Perceived uncertainty, social support and psychological adjustment in older patients with cancer being treated with surgery

Aim. The purpose of this longitudinal correlative study was to explore the degree, compare the differences and to detect the relationships of uncertainty, social support and psychological adjustment for older cancer patients who were undergoing surgery. Background. While the number of the older cancer patients has been increasing, there has been little research exploring their needs with respect to psychological adjustment during cancer treatment. Design. The study used a pre-/postdescriptive design. Methods. Purposive sampling was used to recruit 43 patients aged 65-84 from six surgery wards in a medical centre in northern Taiwan from Jaunary 2005-May 2005. Participants were interviewed one to two days prior to surgery and interviewed again one to two days before hospital discharge. Demographic data, Mishel's Uncertainty Illness Scale, Hospital Anxiety and Depression Scale and the Interpersonal Support Evaluation List were used to collect data. Results. Uncertainty varied with cancer stage. At the time of surgery, the patients had moderate levels of uncertainty. There was a significant decrease in uncertainty at the second data collection period before hospital discharge. In these participants, anxiety was significantly associated with past medical history. The participants obtained social support from family members, physicians, nurses, relatives and other patients. Married patients had higher levels of social support than those without a spouse. Significant relationships were found among uncertainty and anxiety and depression. Interestingly, a positive relationship between anxiety and social support after surgery was also identified. Conclusion. Increasing levels of social support could ameliorate the degree of uncertainty, anxiety and depression in older cancer patients. Nurses should provide resources to establish an effective social network to older cancer patients who were being treated surgically. Relevance to clinical practice. These findings can assist nurses in understanding the psychological adjustment needs among older cancer patients who were undergoing surgery and provide appropriate intervention in nursing care.