Advisory Committee Chair
Marie Bakitas
Advisory Committee Members
Peng Li
James Nicholas Dionne-Odom
Richard Kennedy
Carolyn Pickering
Grant Williams
Document Type
Thesis
Date of Award
2022
Degree Name by School
Doctor of Philosophy (PhD) School of Nursing
Abstract
By 2040, the U.S. is projected to have 26.1 million cancer survivors; 73% of these will be over 65 years old. Much is known about life-space mobility (LSM) in patients with non-cancer serious illnesses. Restricted LSM affects every aspect of an older adult’s life; their independence, autonomy, and quality of life (QOL). To date, there are no studies examining LSM in older cancer survivors. Therefore, we examined LSM, factors that affect LSM, and the relationship between LSM and QOL in older cancer survivors using existing data from the University of Alabama at Birmingham (UAB) Study of Aging (SOA) (NIA AG15062). We conducted a secondary data analysis study based on a literature-derived conceptual model with 3 aims: 1) determine the factors (cognitive, social, physical, environmental, financial, sociodemographic, spiritual, and psychological) that have the greatest impact on LSM over time, 2) describe the relationship between LSM trajectory and QOL over time, and 3) determine how a new cancer diagnosis affects LSM trajectory over time. Correlations and general linear mixed regression models revealed associations between sociodemographic/clinical characteristics and factors and LSM trajectories. LSM trajectory patterns were determined using Group-Based Trajectory analysis. Cross Lag Path Model analysis assessed a causal relationship between LSM and QOL over time. iv The average age of participants (n=153) was 76, 42% AA/58% W, 42% M, years of education M=11.25, rural n=73. Three trajectory patterns of LSM were identified, each with unique demographic and clinical characteristics. Eight predictor factors of importance for LSM trajectory patterns were identified for all participants. Unique predictors for rural and urban residents emerged. A lower LSM trajectory pattern is associated with poorer QOL. A causal relationship between the LSM and PCS over time was suggested. A new cancer diagnosis caused a large immediate decrease of LSM with little recovery. The LSM trajectory of those with a new cancer diagnosis (n = 53) over time was lower than those without a cancer diagnosis. These findings suggest that older cancer survivors have unique factors affecting LSM trajectory patterns over time. LSM is causal for QOL. A new cancer diagnosis has an important impact on LSM over time.
Recommended Citation
Taylor, Richard A., "Life-Space Mobility in the Older Adult, Community-Dwelling Cancer Survivor in the Deep South: A Secondary Data Analysis" (2022). All ETDs from UAB. 342.
https://digitalcommons.library.uab.edu/etd-collection/342
