Yeom Hyun-e, Heidrich Susan M
School of Nursing, University of Wisconsin-Madison, K6/117 CSC, 600 Highland Ave, Madison, WI 53792-2455, USA.
Cancer Nurs. 2009 Jul-Aug;32(4):309-16. doi: 10.1097/NCC.0b013e31819e239e.
Negative attitudes of both older adults and healthcare providers about aging can be barriers to self-care in old age. The aims of this study were to (1) examine the extent to which older breast cancer survivors experience barriers to symptom management and (2) explore whether barriers influence quality of life. Three possible barriers to symptom management were examined: negative beliefs about managing symptoms, perceived negative attitudes of healthcare providers, and difficulties in communicating about symptoms. This study was a secondary analysis of pooled baseline data from 61 older (age >64 years) women who participated in 2 pilot studies that tested a symptom management intervention for older breast cancer survivors. The most frequent barrier reported was difficulties in communicating about symptoms with healthcare providers. Each of the barriers affected psychosocial, but not physical, quality of life. Barriers to symptom management may lead to poorer self-care of symptoms that can result in lower levels of psychosocial quality of life. Healthcare providers need to encourage older cancer survivors to report symptoms and worries related to their cancer diagnosis and should be cautious in expressing attitudes that could reinforce older adults' negative perceptions about aging.
老年人和医疗服务提供者对衰老的消极态度可能成为老年自我护理的障碍。本研究的目的是:(1)调查老年乳腺癌幸存者在症状管理方面遇到障碍的程度;(2)探讨这些障碍是否会影响生活质量。研究考察了症状管理的三个可能障碍:对症状管理的消极信念、对医疗服务提供者消极态度的认知以及症状沟通困难。本研究是对61名年龄较大(年龄>64岁)女性的汇总基线数据进行的二次分析,这些女性参与了两项试点研究,测试了针对老年乳腺癌幸存者的症状管理干预措施。报告中最常见的障碍是与医疗服务提供者沟通症状困难。每个障碍都影响心理社会生活质量,但不影响身体生活质量。症状管理障碍可能导致症状自我护理较差,进而导致心理社会生活质量水平较低。医疗服务提供者需要鼓励老年癌症幸存者报告与癌症诊断相关的症状和担忧,并应谨慎表达可能强化老年人对衰老消极认知的态度。