Negative attitudes of both older adults and healthcare providers about aging can be barriers to self-care in old age. The aims of a study by Yoem and Heidrich were to (1) examine the extent to which older breast cancer survivors experience barriers to symptom management and (2) explore whether barriers influence quality of life. Three possible barriers to symptom management were examined: (a) negative beliefs about managing symptoms; (b) perceived negative attitudes of healthcare providers; and (c) difficulties in communicating about symptoms. The study was a secondary analysis of pooled baseline data from 61 older (age >64 years) women who participated in two pilot studies that tested a symptom management intervention for older breast cancer survivors. The most frequent barrier reported was difficulties in communicating about symptoms with healthcare providers. Each of the barriers affected psychosocial, but not physical, quality of life.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that barriers to symptom management may lead to poorer self-care of symptoms that can result in lower levels of psychosocial quality of life. Healthcare providers need to encourage older cancer survivors to report symptoms and worries related to their cancer diagnosis, and should be cautious in expressing attitudes that could reinforce older adults' negative perceptions about aging.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The conclusions of the study are likely correct. However, as many healthcare providers are apt not to change without prompting by patients, it is up to you to be certain you report symptoms and worries about a cancer diagnosis to them. This reporting is a part of the self-management of any condition, including cancer.

HE Yoem, SM Heidrich. Effect of Perceived Barriers to Symptom Management on Quality of Life in Older Breast Cancer Survivors. Cancer Nursing, May 13, 2009.