Poster Presentation 2025 National Cancer Survivorship Conference

Australian Adaption of Geriatric Specific Psychotherapy Resources for Older Adults with Cancer (#69)

Kirsty Galpin 1 , Sharon He 1 , Joanne Shaw 1 , Haryana Dhillon 1 , Lisa Beatty 2 , Mariko Carey 3 , Michelle Kelly 4 , Agatha Conrad 5 , Amelia Bartczak 3 , Christian Nelson 6 , Brian Kelly 3
  1. Psycho-Oncology Cooperative Research Group, School of Psychology, The University of Sydney, Australia
  2. Psychology and Social work, Flinders University, Australia
  3. School of Medicine and Public Health, The University of Newcastle, Australia
  4. School of Psychological Science, The University of Newcastle, Australia
  5. Hunter New England Mental Health Service, School of Medicine and Public Health College of Health, Medicine and Wellbeing , The University of Newcastle, Australia
  6. Memorial Sloan Kettering Cancer Centre, , New York, United States of America

Introduction

Depression is common amongst older adults with cancer, with up to 27% experiencing depressive symptoms. The USA-developed CARE (Cancer and Aging: Reflection for Elders) psychotherapy telephone-delivered intervention addresses the unique needs of older people (>70 years) managing ageing, depression, and a cancer experience. We aimed to review and tailor the CARE patient workbook/resources to the Australian context and acceptability of the telephone-based intervention.

Methods

We used qualitative methods with semi-structured cognitive ‘think aloud’ interviews with older Australians (≥70 years) diagnosed with a cancer. Participants reviewed the wording, phrases, and examples in the patient workbook/resources and provided feedback on the relevance, acceptability, and understandability for older Australians. Interviews were analysed using content analysis.  

Results

We completed 20 cognitive interviews. Participants had a mean age of 74 years (range 70 -79), most were female (65%, n=13), and had a diagnosis of blood (55% n=11) or breast cancer (45%, n=9) within the last 10 years. Six (30%) reported having sought support from a mental health professional. A third (30%) of participants resided in regional and rural/remote areas. Resource content resonated with participants. Most felt the intervention delivered by telephone was acceptable. Participants emphasised need to simplify wording and modify technical language to be inclusive of those with lower literacy. Feedback suggested some activity/pastime examples appeared metropolitan-focussed and should reflect rural and regional activities. In Australia ‘Elders’ is a cultural term used by First Nations peoples to identify a custodian of knowledge; most participants suggested changing this (e.g., elderly, senior). For some participants, the analogy of ageism to racism used felt unfamiliar.

Conclusion

Cultural adaption of psychological treatments improves, feasibility, and acceptability in a new setting. This process emphasised the importance of inclusive and contextually relevant resources for older adults with cancer and depression. Tailoring the patient workbook/resources will occur prior to an Australia-wide CARE intervention trial.