Social functioning of elderly persons with malignant diseases
Abstract
Background/Aim. Malignant disease, its treatment and consequences of treatment can often lead to social marginalization and reduced quality of life. The aim of this research was to determine how elderly patients with malignant diseases function in their social environment. Methods. Sociodemographic questionnaire and interview were used to investigate a group of 49 elderly persons undergoing adjuvant chemotherapy treatment against early carcinomas (P1), and a group of 51 elderly persons with advanced stages of cancer undergoing systemic chemotherapy (P2). There were two cycles of assessment: one just before the beginning of the first cycle of adjuvant or systemic chemotherapy, and the other three months later. The research paradigm was based on the relation between individual treatment and the impact of the malignant disease on functional and social incompetence. The obtained findings were compared with the group of 50 healthy elderly people (K) who share the same relevant features but do not suffer from malignant diseases. Results. It was found that most healthy older people live in share house, whereas those who suffer from malignant diseases mostly live in separate households. In both groups of patients and healthy group older people are mostly taken care of by their children. Individuals in both groups of patients have been frequently visited by their relatives during initial stages of treatment, unlike the elderly people in the control group. However, the difference did not reach a statistical significance. Three months after the beginning of chemotherapy, there was a statistically relevant difference in favor of the group undergoing adjuvant treatment. Home visits eventually become less frequent, whereas communication by telephone becomes more frequent. It was also found that visits by friends and neighbors are statistically more frequent among subjects who undergo adjuvant treatment, both before the treatment began and three months later when compared to other groups. Conclusion. Our research shows that elderly people are subject to social exclusion, especially those with malignant diseases. Special care should be dedicated to monitoring of social functioning during treatment of patients with malignant disease considering the detected trend of deterioration and significance for further recover and cure.
References
Syse A, Veenstra M, Aagnes B, Tretli S. Cancer incidence, prevalence and survival in an aging Norwegian population. Norsk Epidemiologi 2012; 22(2): 109−20.
Fallah M, Kharazmi E. Global cancer incidences are substantially under-estimated due to under-ascertainment in elderly cancer cases Asian Pac J Cancer Prev 2009; 10(2): 223−6.
Berat S. Prehabilitation of old persons suffering from malignant diseases [specialist work]. Belgrade: Faculty of Political Science; 2010. (Serbian)
Hepburn WK. Social Gerontology. In: Tallis RC, Fillit HM, editors. Brocklehurst′s Textbook of Geriatric Medicine and Gerontology. 6th ed. London: Churchill Livingstone; 2003. p. 183−91.
Smedslund G, Ringdal GI. Meta-analysis of the effects of psychosocial interventions on survival time in cancer patients. J Psychosom Res 2004; 57(2): 123−31.
Derks W, de Leeuw R, Winnubst J, Hordijk GJ. Elderly patients with head and neck cancer: physical, social and psychological aspects after 1 year. Acta Otolaryngol 2004; 124(4): 509−14.
Stein DK, Syrjala LK, Andrykowski AM. Physical and psychological long-term and late effects of cancer. Cancer 2008; 112(11 Suppl): 2577−592.
Đurđević A, Nikolić S. Profile of handicap situations in cancer patients. J BUON 2009; 14(3): 435−40.
Surbone A, Kagawa-Singer M, Terret C, Baider L. The illness trajectory of elderly cancer patients across cultures: SIOG position paper. Ann Oncol 2007; 18(4): 633−8.
Trask PC. Assessment of depression in cancer patients. J Natl Cancer Inst Monogr 2004; (32): 80−92.
Berat S. Psychosocial rehabilitation of elderly patients with malignant diseases. 5th Conference of Serbian Society of Medical Oncology (UMOS); Geriatric Oncology – Challanges and Deilemmas; 13th -14th May 2011 Kladovo, Serbia; Kladovo: ESMO; 2011. p. 124−9. (Serbian)
Vespa A, Ottaviani M, Rosselli M, Rossini S, Balducci L. Evaluation of intrapsychic processes, anxiety, and depression in postmenopausal women affected by breast cancer: a case-control study. Support Care Cancer 2013; 21(5): 1281−6.
