Treatment-related decisional conflict, quality of life, and comorbid illness in older adults with cancer

Abstract

<p><span>As the aging population the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults will be confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional conflict, quality of life and comorbidity in older adults with cancer. An anonymous survey method was employed. The criteria for inclusion in this study were: (a) 65 years of age or older, (b) English-speaking, (c) ability to read English at an eighth grade level, (d) having a current cancer diagnosis, and (e) currently receiving cancer treatment. A sample size of 200 was recruited for this study from outpatient medical oncology, radiation oncology and palliative care practices in New Jersey. The participants completed four instruments including: (a) Decisional Conflict Scale (DCS), (b) Self- Administered Comorbidity Questionnaire (SCQ), (c) European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and (d) Demographic Information Form (DIF). Bivariate relationships existed between increased levels of decisional conflict and increased quality of life (</span><em>p</em><span> = .009) and quality of life and comorbidity (</span><em>p</em><span> = .001). All six regression models achieved significance (</span><em>p</em><span> < .001). Three to five statistically significant relationships were identified in each of the six regression models. Positive relationships existed between decisional conflict and financial problems, physical function, and global health status/quality of life. Increased emotional function may be predictive of decreased decisional conflict in all of the regression models. Other negative relationships existed between decisional conflict and cognitive function, diarrhea, spiritual support, insomnia, year diagnosed, fatigue, and nausea/vomiting. With their focus on patient-centered care, nurses are a crucial component of the multidisciplinary cancer team that can empower older cancer patients to communicate their values and preferences regarding cancer treatment.</span></p>