Supportive Care Center, Samsung Comprehensive Cancer Center, Seoul, Republic of Korea; Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Cancer Policy Branch, National Cancer Center, Goyang, Republic of Korea.
J Geriatr Oncol. 2019 May;10(3):459-464. doi: 10.1016/j.jgo.2018.09.006. Epub 2018 Nov 16.
It is not clear whether age-related differences in treatment and treatment decision-making are the result of age discrimination or just a reflection of older patients' elevated risk and their own preferences. Therefore, it is critical to understand older patients' own views toward their care in regard to its relationship to age.
439 older patients with cancer (age ≥ 60) and 358 family members from eleven cancer centers participated in this cross-sectional survey.
Almost all patients (91.2%) and caregivers (92.7%) thought that older patients should be treated equal to younger patients, across all questionnaire items. The proportions of patients who reported having experienced age discrimination according to each item were: disease information (12.3%), treatment information (11.0%), participation in treatment decision (10.7%), attention from healthcare professionals (6.2%), supportive care (5.2%), and treatment (3.2%). Increasing age was the only demographic characteristic that was associated with greater ageism experience (p < .001). Patients' ageism attitudes, as well as caregivers' ageism attitudes, were negatively associated with ageism experience. Ageism experience was associated with a higher depression score, as well as a lower quality of life.
Discrimination in treatment and the treatment decision process based on age was not justified. Interventions that address ageist attitudes in older patients, family caregivers, and healthcare professionals are needed to reduce age discrimination, and thereby improve the quality of life of older patients with cancer.
尚不清楚治疗和治疗决策方面的年龄差异是源于年龄歧视,还是仅仅反映了老年患者风险增加及其自身偏好。因此,了解老年患者对自身护理的看法及其与年龄的关系至关重要。
来自 11 家癌症中心的 439 名老年癌症患者(年龄≥60 岁)和 358 名家属参与了这项横断面调查。
几乎所有患者(91.2%)和照料者(92.7%)认为,在所有问卷项目中,老年患者应与年轻患者得到平等对待。根据每个项目报告经历过年龄歧视的患者比例为:疾病信息(12.3%)、治疗信息(11.0%)、参与治疗决策(10.7%)、医护人员关注(6.2%)、支持性护理(5.2%)和治疗(3.2%)。年龄是与更多年龄歧视经历相关的唯一人口统计学特征(p<0.001)。患者的年龄歧视态度以及照料者的年龄歧视态度与年龄歧视经历呈负相关。年龄歧视经历与更高的抑郁评分和更低的生活质量相关。
基于年龄的治疗和治疗决策过程中的歧视是没有道理的。需要针对老年患者、家庭照料者和医护人员的年龄歧视态度采取干预措施,以减少年龄歧视,从而提高老年癌症患者的生活质量。