Iconomou G, Iconomou AV, Argyriou AA, Nikolopoulos A, Ifanti AA, Kalofonos HP. Emotional distress in cancer patients at the beginning of chemotherapy and its relation to quality of life. J BUON 2008; 13(2): 217−22.
Pinquart M, Fröhlich C, Silbereisen RK. Change in psychological resources of younger and older cancer patients during chemotherapy. Psychooncology 2007; 16(7): 626−33.
Surbone A, Baider L, Weitzman TS, Brames MJ, Rittenberg CN, Johnson J. Psychosocial care for patients and their families is integral to supportive care in cancer: MASCC position statement. Support Care Cancer 2010; 18(2): 255−63.
Muzikravić LJ. Systemic Treatment in Oncology. In: Jovanovic D, editor. Basics of Oncology and Palliative Care in Cancer. Novi Sad: Faculty of Medicine, University of Novi Sad; 2008. p. 267−97. (Serbian).
Nešković-Konstantinović.Z. Medical treatment of older women with breast cancer. 5th Conference of Serbian Society of Medical Oncology (UMOS); Geriatric Oncology – Challanges and Deilemmas; 13th -14th May 2011 Kladovo, Serbia; Kladovo: ESMO; 2011. p. 58−63. (Serbian)
Balducci L. Aging, frailty, and chemotherapy. Cancer Control 2007; 14(1): 7−12.
Azim HA, de Azambuja E, Colozza M, Bines J, Piccart MJ. Long-term toxic effects of adjuvant chemotherapy in breast cancer. Ann Oncol 2011; 22(9): 1939−47.
Koopman C, Hermanson K, Diamond S, Angell K, Spiegel D. Social support, life stress, pain and emotional adjustment to advanced breast cancer. Psychooncology 1998; 7(2): 101−11.
Simić S, Milovanović S, Barišić J, Crnobarić C, Šikanić N, Bajić G. Aging and psychological changes. Engrami 2007; 29(3−4): 77−85. (Serbian)
Pallis AG, Wedding U, Lacombe D, Soubeyran P, Wildiers H. Ques-tionnaires and instruments for a multidimensional assessment of the older cancer patient: what clinicians need to know. Eur J Cancer 2010; 46(6): 1019−25.
Nedović G, Marinković D, Rapaić D, Berat S, Kozomara R. Health-related quality of life assessment in Serbian schoolchildren hospitalized for malignant disease. Vojnosanit Pregl 2013; 70(2): 195−9.
Graves KD. Social cognitive theory and cancer patients' quality of life: a meta-analysis of psychosocial intervention components. Health Psychol 2003; 22(2): 210−9.
Protheroe D, Turvey K, Horgan K, Benson E, Bowers D, House A. Stressful life events and difficulties and onset of breast cancer: case-control study. Br Med J 1999; 319(7216): 1027−30.
Fors EA, Bertheussen GF, Thune I, Juvet LK, Elvsaas IØ, Oldervoll L, et al. Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review. Psychooncology 2011; 20(9): 909−18.
Gelder M, Mayou R, Gedded J. Psichiatry. London: Oxford University Press; 2009.
Jakšić Ž. Social-medical difficulties. In: Duraković Z, editor. Geriatry – Medicine of Elderly. Zagreb: Medicinska naklada; 2007. p. 527−38. (Croatian)
Novaković M, Pečenica V. Neglecting of older people and suicide. Engrami 2004; 26(1−2): 53−66. (Serbian)
Thomé B, Hallberg IR. Quality of life in older people with cancer - a gender perspective. Eur J Cancer Care (Engl) 2004; 13(5): 454−63.
Petrak O, Despot-Lučanin J, Lučanin D. Quality of ageing-some characteristics of the elderly population of Istria and the comparison with other regions of Croatia. J Soc Policy 2006; 13(1): 37−51.
Godden S, Pollock AM. How to profile the population's use of health care and social care in one district. J Public Health Med 1998; 20(2): 175−9.
Johnston G, Vukic A, Parker S. Cultural understanding in the provision of supportive and palliative care: perspectives in relation to an indigenous population. BMJ Support Palliat Care 2013; 3(1): 61−8.
