The purpose of this Heideggerian hermeneutical study was to explore and uncover the hidden meaning of quality of life as experienced by a population of individuals 65 years of age and beyond. Five participants were interviewed and asked to describe quality of life as these individuals experienced it. Consistent with the method, purposive sampling was used in order to gain an understanding from subjects who have experienced the phenomenon and could articulate experiences. A group of retirees who meet monthly at a church were asked to participate. Interviews were audiotaped and the data was transcribed by this researcher. Audio tapes were destroyed when the study was completed. Transcribed data was shared with other researchers who are familiar with Heideggerian hermeneutics for the purpose of gaining insight into interpretation. When data was shared, names of participants and other identifying information was removed. Sharing of data for the purpose of interpretation is inherent in the Heideggerian method as described by Diekelmann, Allen and Tanner (1989). Participants were guaranteed confidentiality and were free to withdraw from the study without prejudice at any time. Data was analyzed in seven stages as described by Diekelmann, Allen and Tanner (1989). Findings included a constitutive pattern of quality of life and integrity as one experience. These two ways of being allowed the elderly to experience a sense of unity and completeness as well as a sense of fulfilling one's own destiny. The main theme supporting the constitutive patter was a strong belief and connectedness to a higher power. This faith allowed the elderly to connect to family, friends, church groups and memories. Anticipation of loss and change was a daily experience of being elderly, yet it allowed them to appreciate each day as it was lived without fear or loss of hope. Health promotion was significant because the elderly knew maintaining health was a way to maintain connectedness to that which was valued. The study was significant in contributing an understanding to the experience of quality of life in the elderly population. / School of Nursing

The use of quality of life instruments to evaluate the effect of cancer and its treatment on individuals has increased but the process by which the patient comes to make these quality of life evaluations has not been addressed. Earlier studies have shown the reporting of physical symptoms and the evaluation of one's health to be related to negative affect. The purpose of this study was to investigate whether the relationship between negative affect and the evaluation of ones health would remain the same in a group of cancer patients, when a major disease and treatment symptom, fatigue was controlled for. The current study found no relationship between negative affect and the evaluation of health once fatigue was controlled for. Negative affect and fatigue were found to be moderately correlated and fatigue accounted for a large proportion of the variance in the quality of life domains of physical, functional and emotional well-being. Both empirical and theoretical issues are discussed. / Department of Counseling Psychology and Guidance Services

As the development of medical treatments and the increase in longevity of human life interface with the rising cost of medical care, the issue of quality of life appears to be coming to the forefront in understanding how health care decisions will best be realized for patients. Ethical questions relating to matters such as cost-effective economics, physician-assisted suicide, and quantity of life versus quality of life make the construct of quality of life even more important to ascertain.Quality of life can be an elusive construct to define as well as a difficult one to measure; however, recent literature has shown promising trends. Many quality-of-life measures have been developed in recent years. Initially these measures focused on life satisfaction in general. Then instruments for healthrelated concerns were developed. In the last decade such measures have become more specific as several have emerged to identify the quality-of-life experience regarding a particular illness, such as cancer. The current step is the development of measures for specific populations in oncology. Another trend is the move from objective to subjective measures of assessment. A third trend is movement toward a multidimensional perspective, with the latest addition being the inclusion of a spiritual domain.This project explored the unique experience of cancer patients with recurrent or metastatic disease by utilizing qualitative methodology to describe common themes which emerged from the data. Focus group sessions centered around defining quality of life and discussing the factors that diminish or enhance a meaningful quality of life. A unique contribution of this study was the involvement of the participants as co-researchers in the analysis of the data. Thirteen central themes were identified: control, attitude, humor, death, gratitude, faith, fear, pain, social comparison, social support, financial concerns, information and knowledge, and the focus group experience. The findings confirmed the recent trends in quality-of-life research--multidimensionality, subjectivity, and the uniqueness of a specific cancer population, those with recurrent or metastatic disease. With this elicitative data, future research could include the development of a quality-of-life instrument for this population of oncology patients with more advanced cancer. / Department of Counseling Psychology and Guidance Services