Health care and family resilience from the perspective of older people with cancer
DOI:
https://doi.org/10.48492/servir0214.41497Keywords:
Oncogeriatrics, promoting resilience, family health, humanizing care, empathyAbstract
Introduction: In Portugal, cancer in older people is one of the main causes of disability and physical, psychological and social suffering, with an impact on family health. When experiencing these illnesses, families, as open systems in permanent interaction with multiple systems around them, can build resilience processes that are relevant to their health and development. Family resilience depends not only on the capacity of family members but also on community resources, with health professionals playing an important role.
Objective: To analyze the perceptions of older people with cancer regarding the health care received and its influence on the construction of family resilience processes.
Methods: This descriptive qualitative study is part of a study on family resilience and health in the Central region of Portugal. An in-depth interview was conducted with 10 families of elderly people with cancer, selected from the community by snowball. A thematic analysis was carried out, based on Froma Walsh's conceptual framework of family resilience, generating a thematic map with three themes: “omitted care”; “positive experiences in the care received”; “care that promotes family resilience”.
Results: Both at the beginning of the illness and during treatment, older people sometimes felt a) the omission of care, due to a lack of humanization, ageism and unclear communication; but also, b) positive experiences, recognizing the presence of professionals in painful moments, relevant educational interventions and respect for privacy; and that a) some care contributed to family resilience, by promoting acceptance, hope and intra-family communication.
Conclusion: The conclusions highlight the urgent need for health care that recognizes the needs of older people and their family systems during the course of cancer, promoting resilience and health.
Downloads
References
Babic, R., Babic, M., Rastovi, P., Curlin, M., Simic, J., Mandi, K., & Pavlovi, K. (2020). Resilience in health and illness. Psychiatria Danubina, 32, 226–232
Clarke, V., Braun, V., & Hayfield, N. (2019). Análise temática. In J. A. Smith (Ed.), Psicologia qualitativa: Um guia prático para métodos de pesquisa (pp. 295-327). Vozes.
Costa, J. E. da, Simpson, C. A., Mendonça, A. E. O. de, Isoldi, D. M. R., Silva, R. S. da C., & Silva, N. R. da C. (2016). Percepção e impacto da dor na vida de idosos com doença oncológica. Rev Rene, 17(2), 217–224. https://periodicos.ufc.br/rene/article/view/3003
Cui P, Shi J, Li S, Getu MA, Wang R, Chen C. (2023). Family resilience and its influencing factors among advanced cancer patients and their family caregivers: a multilevel modeling analysis. BMC Cancer. Jul 4;23(1):623. https://doi.org/10.1186/s12885-023-11101-z
Gao, J., Li, J. X., Chen, W. Y., Song, J. Y., Zhou, M. K., Zhang, S. S., & Li, H. P. (2022). A randomized controlled trial of a coping-focused family resilience intervention program for breast cancer patients: Study protocol. Frontiers in psychology, 13, 968154. https://doi.org/10.3389/fpsyg.2022.968154
Geng, H. M., Chuang, D. M., Yang, F., Yang, Y., Liu, W. M., Liu, L. H., & Tian, H. M. (2018). Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine, 97(39), e11863. https://doi.org/10.1097/MD.0000000000011863
Lietz, C. A. (2007). Uncovering stories of family resilience: A mixed methods study of resilient families, part 2. Families in Society: the journal of contemporary human services, 88(1), 147-155. http://dx.doi.org/10.1606/1044-3894.3602
Martins, M. H. (2014). Resiliência familiar: Revisão teórica, conceitos emergentes e principais desafios. Cadernos do GREI, 10.
McGoldrick, M.; Carter, B. & Garcia-Preto, N. (2014). The Expanded Family Life Cycle Individual, Family, Social Perspectives. Pearson Education Limited. https://api.pageplace.de/preview/DT0400.9781292037875_A24569839/preview-9781292037875_A24569839.pdf
Ministério da Saúde. (2023). Estratégia Nacional de Luta contra o Cancro, Horizonte 2030. MS.
Neal, D., Morgan, J. L., Kenny, R., Ormerod, T., & Reed, M. W. (2022). Is there evidence of age bias in breast cancer health care professionals' treatment of older patients?. European Journal of Surgical Oncology, 48(12), 2401–2407. https://doi.org/10.1016/j.ejso.2022.07.003
OECD/European Commission (2025). Perfil sobre cancro por país: Portugal 2025. OECD Publishing. https://doi.org/10.1787/ffdcd7a9-pt
OPAS (2022). Relatório mundial sobre o idadismo. Organização Pan-Americana da Saúde. https://doi.org/10.37774/9789275724453.
