Education and Human Sciences, College of (CEHS)

 

Title

Treatment Decision-Making in Older Adults with Cancer

Document Type

Article

Date of this Version

July 2007

Comments

A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Doctor of Philosophy. Major: Human Sciences (Gerontology). Under the Supervision of Professor James A. Thorson.
Lincoln, Nebraska: June, 2007. Copyright © 2007 Maribeth McCullough Hercinger.

Abstract

Decision-making for cancer treatment is becoming more and more complex and individuals are expected to be active participants in this process. As the diagnosis of cancer occurs more frequently among adults, health care professionals must be accountable to place a greater emphasis on assisting individuals with the difficult treatment decisions.

This study explored the experiences of older adults when making decisions for cancer treatment using a phenomenological approach. Thirteen in-depth, face-to-face interviews were completed with individuals who experienced a new diagnosis of cancer. Participants of the study included eight females and five males ages 51-83 years of age. Five major themes emerged in the present study: (1) importance of relationships, (2) communication, (3) spirituality, (3) positive coping, and (5) powerlessness. Powerlessness or lack of control was highlighted as one of the strongest themes. Psychosocial influences of the treatment decision-making process were voiced most frequently. The treatment decision-making process came into view as an ongoing, non sequential, interactive process that is complex with many influencing factors.

The implications of the present study are presented in relationship to the health care professionals’ role with an emphasis on nursing. An understanding of the individual’s unique perspective, including an assessment of the cancer patient’s social, physical, psychological and spiritual needs and desires should be at the base of all nursing care. The results from the present study may add to the limited knowledge of the individual’s perspective of the treatment decision-making process. Acknowledging the uniqueness of the older adult cancer patient’s experience of treatment decision-making may assist health care providers to provide appropriate supportive care and improve their quality of life during this difficult process.
Advisor: James A. Thorson