The Perceptions and Expectations of Older Women in the Establishment of the Senior Women’s Breast Cancer Clinic (SWBCC): a Needs Assessment Study

Abstract

This study explored older women's perceptions and expectations of the prospective Senior Women's Breast Cancer Clinic (SWBCC) at Sunnybrook Odette Cancer Centre (SOCC) in Toronto, Ontario, Canada. In our previous studies, older breast cancer patients had expressed a greater need for informational, decisional, and post-treatment support. This study also assessed women's perspectives on the involvement of geriatricians and incorporation of geriatric assessment in their cancer care. Twelve breast cancer patients aged 68 years or older who were treated at the SOCC participated in the study. We recorded and transcribed 11 interviews and analyzed them using qualitative thematic analysis methods to identify major themes; one interview was excluded due to recording defect. Eight major themes were identified: transportation issues, service, communication between patient and healthcare professionals, communication between healthcare professionals, support during treatment, support after treatment, informational resources, and patient suggestions. Important issues were raised by participants, such as difficulties in arranging transportation to the clinic, barriers in accessing family physician service, and communication breakdown that result in treatment delay and unaddressed complications. In conclusion, there were important gaps in the cancer care of older women with breast cancer that could be detected earlier and better addressed in the new multidisciplinary SWBCC. The participating women were highly supportive of the initiative and made several suggestions on how the clinic could better accommodate their specific needs during and after breast cancer treatment.

A Retrospective Age Analysis of the Ambulatory Oncology Patient Satisfaction Survey: Differences in Satisfaction across Dimensions of Person-Centred Care and Unmet Needs among Older Adults Receiving Cancer Treatment

“…The difference across age groups was statistically significant for emotional, financial, social/family, and sexual health issues, and it neared statistical significance for practical and spiritual issues. This finding is consistent with previous studies that have identified unmet needs among older adults diagnosed with cancer [10,42], among older adults undergoing active cancer treatment [11,43], and among older cancer survivors [12]. The types of unmet needs highlighted, however, vary widely across studies, including medical issues [10]; informational issues [10,11,[42][43][44]; practical issues, such as transportation or insurance [12,42]; financial issues [12,44]; psychological issues [11,12]; physical issues [11,12]; relational issues [12]; communication issues [42,43]; spiritual issues [44]; and issues relating to coordination among care providers, including primary care providers [42].…”

“…This finding is consistent with previous studies that have identified unmet needs among older adults diagnosed with cancer [10,42], among older adults undergoing active cancer treatment [11,43], and among older cancer survivors [12]. The types of unmet needs highlighted, however, vary widely across studies, including medical issues [10]; informational issues [10,11,[42][43][44]; practical issues, such as transportation or insurance [12,42]; financial issues [12,44]; psychological issues [11,12]; physical issues [11,12]; relational issues [12]; communication issues [42,43]; spiritual issues [44]; and issues relating to coordination among care providers, including primary care providers [42]. The differences in unmet needs across studies may reflect differences in the measures used, as well as variations in the health system context, specifically related to the available services and resources.…”

Advocate-BREAST80+: A Comprehensive Patient and Advocate-Led Study to Enhance Breast Cancer Care Delivery and Patient-Centered Research in Women aged ≥ 80 years

“…An initial approach could be to focus on one side effect, with patient satisfaction levels assessed thereafter. Given our aging population, strategies focusing on catering to the educational needs of elderly BC patients will increasingly need to be prioritized [25,26].…”

Comprehensive Geriatric Assessment as a Versatile Tool to Enhance the Care of the Older Person Diagnosed with Cancer

“…Caring for the older adult who is diagnosed with cancer can be a complex orchestration of managing existing comorbid conditions, cancer care, caregiver concerns, while maintaining quality of life [1,2,3,4]. Older people have unique healthcare needs compared to younger adults who may not have challenges regarding comorbidities [4,5,6,7], functional ability [8], transportation and social support [9]. Many academic and community cancer centers establish some type of multidisciplinary geriatric oncology program to meet the needs of the older person [10,11,12,13,14,15].…”