Older Women's Reflections on Accessing Care Across Their Breast Cancer Trajectory: Navigating Beyond the Triple Barriers

Huibrie C. Pieters

MarySue V. Heilemann

Marcia Grant

Rose C. Maly

geriatric nursing, healthcare delivery
ONF 2011, 38(2), 175-184. DOI: 10.1188/11.ONF.175-184

Purpose/Objectives: To describe the experiences of older women regarding barriers to care for breast cancer in their prediagnostic period and throughout their diagnoses, treatments, and beyond.

Research Approach: Qualitative, descriptive study guided by grounded theory.

Setting: Participants' homes or apartments in southern California.

Participants: 18 women aged 70 years or older who recently completed treatment for breast cancer.

Methodologic Approach: Semistructured, individual interviews. The analytic approach was constructivist grounded theory.

Main Research Variables: Gero-oncology perspective of accessing care across the breast cancer trajectory.

Findings: Three interconnected, age-related barriers to care were described by the women throughout their cancer trajectories: knowledge deficits, preexisting comorbid diseases, and multiple appointments with healthcare providers. The women navigated beyond the triple barriers to life after cancer. Women described how the services of an oncology nurse navigator facilitated their progress.

Conclusions: Despite diverse sociodemographic circumstances and challenges in the healthcare system, all women successfully navigated the triple barriers.

Interpretation: Effective age-appropriate care requires sensitivity to the unique needs of older people newly diagnosed with cancer. Awareness of the triple barriers can be a catalyst for nurses to enhance access to care for older adults who fight to overcome a life-threatening disease and move on with their lives. More research is needed that specifically focuses on the role of oncology nurse navigators in older populations.

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