A Year in Their Lives: Trajectories of Well-Being Among Patients Diagnosed with Advanced Stage Cancer

Research on the well-being of older adults can increase theknowledge and information of care-providers and patients tobetter respond to needs pertaining to psychological, physical,spiritual, social and functional dimensions. In oncology thereis a considerable amount of material of interventions aiming toimproving the patient's well-being. However, in the literaturethere is a gap on empirical models that provide support of thoseinterventions. The purpose of this study is to analyze longitudinal data on patients with advanced-stage cancer in order to describe multiple dimensions of their experience. Specifically the aims are: to identify trajectories and model the patterns of change of different domains of well-being; to capture variation in well-being outcomes attributed to modifiers such as demographics and utilization; to examine how the different domains of well-being relate overtime. Five hundred seventy six patients analyzed at baseline, who have data until death or for up to one year. In this study,six quality of life domains will be analyzed exploring the development in time and the interplay among them. All domains are assessed at baseline (on average 8 weeks after diagnosis) at 3 months, at 6 months, and at 12 months. Results of the study reinforce the strong presence of linkageamong dimensions of well-being, as well as, individual characteristics. Moreover, the illness experience of the patientsis been shown to be heterogeneous based on both survival time andpersonal characteristics, and thus not summarized by a singletheory. Indeed, the study found that the illness trajectories arenot reflected in the disease trajectory of the patients.From a methodological standpoint the need for complex models that better capture the reality of the patients' experiencesis suggested. Findings also revealed important aspects of thepatient's experiences relative to policy. Finally, the findingsshow that short-term survivors have both different patterns ofchange of well-being and different effects of covariates on theirexperience. This diverse type of experience must be acknowledged when caring for the advanced-stage cancer patient.

Name thesis:degree_name

Doctor of Philosophy

Level thesis:degree_level

doctoral

Discipline thesis:degree_discipline

Sociology

Grantor dc:publisher

Case Western Reserve University School of Graduate Studies

Year dc:date

2013

Author dc:creator

• Kypriotakis, Georgios

Contributors dc:contributor

• Kelley-Moore, Jessica

• Health
• Health Care
• Health Care Management
• Sociology
• cancer
• quality of life
• well-being
• longitudinal
• social constructionism

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: some rights reserved. It is licensed for use under a Creative Commons license. Specific terms and permissions are available from this document's record in the OhioLINK ETD Center.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=case1354853720

OAI identifier oai:identifier

oai:etd.ohiolink.edu:case1354853720