Relationships between three beliefs as barriers to symptom management and quality of life in older breast cancer survivors.

PURPOSE/OBJECTIVES: To describe relationships among perceived barriers to symptom management and quality of life and to test the mediating role of perceived communication difficulties on the relationships between other perceived barriers to symptom management and quality of life in older adult breast cancer survivors.

DESIGN

Cross-sectional descriptive-correlational design using baseline data from a randomized, controlled trial that tested the efficacy and durability of the individualized representational intervention in reducing symptom distress and improving quality of life in older adult breast cancer survivors.

SETTING

The community, an oncology clinic, and a state tumor registry.

SAMPLE

190 older adult breast cancer survivors (X age = 70.4 years) who were an average of 3.3 years after breast cancer diagnosis.

METHODS

Path analysis using Mplus, version 5.1.

MAIN RESEARCH VARIABLES

Negative beliefs about symptom management (Symptom Management Beliefs Questionnaire [SMBQ]), perceived negative attitudes from healthcare providers (Communication Attitudes [CommA]), perceived communication difficulties (CommD), and quality of life.

FINDINGS

Significant direct effects of SMBQ and CommA on CommD were found after controlling for age, number of health problems, and number of symptoms. CommD was a significant mediator of the effects of CommA on quality of life after controlling for the covariates. SMBQ had significant total effects on quality of life after adjusting for the covariates but was not mediated by CommD.

CONCLUSIONS

Patient-provider communication is an important factor in the quality of life of older adult breast cancer survivors.

IMPLICATIONS FOR NURSING

Developing and testing nursing interventions focusing on enhancing both positive beliefs about symptom management and effective communication in old age is suggested.

KNOWLEDGE TRANSLATION

Older adults and healthcare providers must overcome stereotyped beliefs about aging that may affect self-care and health outcomes for this population. Older adults must be allowed to express their views and emotions about aging.