Cancer screening behaviors in older adults: Grounded theory

The purpose of this study was to address the knowledge gap regarding older adults' health care decisions occurring after a cancer screening examination was performed. The research question "What phenomena are perceived by older adults to influence their decision not to seek health care following a positive cancer screening examination"? was the domain and primary purpose of the study. Generation of grounded theory regarding older adults' beliefs and perceptions about cancer screening was the ultimate goal.

Formal, unstructured interviews were completed with fifteen older adults who had completed a cancer screening examination and had not obtained further recommended healthcare. Analysis of the interview data was completed using the constant comparative data analysis. The theory of cancer screening behaviors in older adults was generated from these older adults' realities. The theory was then validated by the participants with additional justification from the review of literature.

Data revealed that older adults hold negative perceptions about cancer that influence their interpretation of the meaning and purpose of cancer screening. These perceptions also influenced their ability to enter the decision making process about their positive cancer screening findings. Developmental life stage, concurrent life events and suspension of the decision making process can pose barriers to the older adult's choice to ultimately obtain recommended follow-up care. The final outcome of the theory is the participant's active choice of health care or health care that has been disease driven, leaving the participant with few options. Implications for nursing involve public education efforts for older adults regarding cancer, cancer screening and normal changes of aging. Mechanisms to routinely include gerontology and geriatric oncology into nursing curriculums must also be addressed. Finally, society must mandate that the health and well-being of the nation's oldest citizens deserves priority research and funding, if there is to be a reduction in the mortality rates of older adults with cancer.