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The CSRP's primary aim is to determine the
physiological, psychological, and sociological
long-term effects of surviving cancer on older
adults (age 60+). This study uses the general stress
and coping paradigm and combines the perspectives of
extreme stress theory and identity theory to examine
the effects of cancer among this uniquely vulnerable
group of older adult survivors. The physiological
outcomes include indicators for assessing the
quality of life (QOL) of older adults such as
physical and cognitive functioning, and their
appraisal of their physical health and symptoms.
Psychological outcomes include a global indicator of
well being/life satisfaction along with measures of
psychological distress (e.g., anxiety and
depression) and symptoms of post-traumatic stress
disorder (PTSD). In addition, several cancer
specific measures of psychological QOL will tap fear
of recurrence and stigma. Social QOL outcomes
include effects on survivor identity; relevant
characteristics such as self esteem, body image, and
development of the survivor identity; and indicators
of survivor ability to maintain valued roles. Other
core features of the model are personal dispositions
such as coping style and health beliefs, along with
proactive behaviors such as health promotion and
marshalling support, and how these buffer cancer
survivors from the chronic stressors associated with
cancer survivorship.
Other buffers include social support (e.g.,
informal support received from family and friends
and responsiveness of medical care). Central to the
analysis are age-related stressors such as co-morbid
health problems and other negative life events that
may exacerbate the stress associated with cancer.
Our 10-year study uses a longitudinal design to
collect and analyze three waves of in-person
interviews with 321 older adult (60 years of age and
older) former patients of the Ireland Cancer Center
(ICC) of University Hospitals (UH) of Cleveland. The
interview data will be combined with the tumor
registry file data for each survivor. The sample
includes long-term survivors (5 years beyond primary
treatment and currently in remission) and stratified
samples on colorectal, prostate, and breast cancer,
three of the four most common cancers among older
adults and those in the ICC tumor registry. It
over-samples African-Americans to provide maximum
analytic power to identify racial differences. The
ICC of UH is one of 12 National Institutes of Health
(NIH) Clinical Cancer Centers and maintains data on
28,500 cancer patients diagnosed and/or treated at
University Hospitals of Cleveland since 1975.
Multivariate analyses such as regression, structural
equation modeling, and growth curve analysis will be
used to investigate the relationship between the
variables in our conceptual model. Specific
comparative analyses are planned with age, gender
and racial subgroups.
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