Experiences in Health Care Using Local Wisdom of Older Cancer Survivors

Abstract

Thailand officially became an aged society in 2022 and is expected to reach a super-aged status by 2031. This demographic shift has led to an increased risk of cancer and higher mortality rates. Cancer survival depends on individual factors such as age, underlying health conditions, and health behaviors, as well as external factors such as access to treatment and support from family and the community. Older people are at higher risk and require continuous care after surviving cancer.In the Thai context, local wisdom plays a crucial role in maintaining both physical and mental wellbeing,as it is deeply connected to culture and spirituality. However, research on the firsthand experiences of cancer survivors who incorporate local wisdom into their care remains limited. Therefore,exploring this issue will be beneficial in developing a care approach that aligns with Thai lifestyles,culture, and context- emphasizing holistic, person-centered care. This study aimed to explore experiences in health care using the local wisdom of older adults who have survived cancer.This study employed a qualitative descriptive research approach, seeking to uncover and understand the natural phenomena experienced by older cancer survivors. It values the attitudes, thoughts, beliefs,behaviors, and cultural aspects of older adults, aiming for a holistic understanding of their experiences within the studied context called “naturalistic inquiry.” In the study, the researchers investigated real-life phenomena within the natural environment of older adults who have survived cancer. Data collection took place in locations convenient and private for participants, such as their homes,community health centers, gardens, and hospitals. The primary data collection methods included interviews and observations.The study sample consisted of 11 participants, both male and female, aged 60 years or older who had survived cancer for at least five years. The sample size was determined based on data saturation. Data collection took place between June 2019 and January 2020. Inclusion criteria included: 1) having experience using local wisdom for health care during and after cancer, 2) being able to perform daily activities independently, 3) being able to articulate their experiences and communicate in Thai clearly, 4) having normal cognitive function, 5) having no signs of depression,and 6) being willing to participate in the study. The exclusion criterion was having experienced severe illness during the study period. The participants were selected through purposive and snowball sampling.A researcher experienced in qualitative research and care of cancer patients was regarded as a research instrument. The data collection instruments included a personal information record form, a semi-structured interview guide, and observation and field note forms. Data collection involved in-depth interviews, observation of behaviors and health care practices, and review of relevant information.Data analysis was conducted simultaneously using inductive analysis, following Braun and Clarke's six-step thematic analysis approach.The sample had an average age of 66.54 years, and all were identified as Buddhists.Almost all of the participants were female. Breast cancer was the most common diagnosis (n = 5),followed by cervical cancer (n = 3). All participants possessed knowledge, beliefs, concepts, and behaviors accumulated through both direct and indirect experiences. These experiences were used to cope with life’s hardships, maintain their health, and were willingly shared with others—collectively eferrred to as the "wisdom of older people." Three main findings emerged: 1) Life skills for disease protection: living in the present, establishing healthy behaviors, and cultivating life skills; 2) Main support for success: the older people themselves, family members, health professionals, and communities; and 3) Dharma principles for life understanding: commitment to problem-solving,taking personal responsibility, and demonstrating perseverance and patience, acceptance of reality,letting go, understanding one's inner self, and following the middle path. The findings highlight that the wisdom of older adults serves as a vital tool for overcoming life’s adversity, leading to holistic well-being—physically, mentally, socially, and spiritually. Therefore, promoting and integrating this wisdom into healthcare approaches can play a crucial role in the recovery and well-being of older cancer survivors. Healthcare professionals can apply these research findings to develop care models that integrate traditional wisdom with modern medical practices. Additionally, rehabilitation programs should be designed to align with the cultural contexts of older adults in different regions, grounded in holistic traditional wisdom.
Keywords: Cancer survivorship, Experiences, Older people, Wisdom