herston, Queensland, Australia ABSTRACT: This study examines the impact of travelling for treatment on cancer patients and their families. Twenty-eight consecutive cancer patients, who were receiving radiation therapy treatment and 19 family carers, com- pleted a structured needs assessment questionnaire and an in-depth interview. Both patients and carers reported moderate to high levels of unmet psychological need. Carers were found to have higher levels of anxiety than patients, although both groups had higher anxiety levels than the general population. Taking more responsibility for household tasks and organising new living arrangements for the family were the most frequently identified demands of a dual burden of caring. Nearly 40% of carers reported some disruption to their schedule and half reported experiencing financial difficulties. The qualitative interviews highlight the disruption that parents and children experience under the present system, particularly in relation to the demands of family life and the need to maintain some level of continuity and security for children. KEY WORDS: burden of care, family caregiving, family disruption, psychological distress, rural and remote. INTRODUCTION Approximately 29% of Australians live in rural and remote areas and some of the difficulties associated with accessing both community and hospital-based, generalist and specialist services for medical care are well docu- mented. 1–3 Major concerns include a lack of specialised local care, additional costs associated with travel require- ments and accommodation needs. 3–5 The location of the treatment facility and the frequency of treatment have the potential to significantly disrupt family life. 6 These logistic concerns can have their greatest impact where long-term treatment requires a parent to be physi- cally separated from family and friends for extended periods of time. 7 This is of particular relevance for cancer patients requiring radiation therapy for their disease. The increased burden placed on cancer patients, particularly breast cancer patients, from rural and remote areas who must travel for treatment is well documented. 1,2,4,8 Cancer patients in Queensland who require radiotherapy treat- ment can only access that service in one of three major metropolitan centres, only one of which is located outside Brisbane. Generally, radiation treatment for diseases such as breast cancer requires attendance daily for a period of approximately 4 weeks or possibly longer. 9 For many rural and remote dwellers, these health services can only be accessed at considerable expense to patients or their sources of support. Early discharge and greater reliance on outpatient care has shifted the demand from professional caregivers towards family members who provide informal but ongoing care to patients in their homes. 10 We need to know more about the impact that this caring role has on carers and families of patients from rural and remote areas. Correspondence: Dr Alexandra M. Clavarino, Centre for Health Promotion and Cancer Prevention Research, School of Population Health, University of Queensland Medical School, Herston Road, Herston, Queensland 4006, Australia. Email: a.clavarino@sph.uq.edu.au Accepted for publication January 2002.