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See detailKrankheitsbewältigung im Kontext einer Krebserkrankung im höheren Lebensalter
Lessing, Juliane Eva Margarethe UL

Doctoral thesis (2017)

The risk to develop cancer increases with age. Due to demographic change and extending life expectancy, the number of older cancer patients continues to grow. Despite this, the group of older cancer ... [more ▼]

The risk to develop cancer increases with age. Due to demographic change and extending life expectancy, the number of older cancer patients continues to grow. Despite this, the group of older cancer patients appears to be underrepresented in psycho-oncological research as well as in care and treatment. The present dissertation focuses on the psycho-social situation of older cancer patients in the Greater Region. Three main topics are studied using different methodological approaches. The first main topic focuses on the general situation of older cancer patients in Luxembourg. A descriptive analysis of epidemiological data from the Direction de la Santé and the International Agency for Research on Cancer shows increasing cancer incidence and mortality rates among older adults in Luxembourg. Comparative analyses using the Luxembourgish data from SHARE wave 5 show similar physical and psychological burden among older cancer patients (n = 44) and older cardiac patients (n = 46), but both patient groups report higher burden than older healthy adults (n = 51). Furthermore, in both patient groups, a percentage of about 22 % reports significant psychological burden. The second main topic focuses on the social context of older cancer patients analysing attitudes as well as emotional and behavioural reactions towards older cancer patients. Two quantitative studies using a 2x2x2 factorial vignette approach present each a brief scenario with varying information about a person´s gender, age (study 1: 30 vs. 74 years; study 2: 38 vs. 83 years) and health status (study 1: healthy vs. skin cancer; study 2: colon cancer vs. myocardial infarction). The two studies survey lay persons as well as health professionals and student health professionals (study 1: N = 683; study 2: N = 328). Both studies find no indicators of negative attitudes and reactions towards older cancer patients. However, study 1 shows more negative attitudes towards skin cancer patients but also higher prosocial emotions and less social distancing compared to healthy adults. In study 2, patients with colon cancer are rated as more thoughtful and less responsible for their disease than cardiac patients. Here, no differences are found in emotional or behavioural reactions. The third main topic focuses on individual experiences and coping processes of older cancer patients. Nine qualitative interviews with male and female cancer patients as well as a comparison group of male cardiac patients (each n = 3) between 64 and 90 years are conducted and analysed using qualitative content analysis. Results show that the diagnosis is perceived as a critical life event, but initial psychological burden decreases after the completion of treatment. Particularly, cognitive coping strategies are reported, above all acceptance and comparative processes. Psychological well-being as well as a sense of stability and continuity are maintained in spite of considerable physical changes and constraints. Practical implications of the findings are discussed. [less ▲]

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