Reclaiming Self-Balancing on a Tightrope Across Time a grounded theory of transition to survivorship in older adult blood cancer survivors

Abstract

Aim: To develop a theoretical understanding of the transition to survivorship in older adult blood cancer survivors.

Design: Qualitative research employing Classic Glaserian Grounded Theory methods.

Methods: Purposive and theoretical sampling recruited 17 participants via Leukaemia & Lymphoma Society© Community webpages (65-83 years) from across the US and Canada. Data from individual semi-structured interviews using HIPPA-compliant Zoom© were analysed from September 2020 to March 2021.

Results: Participants' main concern was losing their sense of self and reclaiming self was the core category. The substantive theory of Reclaiming Self-Balancing on a Tightrope Across Time is a six-phase transition process to survivorship: receiving a blood cancer diagnosis, finding bearings, reclaiming self, persevering through, realizing a transition and living in a new reality.

Conclusions: The transition to survivorship in older adult blood cancer survivors is a complex process because of age and disease type.

Implications: Age-related aspects of one's sense of self and its relation to health, well-being and quality of life, as older adult blood cancer survivors advance into older age need further research. Ageism and its impact on cancer survivorship care in older adults should also be explored.

Impact: What problem did the study address?: Existing theoretical frameworks do not explain the complex process of transition to survivorship for older adult blood cancer survivors. What were the main findings?: A substantive theory Reclaiming Self-Balancing on a Tightrope Across Time is a six-phase transition process from cancer diagnosis to survivorship characterized by an uncertain and liminal nature. Where and on whom will the research have an impact?: Understanding how older adults experience the transition to survivorship can inform age-appropriate person-centered nursing practices and healthcare policies specific to their needs.

Reporting method: COREQ.

Patient or public contribution: No patient or public contribution.

Keywords: blood cancers; cancer survivors; grounded theory; older adults; sense of self; survivorship; transition.