Experiencing Cancer in Old Age: A Qualitative Systematic Review

Abstract

Our purpose in this study was to find, report, and interpret the results of qualitative studies which investigated the experiences of older people living with cancer. We conducted systematic literature searches, identified and extracted the findings from 11 studies, and analyzed them systematically. We interpreted the findings to suggest that living with cancer in old age is to live in a perpetual state of ambiguity. The experience is characterized by a sense of disintegration, diminished identity, suffering, and social retraction. These experiences are balanced by sources of comfort and strength found within the self and among diverse relationships. The results of our study illuminate the complex, multidimensional character of living with cancer in old age. They show that older people living with cancer are resilient as well as vulnerable. We argue for changes in attitudes and behavior that will enable health care professionals to foster older peoples' resilience. In this article we report the purpose, design, conduct, and findings of a systematic search and review of qualitative research literature that investigated older peoples' experiences of living with cancer.Cancer has its highest incidence in older populations. There is extensive literature reporting the incidence and prevalence of cancers in older age groups, along with approaches to treatment and the effects and management of comorbidity (Bennahum, Forman, Vellas, & Albarede, 1997;Extermann, Overcash, Lyman, Parr, & Balducci, 1998;Satariano & Silliman, 2003). However, the subjective perceptions of older individuals undergoing the experience of cancer remain largely unknown. This review provides a basis for developing clinical health services that are based on older peoples' perceived and expressed needs.To make the most effective use of research findings, approaches to synthesizing the results of many studies on the same topic have increasingly found favor and, in quantitative research, sophisticated methods of meta-analysis have been developed which aim to produce a definitive set of findings from a wide range of work. In qualitative research, also, such an approach is deemed to be an essential part of increasing the usefulness and relevance of findings (Sandelowski, Docherty, & Emden, 1997), though the methodology is at an earlier stage of development (Dixon-Woods, Booth, & Sutton, 2007;Popay & Roën, 2003) and there has been debate about whether the approach is epistemologically appropriate (Campbell et al., 2003;McDermott, Graham, & Hamilton, 2004;Sandelowski et al., 1997). This approach is termed variously "metastudy," "metasynthesis," and "research integration." It is an approach to the literature that is more than a critical review: it is an attempt to integrate findings across studies to arrive at new understandings.Our reading of methodological literature in the field of qualitative reviewing and synthesis (Barbour, 2001;Booth, 2001;Britten et al., 2002;Campbell et al., 2003;Noblit & Hare, 1988;Paterson, Thorne, Canam, & Jillings, 2001...

Adaptive Comanagement: a Systematic Review and Analysis

“…The orderly and transparent nature of such reviews permits the detection of literature omissions (Petticrew and Roberts 2006) and gaps not obvious in single studies (Crowther and Cook 2007). Although, historically, systematic reviews have tended to be quantitative in nature, qualitative systematic reviews have emerged as a similarly useful methodology (Dixon-Woods et al 2006, Hughes et al 2009, O'Connell and Downe 2009. For all these reasons, systematic reviews have received increasing interest and are an appropriate means to accomplish the intent of this research.…”

Masculinity lost: a systematic review of qualitative research on men with spinal cord injury

“…33 However, incorporating qualitative research in systematic reviews poses daunting methodological problems, 34 methods remain underdeveloped and under-evaluated 35 and terminology is fluctuating and often conflicting. 33,36 …”

Which standards from which disciplines? A test of systematic review for designing interdisciplinary evaluations

“…We hope a systematic approach to reviews will create pressure for the identification of crossdisciplinary quality criteria. In this respect, standards of reporting might be a useful starting point and variations of this approach are already being experimented with (Atkins et al 2012;Carroll, Booth, and Lloyd-Jones 2012;Da Silva 2014;Dixon-Woods et al 2006b;Edwards, Russell, and Stott 1998;Hughes, José Closs, and Clark 2009).…”

“…2012;Noblit and Hare 1988;Wallace et al 2004;White and Waddington 2012). SRs are now used in fields such as education and training (Evans and Benefield 2001;Price 2005;Secomb 2008), social policy (Wallace et al 2004) and experiential research in health care (Arman and Rehnsfeldt 2003;Campbell et al 2003;Dixon-Woods et al 2007, 2006bHughes, José Closs, and Clark 2009). The expanding range of domains in which SR is applied and its suitability for working from a broad literature commended it to our use.…”