Coping Strategies Used by Older Cancer Survivors During the COVID-19 Pandemic: A Longitudinal Qualitative Study.

Objectives: The objective of this study is to longitudinally examine the coping strategies used by older cancer survivors (≥60 years of age) during COVID-19. Methods: An interpretive descriptive approach was used to collect and analyse qualitative data collected via 1:1 telephone interviews at three timepoints: June/July 2020, January 2021, and March 2021. Main Findings: Coping strategies used by older adults reflected the resources available to them, and their agency in self-triaging and deciding on resources to support their coping. These decisions were impacted by pandemic-imposed restrictions and necessitated readjustment over time. Three themes were developed to describe coping strategies (including any changes): adapting means and methods to connect with others; being intentional about outlook; and taking actions toward a brighter future. Conclusion: Older adults used a variety of coping strategies, though their reliance on resources beyond themselves (e.g., family/friends) indicates a need to add tailored resources to existing professional services.

A Survey of Older Adults' Self-Managing Cancer.

BACKGROUND: Older adults living with cancer can experience significant challenges in managing their cancer treatment[s], care, and health. Cancer self-management is much discussed in the research literature, but less is known about the perceptions and experiences of older adults', including their self-management capacities and challenges. This study explored the factors that supported and hindered cancer self-management for older Canadian adults living with cancer. METHODS: We conducted a 17-item population-based telephone survey in the Canadian province of British Columbia among older adults (age ≥ 65) living with cancer. Descriptive and inferential statistics were used to analyze quantitative data and thematic analysis for open-text responses. RESULTS: 129 older adults participated in the study (median age 76, range: 65-93), of which 51% were living with at least one other chronic illness. 20% reported challenges managing their cancer treatment and appointments, while only ~4% reported financial barriers to managing cancer. We organized the findings around enabling and encumbering factors to older adults cancer self-management. The main encumbering factors to self-management included health system and personal factors (physical and emotional challenges + travel). Whereas enablers included: access to interpersonal support, helpful care team, interpersonal support and individual mindset. CONCLUSIONS: Considering factors which enable or encumber older adults' cancer self-management is critical to supporting the growing aging population in the work required to manage cancer treatment and navigate cancer services. Our findings may guide the development of tailored resources for bolstering effectual self-management for older Canadians living with cancer.

The Psychosocial Impact of COVID-19 on Older Adults with Cancer: A Rapid Review.

BACKGROUND: Older adults with cancer are amongst the most vulnerable population to be negatively impacted by COVID-19 due to their likelihood of comorbidities and compromised immune status. Considering the longevity of the pandemic, understanding the subjective perceptions and psychosocial concerns of this population may help ameliorate the psychological aftermath. In this review, we systematically analyze the literature surrounding the psychosocial impact and coping strategies among older adults with cancer within the context of COVID-19. METHODS: We conducted a rapid review of literature following PRISMA guidelines between January 2020 to August 2021 using (1) MEDLINE, (2) Embase, (3) CINAHL, and (4) PsychINFO and keyword searches for "cancer" and "COVID-19" focused on adults 65 years or older. RESULTS: Of the 6597 articles screened, 10 met the inclusion criteria. Based on the included articles, the psychosocial impact of COVID-19 was reported under four domains, (1) impact of COVID-19 on quality of life (QoL), (2) concerns related to COVID-19, (3) coping with the impact of COVID-19, and (4) recommendations for future care. Results pertaining to perceived quality of life were inconsistent across the included articles. The most common concerns related to: contracting COVID-19, survivorship transitions, and feelings of isolation. Coping strategies reported by older adults included: spiritual care, lived experience, acceptance, and positive reinterpretation. CONCLUSIONS: We found many psychosocial impacts of the pandemic on older adults with cancer. The findings from this review can inform interventions related to shared decision-making and tailored patient care in the future.

Impact of COVID-19 on care of older adults with cancer: a narrative synthesis of reviews, guidelines and recommendations.

PURPOSE OF REVIEW: The aim of this study was to summarize the literature on the impact of COVID-19 on older adults with cancer, including both the impacts of COVID-19 diagnosis on older adults with cancer and the implications of the pandemic on cancer care via a synthesis of reviews, guidelines and other relevant literature. RECENT FINDINGS: Our synthesis of systematic reviews demonstrates that older adults with cancer are prone to greater morbidity and mortality when experiencing concurrent COVID-19 infection. Current evidence related to the association between anticancer treatment and COVID-19 prognosis for older adults with cancer is conflicting. Guidelines and recommendations advocate for preventive measures against COVID-19; the uptake of telemedicine and virtual care; encourage vaccination for older adults with cancer; and the use of geriatric assessment. SUMMARY: The COVID-19 virus itself may be particularly deleterious for older adults with cancer. However, the health system and social impact of the pandemic, including global disruptions to the healthcare system and related impacts to the delivery of cancer care services, have equally important consequences.

The Needs of Older Adult Cancer Survivors During COVID-19: Implications for Oncology Nursing.

OBJECTIVES: Older adults living with cancer have been described as more susceptible to coronavirus disease 2019 (COVID-19) and in need of special attention during the COVID-19 pandemic. For cancer survivors, the first year post-treatment is a critical time because many individuals transition back to their primary care provider and adjust to physical and psychosocial changes that occurred during their cancer treatment. In this longitudinal qualitative study, we followed a cohort of older adult cancer survivors through the first three waves of the pandemic to describe their experiences as a means for providing recommendations for how oncology nurses can tailor support to this unique population. DATA SOURCES: We conducted individual, semi-structured qualitative interviews with 24 older adults at three time points during the pandemic. Data were analyzed drawing from interpretive descriptive methodologies. CONCLUSION: Older adult cancer survivors' needs shifted during the pandemic from feeling confident and self-assured during the early days of COVID-19 to growing uncertainty and unease about their health and well-being. The main survivorship concerns included a preference for in-person appointments (as opposed to virtual), barriers to caregiver attendance at appointments, and diminished access to health care services. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses play a critical role providing care to older adult cancer survivors and are most familiar with unique patient needs and the gaps in services they face. We provide recommendations for oncology nursing practice that consider the shifting needs of older adult cancer survivors during COVID-19 and beyond.