Factors Affecting Perceptions of Disability and Self-Rated Health Among Older Adult, Long-Term Cancer Survivors
Deimling, G.T.; Pappada, H.T.; Ye, M.; Nalepa, E.; Ciaralli, S.; Phelps, E.; Burant, C.J.
Journal of Aging and Health, First published: December 6, 2017
Objective: This article examines the relative importance of cancer-related and noncancer illness factors as they predict the health quality of life among older adult, long-term cancer survivors. Specifically, it examines the effects that continuing cancer symptoms and comorbidities have on functional difficulties and how they in turn affect perceptions of disability and self-rated health. Method: Data from an National Cancer Institute (NCI)-funded, tumor registry–based 10-year study of 321 older adult (age 60+), long-term (5+years post diagnosis) survivors of breast colorectal and prostate cancer are examined using regression analyses. Results: The analyses documented the independent effects of both cancer-related and age-related health factors as they contribute to explaining functional difficulties, perceptions of disability and self-rated health. Gender and racial differences in health quality of life were also identified. Discussion: The findings suggest that geriatricians, geriatric nurses, and clinical gerontologists who work with cancer survivors need to be aware of the ways in which both cancer and noncancer illness factors work together in producing threats to health quality of life through the extent and nature of functional impairments.
Personality and Psychological Distress Among Older Adult, Long-term Cancer Survivors
Deimling, G.T., Albitz, C.; Monnin, K.; Renzhofer Pappada, H.T.; Nalepa, E.
Journal of Psychosocial Oncology 35(1):17-31 Published online: 1 Nov 2016
This research examines a model of how personality (Five-Factor Model) is related to adjustment to cancer in later life in terms of the presence of continuing cancer-related worry and depression among older adult, long-term cancer survivors. Data from an NCI-funded study with 275 older adult (age 60+), long-term (5+ years) survivors of breast, prostate, and colorectal cancer were examined. Regression analyses identified neuroticism as the strongest predictor of cancer-related worry along with continuing cancer-related symptoms. For depression, three personality dimensions (neuroticism, conscientiousness, and agreeableness) were significant predictors. Findings suggest the importance of considering the central role that survivors’ personality characteristics play in understanding cancer-related worries and depression. Understanding these dispositional characteristics is key for social workers and health-care practitioners in counseling survivors experiencing these common mental health effects.
Survivors of Cancer
Deimling, G.T. and Brown, S.
In The SAGE Encyclopedia of Cancer and Society – Second Edition, Graham A. Colditz (Editor), Thousand Oaks: SAGE Publications, Inc. 2015
This research examines a model of how personality (Five-Factor Model) is related to adjustment to cancer in later life in terms of the presence of continuing cancer-related worry and depression among older adult, long-term cancer survivors. Data from an NCI-funded study with 275 older adult (age 60+), long-term (5+ years) survivors of breast, prostate, and colorectal cancer were examined. Regression analyses identified neuroticism as the strongest predictor of cancer-related worry along with continuing cancer-related symptoms. For depression, three personality dimensions (neuroticism, conscientiousness, and agreeableness) were significant predictors. Findings suggest the importance of considering the central role that survivors’ personality characteristics play in understanding cancer-related worries and depression. Understanding these dispositional characteristics is key for social workers and health-care practitioners in counseling survivors experiencing these common mental health effects.
The Relative Importance of Cancer-Related and General Health Worries and Distress Among Older Adult, Long-term Cancer Survivors: Cancer and General Health Worries
Deimling, G.T.; Brown, S.P.; Albitz, C.; Burant, C.J.; and Mallick, N.
Psycho-Oncology 26(2): 182-190 Published online: 22 October 2015
Objective: This research examines the relative importance that cancer-related and non-cancer illness factors play in generating general health worries and/or cancer-related worries. The analysis also examines how these in turn impact anxiety and depression among older adult, long-term cancer survivors. Methods: Data from a longitudinal study of 245 older-adult (age 60+ years), long-term survivors (5 or more years after diagnosis) of breast, prostate, and colorectal cancer are examined to identify the measurement properties and structure of general health and cancer-related health worries. Based on that measurement analysis, structural equation models (SEM) are used to estimate the relative importance of cancer-related and other illness predictors on cancer-related worry and general health worry and how these two forms of worry affect both anxiety (POMS) and depression (CES-D). Results: The results from the exploratory and confirmatory factor analysis of health worries identify two relatively independent measures of health worry, one of general health worry and a second of cancer-related worries that includes fears of recurrence, new cancers, and follow-up testing. SEM analyses identified the importance of current cancer-related symptoms and comorbidities on cancerrelated worry. It also documents the primacy of non-cancer symptoms and general health worry as predictors of anxiety and depression among older survivors. Conclusions: The fact that cancer-related symptoms continue to be associated with cancer-related worries years after diagnosis speaks to the significance of these continuing sequelae. While the findings suggest the relative independence of cancer-related worries and general health worries, both are correlated with anxiety and depression. This may be particularly problematic as survivors age and symptoms related to new health problems increase, while cancer-related symptoms persist.
Correlated and Coupled Trajectories of Cancer-Related Worries and Depressive Symptoms among Long-Term Cancer Survivors
Kypriotakis, G.; Deimlng, G.T.; Piccinin, A.M., Hofer, S.M.
Behavioral Medicine 42(2): 82-92 Published online: 4 Nov 2014
The quality of life over time of long-term survivors has become an important part of both cancer and aging research. This paper examines individual differences in trajectories of cancer-related worries and depressive symptoms of 179 participants who completed four waves of annual interviews. Cancer-related worries were significantly associated with both initial level and trajectories of depressive symptoms. In a parallel process growth curve model, the initial level of depressive symptoms was significantly correlated with both the initial level and rate of change in cancer-related worry over time. Our findings indicate that cancer survivors are never completely removed from cancer’s threats to quality of life, even as they survive into later life. These findings also suggest that older adults face the dual vulnerability of aging with its growing number of comorbidities and related symptoms along with the vulnerability conferred by cancer-related sequelae and the possibility of recurrence or new cancers.
Adaptation and adjustment to cancer in later life: a conceptual model
Deimling, G., Kahana, B., Bowman, K.
In Cancer and Aging Handbook: Research and Practice – First Edition, Keith M. Bellizzi and Margot A. Gosen (Editors). Wiley-Blackwell. 2012
This chapter entitled ”Adaptation and Adjustment to Cancer by Older Adults”, examines two related questions. The first is exactly what do we mean by “adaptation” and “adjustment” to cancer. The second question is how do we conceptualize aging and older adulthood in relationship to cancer adaptation or adjustment? This chapter considers possible answers to both of these questions and discusses alternative approaches to adaptation and adjustment with a focus on older adult cancer patients and survivors. A conceptual model is presented that identifies the factors that represent adaptation and adjustment to cancer that are most relevant for older adults who have been diagnosed and treated for this disease. This model is then used to organize a review of research findings from the recent aging and oncology literatures related to the conceptual model. In this review we integrate research findings from our own NCI funded study on “The Quality of Life of Older-adult, Long-term Cancer Survivors”.