title: Older women's reflections on accessing care across their breast cancer trajectory: navigating beyond the triple barriers.
abstract: OBJECTIVE
  To describe the experiences of older women regarding barriers to care for breast cancer in their prediagnostic period and throughout their diagnoses, treatments, and beyond.
  
  
  METHODS
  Qualitative, descriptive study guided by grounded theory.
  
  
  METHODS
  Participants' homes or apartments in southern California.
  
  
  METHODS
  18 women aged 70 years or older who recently completed treatment for breast cancer.
  
  
  METHODS
  Semistructured, individual interviews. The analytic approach was constructivist grounded theory.
  
  
  METHODS
  Gero-oncology perspective of accessing care across the breast cancer trajectory.
  
  
  RESULTS
  Three interconnected, age-related barriers to care were described by the women throughout their cancer trajectories: knowledge deficits, preexisting comorbid diseases, and multiple appointments with healthcare providers. The women navigated beyond the triple barriers to life after cancer. Women described how the services of an oncology nurse navigator facilitated their progress.
  
  
  CONCLUSIONS
  Despite diverse sociodemographic circumstances and challenges in the healthcare system, all women successfully navigated the triple barriers.
  
  
  CONCLUSIONS
  Effective age-appropriate care requires sensitivity to the unique needs of older people newly diagnosed with cancer. Awareness of the triple barriers can be a catalyst for nurses to enhance access to care for older adults who fight to overcome a life-threatening disease and move on with their lives. More research is needed that specifically focuses on the role of oncology nurse navigators in older populations.
authors.affiliation: School of Nursing, University of California, Los Angeles, USA. hpieters@sonnet.ucla.edu
authors.forename: Huibrie C
authors.initials: HC
authors.lastname: Pieters
authors.forename: MarySue V
authors.initials: MV
authors.lastname: Heilemann
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Rose C
authors.initials: RC
authors.lastname: Maly
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D001943:Breast Neoplasms / Q000451:nursing* / Q000523:psychology*; D005260:Female; D005851:Geriatric Nursing / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009859:Oncology Nursing / Q000379:methods* / Q000458:organization & administration; D017060:Patient Satisfaction; D015397:Program Evaluation