title: Older women with breast cancer: perceptions of the effectiveness of nurse case managers.
abstract: BACKGROUND
  There are many challenges that an older woman and her family face when diagnosed with breast cancer. Utilizing community-based nurse case managers may influence the older client and her family to adapt to the many challenges associated with the diagnosis and treatment of breast cancer.
  
  
  OBJECTIVE
  The purpose of this qualitative study is to describe how older breast cancer clients perceive community-based nurse case managers. From findings generated, recommendations were developed to improve the practice of community-based nurse case managers.
  
  
  METHODS
  A randomized prospective trial to evaluate the effect of nurse case management on the treatment of 106 older women with breast cancer provided data for this content analysis. Older women (>65 years of age) newly diagnosed with breast cancer cared for by 60 surgeons practicing at 13 community and 2 public hospitals in southeast Texas were invited to participate.
  
  
  CONCLUSIONS
  Community-based nurse case managers made a positive impact on older women with breast cancer by helping in managing coexisting medical conditions, providing support, providing education, giving assistance with activities of daily living (ADLs), and helping to navigate through the health care system. To increase their effectiveness, it was recommended that nurse case managers communicate well, be well educated about breast cancer, have standard gerontology nurse case management training, and integrate multiple support systems when caring for older clients with breast cancer.
  
  
  CONCLUSIONS
  There are unique challenges that an older woman and her family face when diagnosed with breast cancer. Utilizing community-based nurse case managers may influence the client and her family to adapt to the many challenges associated with the diagnosis and treatment of breast cancer. Community-based nurse case managers can make a positive difference on the outcomes of older women with breast cancer.
authors.affiliation: Jennie Sealy Hospital, Galveston, Texas 77555-0460, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Jennings-Sanders
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Anderson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology*; D019090:Case Management / Q000592:standards*; D003152:Community Health Nursing / Q000592:standards*; D005260:Female; D006379:Helping Behavior; D006801:Humans; D020380:Needs Assessment; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010344:Patient Advocacy; D010353:Patient Education as Topic; D036301:Qualitative Research; D012944:Social Support; D011795:Surveys and Questionnaires; D013781:Texas; D014930:Women / Q000523:psychology*; D016387:Women's Health