Case study finds beating cancer takes team work by doctor, patient,
caregiver
Case sociologists study health care trio for
older adult patients with cancer
May 4, 2005 | For more information: Susan
Griffith 216-368-1004
Beating cancer takes team work by the doctors, patients and significant
caregivers, like spouses and children. With a $1.1
million, five-year National Cancer Institute grant, sociologists from
Case Western Reserve University and Cleveland State University will
focus on elderly cancer patients, studying the relationship and communications
amongst the health care trio.
The research project will contribute a
new dimension to a longitudinal study on successful
aging, now in its 16th year and led by Eva Kahana, Case professor of
sociology and director of the Elderly Care Research Center at Case,
with co-investigators Boaz Kahana from Cleveland State University (Eva’s
husband); Gary Deimling, Case professor of sociology; and Kurt Stange,
professor of Family Medicine.
Approximately six percent of adults over
the age of 65 are diagnosed with cancer each
year, according to Kahana. However, many of these
elderly patients do not receive all the recommended screenings - like
mammograms for breast cancer or colonoscopies for colon cancer - that
doctors routinely recommend for middle-aged patients. These screenings
can provide early detection and save lives.
Communications plays a role
in “closing the gap between health
care providers and consumers,” report the researchers.
They plan
to determine if other chronic health problems
overshadow cancer screenings or if it might be
attributed to other factors in the doctor-patient
relationship and communications. The research team
is also looking at how communication influences the outcome in cancer
prevention and cancer care. What they learn about health care through
this disease can be applied to other health care concerns, said Kahana.
The
researchers published a proposed communications
model in Patient Education and Counseling that provides the study’s
framework and could potentially result in ways to improve
health care for the elderly, according to Kahana.
The study
will look at:
- The content of physician communications
to inform their patients of health risks, preventative
health practices and advice, diagnosis and
prognosis; doctor-patient relations in decision making; and emotional
support, including empathy, hopefulness and respectfulness towards
the patient.
- Patients
will be asked how well the communications were
for the diagnosis and treatment plans; how
much information was sought from the physician, media or caregiver;
and the assertiveness and confidence in interacting with the doctor.
- Significant
others will be interviewed for their role as
an advocate and supporter of the patient in understanding and evaluating
risks, preventative advice and corrective advice
provided by the doctor, as well as how much decision-making sharing
takes place between the caregiver and patient.
“We visualize older people finding ways to optimize their health
by seeking out information from the doctor and non
medical sources like the media or the Internet,” said Kahana. “This
moves the older adult from a passive health care participant to an
active and proactive one.”
As part of the new cancer grant, the
researchers will interview and follow several hundred
newly diagnosed cancer patients every three months to understand the
dynamics in the communications between the doctor, patient and significant
caregiver. They also will ask participants in the longitudinal study
questions about preventative cancer information from doctors or non
medical sources.
“Family members and friends can be powerful influences on the
health behaviors of older adults. They can find information, make the
patient adhere to doctor’s recommendations and pursue healthier
lifestyles,” Kahana said.
Kahana’s research began more than 16 years ago with 1,000 retirees
from Cleveland and Clearwater, Fl. Today approximately 150 older Americans
between the ages of 88 and 104 continue to participate in the annual
interviews that research various factors in their lives that contribute
to the researchers’ knowledge about how the elderly age successfully
and cope with the increasing numbers of chronic
illnesses in the late stages of life.
Recently
the researchers received continued funding that
will add another 1,300 new older adults, 65 years
and older, from Cleveland and the Florida communities of Celebration
(an, intergenerational community that uses technology), and Miami with
a diverse population of Hispanics, to allow for
a comparison between the first generation of older adults with the next
generation of aging adults. The continuation of this longitudinal study
received $1.8 million from the National Institutes on Aging over the
next five years.
Because of the broad and random sample of participants
in the longitudinal study, Kahana stated they
will have a more accurate overview of health care
and information-seeking practices of the elderly.
Information
gained from the cancer health care partnership
study will contribute to the model the researchers are constructing
about successful aging.
About Case Western Reserve University
Case is among the nation's leading research institutions. Founded in 1826
and shaped by the unique merger of the Case Institute of Technology and Western
Reserve University, Case is distinguished by its strengths in education, research,
service, and experiential learning. Located in Cleveland, Case offers nationally
recognized programs in the Arts and Sciences, Dental Medicine, Engineering,
Law, Management, Medicine, Nursing, and Social Work. http://www.case.edu.
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