Pimentel, F. L., Veríssimo, M., Oliveira, C., Soares, J., Sousa, G., Martinho da Silva, P., Vilaverde Cabral, M., & Lopes Ferreira, P. (2021). Cancer Network for Welfare Aging (NEWAYS): Strategies for Optimizing the Care of Elderly Patients with Cancer. Internal Medicine, 27(4), 334–336. https://doi.org/10.24950/PV/6/19/4/2020
Pinker, I.; Wetzlmair-Kephart, L.; Da Costa, A. & Pilleron, S. (2025). The role of healthcare professionals' attitudes in treatment decision-making for older adults with cancer: A scoping review. Journal of Geriatric Oncology. 16 (3). https://doi.org/10.1016/j.jgo.2024.102151
PORDATA (2025). Índice de envelhecimento e outros indicadores de envelhecimento. https://www.pordata.pt/pt/estatisticas/populacao/populacao-residente/indice-de-envelhecimento-e-outros-indicadores-de
Ramírez-Perdomo, C. A., Rodríguez-Velez. M. E., & Perdomo-Romero, A. Y. (2018). Incertidumbre frente al diagnóstico de cancer. Texto & Contexto - Enfermagem, 27(4), e5040017. https://doi.org/10.1590/0104-07072018005040017
Relvas, A. P. (2017). Avaliação familiar: funcionamento e intervenção. Vol. I. Imprensa da Universidade de Coimbra.
Resende, L. B. ., & Moraes Filho, I. M. de . (2020). Câncer em idosos: revisão narrativa das dificuldades na aceitação da doença e no tratamento. Revista JRG De Estudos Acadêmicos, 3(6), 159–169. https://doi.org/10.5281/zenodo.3891905
Santos, A.; Braz, P.; Gomez, V.; Folha, T.; Alves, T. & Dias, C. (2022). Envelhecimento e Saúde: caracterização da saúde da população idosa em Portugal. Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA, IP).
Santos, C. A., Costa, K. S. R. da, Dantas, M. J., & Morais, C. (2021). Factors influencing the adaptation of families, as systems and clients, to cancer: A scoping review. Journal of Nursing Referência, 5(8), 1–10. https://doi.org/10.12707/RV20149
Schuc, L. & De Antoni, C. (2018). Resilience and vulnerability in ecological systems: Aging and public policies. Psicologia: Teoria e Pesquisa. 34. https://doi.org/10.1590/0102.3772e3442
Senden, C., Vandercasteele, T., Vanderberghe, E., & Versluys, K., Piers, R., Grypdonck, M., & Van Den Noortgate, N. (2015). The interaction between lived experiences of older patients and their family caregivers confronted with a cancer diagnosis and treatment: A qualitative study. International Journal of Nursing,52(1), 197-206. https://doi.org/10.1016/j.ijnurstu.2014.07.012
Shao, M., Yang, H., Du, R., Zhang, M., Zhu, J., Zhang, H., Ma, B., Chen, C., & Wang, T. (2023). Family resilience in cancer treatment and key influencing factors: A systematic review. European journal of oncology nursing : the official journal of European Oncology Nursing Society, 66, 102403. https://doi.org/10.1016/j.ejon.2023.102403
Sousa, L; Patrão, M. & Vicente, H. (2012). Famílias e envelhecimento: o último estádio do ciclo de vida. In C. Paúl & O. Ribeiro (Coord.) Manual de Gerontologia: Aspetos biocomportamentais, psicológicos e sociais do envelhecimento (255-272). Lidel.
Walsh, F. (2016). Family resilience: a developmental systems framework. European journal of developmental psychology. Taylor & Francis. http://dx.doi.org/10.1080/17405629.2016.1154035
Walsh, F. (2021). Family resilience: A dynamic systemic framework. In M. Ungar (Ed.), Multisystemic resilience: Adaptation and transformation in contexts of change (255–270). Oxford University Press. https://doi.org/10.1093/oso/9780190095888.003.0015
World Health Organization (2020). UN Decade of Healthy Ageing: plan of action. https://www.who.int/initiatives/decade-of-healthy-ageing
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Ana Carolina Frias, Ana Jorge
This work is licensed under a Creative Commons Attribution 4.0 International License.
In order to promote the free circulation of knowledge, Servir is open access journal. All its content is available and protected under the Creative Commons license (CC BY 4.0).
The journal allows self-archiving in institutional repositories of all versions, which may become immediately available
