Similarities and differences across the underlying dimensions of social functioning in rural and nonrural cancer survivors: A mixed-methods study

Purpose: For cancer survivors, social functioning greatly influences other quality of life dimensions. While there is potential for differences in social functioning to vary as a function of geographic residence, few studies examine the social functioning of rural cancer survivors specifically. This study aims to help fill this gap. Methods: This was an embedded mixed-methods study where all participants completed a questionnaire, and some were purposively selected to complete an interview to gather more information about social functioning (ie, social roles, activities, network, support, and constraint). Participants (n = 93; 63% rural) were recruited through a state cancer registry and cancer care facility. Participants were predominately White, non-Hispanic (92.47%), roughly half female (54.84%), and on average, diagnosed in the past two years (SD = 1.68), and 61.45 (SD = 10.87) years old. Findings: Few differences in the social functioning of rural and nonrural participants were found on questionnaires, though rural participants reported larger networks and more overall support. Across groups, common themes in the interview data were the experience of both social support (eg, instrumental support) and social constraint (eg, others minimizing participants’ problems or sharing their own negative experiences). Conclusions: This was the first cancer survivorship study to thoroughly examine social functioning by geographic residence. Rural cancer survivors described some unique strengths, but major group differences were not apparent. All participants highlighted situations when others, even with good intentions, were unhelpful to them. Future interventions to improve social functioning could work to dispel the belief that cancer survivors should handle their cancer on their own.