Positive Psychological Change Following a Cancer Diagnosis in Old Age: A Mixed-Methods Study

Background Despite the stress inherent in a cancer diagnosis, many cancer survivors report benefits, including perceptions of personal growth and well-being. Among adults 60 years or older, for whom cancer diagnoses are most prevalent, there is a notable lack of research on positive psychological change. Objective This mixed-methods study was designed to advance current understanding of positive psychology (ie, posttraumatic growth, well-being) in older adults with cancer. Methods Fifty-six older adult cancer survivors were recruited through a statewide cancer registry and the community. Participants completed questionnaires on posttraumatic growth, well-being, coping, and quality of life, as well as a series of open-ended questions via mail. Results Participants reported high posttraumatic growth and well-being and primarily adaptive and emotion-focused coping strategies. They also reported better mental quality of life (P =.0001) but not physical quality of life (P =.31) compared with age-adjusted population norms. Older age was associated with less posttraumatic growth (r = -0.32, P =.02) but not well-being (P =.34). Qualitative responses emphasized appreciation and acceptance and a reliance on faith and social support and provided context for quantitative results. Conclusions This mixed-methods study suggests that older adults report positive psychological change and adaptive coping with cancer, demonstrating their high level of emotional resilience. Implications for Practice Mental health screenings should be provided as appropriate, but oncology nurses should also consider the potential for positive psychological change postdiagnosis. The provision of care and social support may need to be modified to accommodate older cancer survivors' needs.