Cancer Support and Resource Needs Among African American Older Adults

Jones, Randy; Klimmek, Rachel; Krumm, Sharon; Darrell, Linda; Song, Danny Y.; Stearns, Vered; Ford, Jean G.

doi:10.1188/12.cjon.372-377

Cited by 21 publications

(21 citation statements)

References 27 publications

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“…At least two coders reviewed each transcript, using a previously described inductive approach to coding [27]. The team developed all concepts and themes, based on the final codes.…”

Section: Methodsmentioning

confidence: 99%

A Model of Cancer Clinical Trial Decision-making Informed by African-American Cancer Patients

Mbah

Moscou-Jackson

et al. 2014

J. Racial and Ethnic Health Disparities

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Background Clinical trials are critical to advancing cancer treatment. Minority populations are underrepresented among trial participants, and there is limited understanding of their decision-making process and key determinants of decision outcomes regarding trial participation. Methods To understand research decision-making among clinical trial-eligible African-American cancer patients at Johns Hopkins, we conducted seven focus groups (n=32) with trial-offered patients ≥18 years diagnosed with lung, breast, prostate, or colorectal cancer ≤5 years. Three “acceptor” and four “decliner” focus groups were conducted. Questions addressed: attitudes towards clinical trials, reasons for accepting or declining participation, and recommendations to improve minority recruitment and enrollment. Data were transcribed and analyzed using traditional approaches to content and thematic analysis in NVivo 9.0. Data coding resulted in themes that supported model construction. Results Participant experiences revealed the following themes when describing the decision-making process: Information gathering, Intrapersonal perspectives, and Interpersonal influences. Decision outcomes included the presence or absence of decision regret and satisfaction. From these themes, we generated a Model of Cancer Clinical Trial Decision-making. Conclusion Our model should be tested in hypothesis-driven research to elucidate factors and processes influencing decision balance and outcomes of trial-related decision-making. The model should also be tested in other disparities populations and for diagnoses other than cancer.

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“…At least two coders reviewed each transcript, using a previously described inductive approach to coding [27]. The team developed all concepts and themes, based on the final codes.…”

Section: Methodsmentioning

confidence: 99%

A Model of Cancer Clinical Trial Decision-making Informed by African-American Cancer Patients

Mbah

Moscou-Jackson

et al. 2014

J. Racial and Ethnic Health Disparities

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“…Aging cancer survivors must deal with consequences of cancer and related therapies that may overlap with simultaneous effects of other chronic conditions or life changes that can serve as barriers to a return to normalcy. Oncology nurses should be attentive to the specific needs of older adult cancer survivors, particularly as they relate to setting goals, planning for the future, physical and social functioning, cancer- and non–cancer-related symptoms, engagement in valued activities, and ability to maintain independence (Bellury et al, 2013; Deimling, Sterns, Bowman, & Kahana, 2007; Lyons, Erickson, & Hegel, 2012; Wenzel, Jones, Klimmek, Krumm, et al, 2012). Older adult survivors seeking to reestablish a sense of normalcy may benefit from education and assistance distinguishing normal, aging-related changes from pathologic changes from cancer, other illnesses, or possible late effects of cancer therapies.…”

Section: Discussionmentioning

confidence: 99%

“…The analysis reported in the current article was embedded within a larger randomized, controlled trial of a nurse-led supportive intervention for rural-dwelling cancer survivors and the people who support them (Wenzel, Jones, Klimmek, Krumm, et al, 2012; Wenzel, Jones, Klimmek, Szanton, & Krumm, 2012). The research reported in the current article used an intensive, multiple case study design (Stake, 1995) and grounded theory analysis techniques (Charmaz, 2006) to evaluate the fit between existing theoretical knowledge related to the process of managing recovery and to generate new theoretical knowledge about that process.…”

Section: Methodologic Approachmentioning

confidence: 99%

Working Toward Normalcy Post-Treatment: A Qualitative Study of Older Adult Breast and Prostate Cancer Survivors

