title: The diagnosis and treatment decisions of cancer patients in rural Western Australia.
abstract: BACKGROUND
  People living in rural areas who have a diagnosis of cancer have poorer outcomes than people living in urban centers. The reasons for this are unclear. Little is known about the impact that living in a rural area has on the diagnosis and treatment decisions of these people and how these may in turn impact on care outcomes.
  
  
  OBJECTIVE
  This study explored the reasons why people living in rural areas may delay diagnosis and what issues affected the decisions they made regarding their cancer treatment.
  
  
  METHODS
  In depth, semistructured interviews were conducted with 18 participants from 3 rural Western Australian health regions. Content analysis was used to develop themes.
  
  
  RESULTS
  Four themes were identified to describe the rural cancer experience. The first 3 themes, Experiences of Diagnosis and Referral, The Treatment Journey, and Managing your own Care, relate to the experiences of rural cancer patients during their journey through the health care system. The final overarching theme, Implicit Faith, described the level of confidence that rural cancer patients had in the health system, often despite delays and inconveniences.
  
  
  CONCLUSIONS
  There is a need to improve primary health care and care coordination for rural cancer patients living in Australia and to promote self-advocacy and consumer empowerment for rural cancer patients.
  
  
  CONCLUSIONS
  Rural patients need help and support throughout their cancer journey, including through the process of diagnosis.
authors.affiliation: Western Australian Centre for Cancer and Palliative Care, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: McConigley
authors.forename: Kristi
authors.initials: K
authors.lastname: Holloway
authors.forename: Jodi
authors.initials: J
authors.lastname: Smith
authors.forename: Georgia
authors.initials: G
authors.lastname: Halkett
authors.forename: Jo
authors.initials: J
authors.lastname: Keyser
authors.forename: Samar
authors.initials: S
authors.lastname: Aoun
authors.forename: Leanne
authors.initials: L
authors.lastname: Monterosso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D019035:Rural Health Services; D012424:Rural Population / Q000706:statistics & numerical data; D014904:Western Australia