Young Adults Adherence to Cancer Treatment as Compared to Older Adults

Young Adults Adherence to Cancer Treatment as Compared to Older Adults by Laurie Cox MS, Illinois State University, 1998, 2000 BS, Illinois State University, 1992 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy PhD Health Psychology Walden University August 2016 Abstract As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, 95% of the time. Additionally, gender and race were explored in relationship to adherence to radiation treatment and follow-up appointments. Demographic data were first extracted from the Cancer Registry of a Midwestern Hospital. Then radiation appointments and follow-up appointments were examined for each patient, in paper and/or computerized charts, to determine adherence rates. McNemar’s test was used to compare young adults and older adult oncology patients’ adherence rates, and Chi-square analysis was used to explore gender and race in relationship to adherence. Results indicated a lower adherence rate to follow-up appointments for younger adults as compared to older adults, with older adults adhering 3 1⁄2 times more than younger adults. Gender was also related to follow-up appointment adherence, with males adhering better than females. This study contributes to positive social change by increasing the knowledge base of healthcare providers on adherence rates of young adult patients and reducing the dollars spent on treatment for reoccurrences.As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, 95% of the time. Additionally, gender and race were explored in relationship to adherence to radiation treatment and follow-up appointments. Demographic data were first extracted from the Cancer Registry of a Midwestern Hospital. Then radiation appointments and follow-up appointments were examined for each patient, in paper and/or computerized charts, to determine adherence rates. McNemar’s test was used to compare young adults and older adult oncology patients’ adherence rates, and Chi-square analysis was used to explore gender and race in relationship to adherence. Results indicated a lower adherence rate to follow-up appointments for younger adults as compared to older adults, with older adults adhering 3 1⁄2 times more than younger adults. Gender was also related to follow-up appointment adherence, with males adhering better than females. This study contributes to positive social change by increasing the knowledge base of healthcare providers on adherence rates of young adult patients and reducing the dollars spent on treatment for reoccurrences. Young Adults Adherence to Cancer Treatment as Compared to Older Adults by Laurie Cox MS, Illinois State University, 2000 MS, Illinois State University, 1998 BS, Illinois State University, 1992 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy PhD Health Psychology Walden University August 2016 Dedication This paper is dedicated to my parents, William and Marilyn Cox, who died much too young from cancer. Their deaths at very early ages changed the course of my life, taking me on an unimaginable journey. I would also like to dedicate this paper to the many cancer patients who have accepted my help along their own journeys. Acknowledgments I would like to thank my family and friends who have provided encouragement and support, and tolerated my frustrations during the course of writing this paper. I would also like to extend a thank you to my committee members at Walden University, Dr. Miranda Van Tilburg and Dr. Peggy Gallaher. Also a special thanks to the Institutional Review Board, Cancer Registry, and Commission on Cancer Committee of my research site.