Exploring the Relationships between Posttraumatic Growth, Wisdom, and Quality of Life in Older Cancer Survivors

Abstract

With a growing number of elderly population and an improvement of cancer prognosis, cancer survivors being older than 65 years are also increasing (Rowland and Bellizzi, 2014). According to a study on cancer survivors and aging population, approximately 60% of cancer survivors are age 65 or older, many of whom have multiple health problems and various survivorship needs (Parry et al., 2011). With increasing trends of cancer survivors, a growing interest in evaluating the quality of life (QoL) of cancer survivors is emerged (Thong et al., 2013). The period after completing cancer treatments is often described as more difficult than the treatment itself because long term effects of cancer treatments such as fatigue, depression, sleep disorders, functional disability, and pain, are highly

Challenges of Survivorship for Older Adults Diagnosed with Cancer

“…Most studies reviewed included survivors of breast, prostate, lung, and colorectal cancers, making use of existing databases and frequently resulting in sizeable sample sizes (121 [ 41 ] to 271,640 [ 42 •]. Studies involved various time intervals following completion of treatment (1 to > 10 years), definitions of older adults (e.g., 60+, 75+, 70+, 75+, and 80+ years) and combinations of physical, psychological, emotional, social, and demographic variables.…”

“…Although these variables were measured in various ways, (e.g., physical well-being [ 44 •], functional health limitations [ 38 ] disability [ 45 ], mobility [ 46 , 47 ], and physical health status [ 48 ], the capacity to manage activities of daily living and maintain independence were critical for older adult survivors and contributed to HRQOL. Cancer type [ 49 •], the number of comorbidities [ 42 •, 45 ], length of time dealing with side effects, side effect severity [ 43 , 50 , 51 ], duration of chronic illness [ 39 ], and deteriorating health status [ 41 , 45 ] are key variables with negative influence on HRQOL. Experiencing fatigue [ 44 •], frailty [ 53 ••], difficulty performing Activities of Daily Living (ADLs) [ 53 ••], difficulty walking [ 46 ],) and increased risk for falls [ 47 , 48 ] are challenges associated with poor HRQOL outcomes [ 53 ••] in older survivors.…”

“…Psychosocial variables have not been explored as frequently as physical variables in older cancer survivors. Depression [ 40 , 50 ], body image (appearance) [ 51 , 54 ], reduced optimism [ 55 ], altered sexual intimacy [ 56 ], treatment decision regret [ 57 ], chronic stress (55), lack of emotional support [ 39 ], and post-traumatic growth [ 41 ] are associated with reduced HRQOL. Depression is concerning in this population, reaching levels of 30% in community-dwelling older survivors [ 40 ].…”

Wise Ancestors, Good Ancestors: Why Mindfulness Matters in the Promotion of Planetary Health

“…Along the way, a variety of validated instruments such as the Self-Assessed Wisdom Scale, the Three-Dimensional Wisdom Scale, the Brief Wisdom Screening Scale, and the San Diego Wisdom Scale have been developed [16][17][18]; these scales can capture many of the features now viewed as critical components of wisdom-prosocial attitudes and behaviors (empathy and compassion), emotional regulation, social decision-making/pragmatic knowledge of life, reflection/selfunderstanding, tolerance of diverse values, humor, and the ability to effectively deal with uncertainty and ambiguity in life (see Box 1). Combined, research related to these instruments show wisdom to be a measurable personality trait that can be linked to many aspects of health, well-being and quality of life [19,20]; [21][22][23][24][25]; moreover, wisdom as a measurable construct can be examined vis à vis biological markers known to be associated with health and disease [26,27]. Dr. Judith Gluck and colleagues (2019) state that wisdom is "deep, personal, experience-based knowledge about life that is acquired through and goes along with a certain mindset".…”

Catalyst Twenty-Twenty: Post-Traumatic Growth at Scales of Person, Place and Planet

“…Validated instruments such as the Self-Assessed Wisdom Scale, the Three-Dimensional Wisdom Scale, and the Brief Wisdom Screening Scale, can capture many of the aforementioned aspects of wisdom, as well as humor and emotional regulation which are also seen as critical components of wisdom [60]. Like purpose in life, wisdom has also been linked with post-traumatic growth, enhanced mental health outcomes, subjective wellbeing and quality of life [61][62][63]. Wisdom is specifically associated with a type of self-reflection (when recalling difficult life experiences) that engages explanatory processing-extracting lessons, insights and meaning [64].…”