Walker¹,

Szanton²

2015

ONF

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Purpose/Objectives To develop a better understanding of how older adult survivors of early-stage breast and prostate cancer managed the work of recovery. Research Approach Multiple case study design embedded in a larger randomized, controlled trial of a nurse-led patient navigation intervention. Setting Community-based research conducted via in-home visits and by phone with participants residing in non-metropolitan areas of a mid-Atlantic state. Participants Rural-dwelling adults aged 60 years or older with early-stage breast or prostate cancer and the people who support them (11 dyads). Methodologic Approach An approach to grounded theory analysis was used to evaluate the fit between existing theoretical knowledge and case findings and to generate new knowledge about the cancer recovery process. Findings Working toward normalcy was a core process of cancer recovery prompted by participants’ internal experiences and external interactions with their environments. This ongoing, iterative, and active process involved multiple concurrent strategies that were not necessarily medically oriented or cancer specific. Working toward normalcy resulted in movement along a continuum of self-appraisal anchored between participants experiencing life as completely disrupted by cancer to a life back to normal. A greater sense of normalcy was associated with higher engagement in valued activities and increased physical and psychological well-being. Conclusions In addition to the core process of working toward normalcy, multiple theories from nursing, sociology, psychology, and gerontology helped to explain case findings. This knowledge could serve as a foundation on which to design survivorship care that supports the goals of cancer survivors working toward normalcy post-treatment. Interpretation Post-treatment wellness goals can include a desire to reestablish or maintain a sense of normalcy. Nursing actions that promote survivors’ efforts to be perceived as capable, stay engaged in valued activities and roles, maintain a sense of control over their lives and bodies, and make plans for the future may help meet this goal. Existing theories about identity, dignity, inner strength, and the work of illness can inform nursing interventions.

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“…Rural cancer survivors may also be disproportionately burdened by treatment-related costs given their geographic isolation, socioeconomic disparities, and limited access to care. In qualitative studies, financial hardship is a common theme among rural cancer survivors (2)(3)(4)(5). In addition, Pisu and colleagues found that, among rural breast cancer survivors, out-of-pocket (OOP) costs represented approximately 10% of available income, with substantially higher OOP cost to income burdens observed for rural, low-income survivors (6).…”

Section: Introductionmentioning

confidence: 99%

Rural Disparities in Treatment-Related Financial Hardship and Adherence to Surveillance Colonoscopy in Diverse Colorectal Cancer Survivors

McDougall

Banegas

Wiggins

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Cancer survivors increasingly report financial hardship as a consequence of the high cost of cancer care, yet the financial experience of rural cancer survivors remains largely unstudied. The purpose of this study was to investigate potential rural disparities in the likelihood of financial hardship and nonadherence to surveillance colonoscopy. Individuals diagnosed with localized or regional colorectal cancer between 2004 and 2012 were ascertained by the population-based New Mexico Tumor Registry. Participants completed a mailed questionnaire or telephone survey about their colorectal cancer survivorship experience, including treatment-related financial hardship and receipt of surveillance colonoscopy. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with urban colorectal cancer survivors ( = 168), rural colorectal cancer survivors ( = 109) were slightly older; more likely to be married (65% vs. 59%) and have an annual income <$30,000 (37% vs. 27%); and less likely to be employed (35% vs. 41%), have a college degree (28% vs. 38%), or a high level of health literacy (39% vs. 51%). Rural survivors were twice as likely as urban survivors to report treatment-related financial hardship (OR, 1.86; 95% CI, 1.06-3.28) and nonadherence to surveillance colonoscopy guidelines (OR, 2.28; 95% CI, 1.07-4.85). In addition, financial hardship was independently associated with nonadherence to surveillance colonoscopy (OR, 2.17; 95% CI, 1.01-4.85). Substantial rural disparities in the likelihood of financial hardship and nonadherence to surveillance colonoscopy exist. Treatment-related financial hardship among rural colorectal cancer survivors may negatively affect adherence to guideline-recommended follow-up care.

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Cancer Support and Resource Needs Among African American Older Adults

Cited by 21 publications

References 27 publications

A Model of Cancer Clinical Trial Decision-making Informed by African-American Cancer Patients

A Model of Cancer Clinical Trial Decision-making Informed by African-American Cancer Patients

Working Toward Normalcy Post-Treatment: A Qualitative Study of Older Adult Breast and Prostate Cancer Survivors

Rural Disparities in Treatment-Related Financial Hardship and Adherence to Surveillance Colonoscopy in Diverse Colorectal Cancer Survivors

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