329

Learning Objective #1: determine primary care providers' perceptions of breast cancer care for women patients in their practice

Learning Objective #2: discover providers' perceptions of their role in the cancer care continuum for rural Appalachian women

---

The purpose of this qualitative analysis was to determine rural primary care providers’ perceptions on cancer care for women patients and to discover their perceptions of their role in the cancer care continuum. The study was conducted in focus groups in three rural practices in southwest Virginia and northeast Tennessee. Primary care providers and their patients are concerned with screening for breast cancer. Rural Appalachian primary care providers report that barriers to recommended screening in their office practices include time constraints, conflicting guidelines and perceptions that patients do not value prevention (Shell & Tudiver, 2004). A qualitative, inductive approach was utilized to collect interview data. Data were generated from structured focus group sessions and investigator fieldnotes. Data collection and analysis proceeded simultaneously. Data were generated from primary care physicians, nurse practitioners and one doctorally prepared psychologist (N=26). Focus group interviews were audiotaped and were transcribed verbatim. Data were analyzed using the constant comparative method where portions of text were compared to yield categories and themes. Emergent findings were reviewed with a group of health professionals (advanced practice nurses) to assist with establishing credibility and truth. Primary care providers in the study described their experiences of providing cancer care to rural women with breast cancer. For all providers, (physicians, nurse practitioners, LPC), their relationships with patients were paramount, provided support for patients to seek screening when they hadn’t before, and were the impetus for providers to problem-solve, coordinate, and piece together services needed by patients. Three themes emerged from the interview data: Knowing the Patient; Walking Through Treatment with the Patient; and Losing the Patient to the System. Understanding of the experiences of providers and patients may influence cancer care for rural women and provide evidence that will help reduce disparities in coordination of care in rural settings.