The experience of Thai elderly patients living with prostate cancer

Rugyatisakul, Krissanakamon (2020) The experience of Thai elderly patients living with prostate cancer. PhD thesis, University of Glasgow.

Abstract

Background:
Prostate cancer is the fourth leading cause of cancer deaths among Thai elderly men. Elderly patients face a unique set of age-associated changes, comorbidities, and circumstances that impact on health and QoL in ways that are different from those of younger patients. In Thailand, there are shortage of specialist cancer centres across the region. Additionally, there is a lack of the evidence regarding patient’s health and QoL and the impact of cancer has on them and their families. Research is required to explore the experience of living with cancer from the perspective of patients and significant others. This will help facilitate effective treatments and provide the potential for holistic care to maintain and improve health and QoL of elderly patients and those who care of them.

Aim:
The aim of this study was to understand the experiences of living with prostate cancer of Thai elderly patients and their significant others.

Methods:
An explanatory sequential design was adopted in two sequential phases. Phase 1: patients age 60 and over (n=125) who were diagnosed with any stage of prostate cancer from two health care centres, were consented and completed the validated questionnaires EORTC QLQ-C30 and EORTC QLQ-PR25. Phase 2: semi-structured interviews were conducted on 18 pairs of patients and their significant others from Phase 1 who agreed to take part in the 2nd Phase to understand the impact on health and QoL of the three age categories of elderly patients and their experiences of living with prostate cancer from the perspective of Thai patients and their significant others.
 
Results:
Elderly Thai patients experienced alterations to their role functioning, physical functioning, cognitive functioning, sexual functioning, and fatigue. Patients in old-old age lower scores of QoL than younger groups, and that differences in the scores between the three age groups had high statistical significance (p<0.001). Patients who underwent hormonal therapy only, had better global health status, social functioning, and less pain than other groups (p<0.05). Patients who had undergone chemotherapy treatment had deteriorated social functioning (p<0.05). Having a combination of surgery and hormonal therapy had poor health, more pain (p<0.05) and more incontinence (p<0.001). In terms of comorbidities Hypertension was a variable of major concern for Thai patients in all age groups and had a more negative effect in old-old age than in other groups. This study found health, social functioning, physical functioning, role functioning, cognitive functioning, and sexual functioning had great influenced on QoL among patients in three age groups (p<0.001). Findings from the interviews identified four similar themes that emerged from both patients and significant others: decision making for treatment; healthcare experience; faith and beliefs; emotion. The broad differences in the themes that emerged from the patients and significant others included effect on physical functioning, symptom and side effect of treatment, family, and social relationships, being a good carer, and worry and anxiety.

Conclusion:
Elderly prostate cancer patients in young-old age were more likely to have better health and QoL in most functioning than middle-old age and old-old age. Better communication through the prostate cancer journey are needed for patients and significant others, as they were more likely to seek alternative ways outside the hospital. Cultural beliefs of Thai people were also associated with the spirituality of elderly patients and the role of caring by family caregivers, as family is often a primary source of support. Ultimately, evidence from this study suggests the healthcare providers’ information may involve the patient in consultations, informing patients about cancer prognosis and responding to their needs. These may help to develop a knowledge base for communication and educational materials that reflect the needs of elderly cancer patients.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Additional Information: Due to copyright issues the electronic version of this thesis is not available for viewing.
• Keywords: Prostate cancer, elderly patient, experience of living with prostate cancer.
• Subjects: R Medicine > RT Nursing
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Supervisor's Name: Rice, Professor Ann Marie, Gracie, Professor J Alastair and Hutchison, Dr. Cathy
• Date of Award: 2020
• Embargo Date: 23 October 2023
• Depositing User: Dr Krissanakamon Rugyatisakul
• Unique ID: glathesis:2020-81754
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 26 Oct 2020 10:34
• Last Modified: 26 Oct 2020 10:34
• URI: https://theses.gla.ac.uk/id/eprint/81754