All ETDs from UAB

Advisory Committee Chair

Marie Bakitas

Advisory Committee Members

Peng Li

James Nicholas Dionne-Odom

Richard Kennedy

Carolyn Pickering

Grant Williams

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


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.

Included in

Nursing Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.