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. 2022 Jun;30(6):4823-4833.
doi: 10.1007/s00520-022-06892-z. Epub 2022 Feb 11.

Self-management by older people living with cancer and multi-morbidity: a qualitative study

Teresa Corbett  1 , Kellyn Lee  2 , Amanda Cummings  3 , Lynn Calman  3 , Naomi Farrington  4 , Lucy Lewis  5 , Alexandra Young  2 , Alison Richardson  2 , Claire Foster  3 , Jackie Bridges  2
Affiliations

Self-management by older people living with cancer and multi-morbidity: a qualitative study

Teresa Corbett et al. Support Care Cancer. 2022 Jun.

Abstract

Purpose: Over half of individuals diagnosed with cancer are aged over 70 years, and more than 75% of those with cancer report at least one other medical condition. Having multiple conditions alongside cancer in old age may lower functional status, greater likelihood of treatment complications and less favourable prognoses. This qualitative study explored how older people with long-term chronic conditions manage their health and meet their health-related goals after they have completed treatment for cancer.

Methods: One-to-one face-to-face qualitative interviews were conducted with 8 older people and 2 informal caregivers based in the UK. Older adults were eligible to participate if they were over 70 and had completed primary cancer treatment with curative intent and had at least one other chronic health condition. A semi-structured interview schedule developed a priori based on Shippee's cumulative complexity model was used. We aimed to explore experiences that could influence self-management, utilisation of healthcare services and health outcomes. A framework analysis was used to describe and interpret the data.

Results: Four overarching themes were identified in the analysis. These themes related to factors that influenced the everyday health-related workload and capacity of the participants. These factors included their health, resources, and opportunities, as well their motivation and sense of perceived control over their lives.

Conclusions: Fragmented healthcare systems and relationships with healthcare professionals also influenced the participants' self-management of their health. Our findings highlight the interaction between an individuals' needs, capacity, treatment burden, and the services and resources available to them. These findings support calls to promote person-centred care to better support older adults to manage their health.

Keywords: Cancer survivorship; Complex conditions; Late effects; Multimorbidity; Older adults; Qualitative research.

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Conflict of interest statement

This research was funded by National Institute for Health Research (NIHR) ARC Wessex. Alison Richardson is a NIHR Senior Investigator. Naomi Farrington is funded by a NIHR Clinical Lectureship (ICA-CL-2015–01-003). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Figures

Fig. 1
Fig. 1
Factors influencing everyday health-related workload and capacity of older adults with multiple conditions alongside a diagnosis of cancer
See this image and copyright information in PMC

References

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    1. Corbett T., et al., Self-management in older people living with cancer and multi-morbidity: a systematic review and synthesis of qualitative studies. Psycho-Oncology. n/a(n/a). - PubMed