Disparity in cancer survivorship care: A cross-sectional study of telehealth use among cancer nurses in Australia

A B S T R A C T Background: Cancer survivors living in rural and remote areas of Australia experience poorer health outcomes than their metropolitan counterparts. Telehealth provides opportunities for the delivery of survivorship care. Aim: To investigate the preparedness of the cancer nursing workforce in Australia to deliver survivorship care using telehealth. Methods: Through a nationally disseminated online survey, nurses' perceptions, attitudes and use of telehealth to deliver cancer survivorship care were assessed using the Technology Acceptance Model (TAM21) scale. Educational and occupational characteristics were also collected. Data were analysed using descriptive statistics and logistic regression. Findings: Seventy-nine respondents completed the survey. Fifteen nurses (19%) used telehealth for cancer survivorship care, with nurses in Queensland and New South Wales five times more likely to use telehealth. Telehealth users had significantly higher mean scores indicating greater acceptance of telehealth for each TAM21 domain and overall (all p < 0.05) compared to nonusers. Telehealth, particularly videoconferencing (67%), and email/messaging (80%) were most commonly used to deliver education and information to cancer survivors. Discussion: While cancer nurses have positive attitudes towards the use of telehealth for survivorship care, actual use is low. Attitudes are therefore poor predictors for telehealth use. The COVID-19 pandemic has exposed challenges experienced by nurses with telehealth-related practice. Conclusion: Cancer nurses are well placed to provide telehealth-facilitated survivorship care. However, the potential of telehealth to close the disparity gap for survivors living in rural and remote areas in Australia, is far from realised. In addition to further research required, lessons learned from the pandemic will be critical to inform the development and implementation of telehealth-facilitated cancer survivorship care. (c) 2021 Australian College of Nursing Ltd. Published by Elsevier Ltd.