142nd APHA Annual Meeting and Exposition

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311841
Discursive Representations of the Meaning of Finitude in 'Cancer Survivorship'

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 3:15 PM - 3:30 PM

Susan Hannum, Ph.D. , Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Katherine Clegg Smith, PhD , Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Kisha Coa, MPH , Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Ann C. Klassen, PhD , Department of Community Health and Prevention, Drexel University School of Public Health, Philadelphia, PA
Background/Significance. Phenomenological investigations surrounding illness and illness behavior are often rooted in a health beliefs model and are thus described according to personal interpretations of disease, and about life and death. In this paper, we evaluate how older cancer patients describe survivorship in everyday language and discuss implications for initiation of care and self-management behaviors, as guided by one’s long-term evaluations of health.

Methods. This work draws on data from the Eating for Life study, which included informants with cancers of the breast and prostate, as well as Non-Hodgkin’s lymphoma (n=53). Informants were recruited to participate in a semi-structured interview pertaining to experiences and conceptualizations of cancer survivorship and dietary behavior, following acute periods of care. Interview transcripts from those aged 60-74 years (n=29) were used for this sub-analysis and were evaluated using techniques of discourse and narrative analyses to focus on survivorship beliefs within the aging context.

Findings. Analyses revealed the importance of age and time, as reflected in beliefs about cancer, its experience, and the potential for recurrence. Cancer illness and survivorship were thus often seen as deeply implicated in disruptions to biography, but also to one’s ability to engage in future planning.

Conclusions. How older persons conceptualize the future seems to bear deeply on decisions made in reaction to cancer therapies, but also uptake of self-care and overall health management. We suggest that notions of time and cancer survivorship be integrated in care models, with an appreciation of how older persons approach decisions relevant to care.

Learning Areas:

Chronic disease management and prevention
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe discursive representations of cancer meaning and cancer survivorship. Discuss the relevance of time and aging to models of health beliefs, particularly during post-treatment periods. Evaluate the importance of cancer survivorship identity on uptake and utilization of continued care services.

Keyword(s): Cancer, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have written and received prior grant funding from AHRQ (in the form of an R36 dissertation award) relevant to the meaning of cancer and comorbid conditions among older adults. This qualitative investigation built upon my previous qualitative work in areas of aging, illness, suffering, and generativity and was successfully defended in May 2013.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.