Clinician and consumer perceptions of head and neck cancer services in rural areas: Implications for speech pathology service delivery

Abstract

Objective: Individuals with head and neck cancer residing in rural areas face numerous challenges accessing post-acute rehabilitation services, including speech pathology services. In order to inform future service enhancements, the key issues impacting access to, and the provision of, speech pathology head and neck cancer services in rural areas was explored through the perspectives of patients, carers, speech pathology clinicians and service managers.

Setting: A rural health referral network in Queensland consisting of tertiary, regional and remote hospitals.

Participants: Twenty-eight participants, including 12 speech pathology staff/managers and 16 consumers (people with head and neck cancer/carers).

Design: Qualitative methodology using semi-structured interviews was analysed using content analysis.

Results: Two themes were identified from the consumer group including (a) navigating health services for head and neck cancer management and (b) burden of accessing head and neck cancer care. Speech pathology staff/managers interviews raised 3 themes: (a) transfer of care and access to local services, (b) workforce and workload and (c) travelling impacts the service our patients can receive. An integrative theme across both groups highlighted the perceived disparity in health care access that existed for people with head and neck cancer in rural areas.

Conclusions: In rural areas, consumers face multiple barriers navigating the head and neck cancer treatment pathway, while health services encounter specific challenges ensuring access and equity in care. Despite the complexities, possible avenues for service change and service enhancement are proposed. Speech pathology services in rural areas need to proactively evaluate services and address existing disparities in order to enact positive change for people with head and neck cancer living outside metropolitan locations.

Keywords: head and neck cancer; health service improvement; qualitative research; rural health; service delivery; speech pathology.