Date of Award


Degree Name

Doctor of Philosophy


Public Affairs and Administration

First Advisor

Dr. Kathleen M. Reding

Second Advisor

Dr. Peter Kobrak

Third Advisor

Dr. Charles W. Given


The purpose of this study was to determine whether there were changes in the quality of life of cancer patients aged 65 and older (N>488) following initial treatment for cancer. A Quality of Life conceptual model was developed. Quality of Life refers specifically to physical, social, and functional status. The study analyzed data from a larger longitudinal data set and compared data for patient’s with prostate, breast, lung, and colon cancer at three observation points: (1) three month Recall, (2) after surgery and prior to chemotherapy or radiation (Wave I), and (3) fourteen weeks following surgery, during chemotherapy or completion of radiation (Wave II). Changes in functional status were measured through Physical Function Subscale of SF-36, CES-D, and total symptom severity instrument.

The mean age of sample was 72.4 (S.D. = 5.5) years. The sample was predominately male (53.3%), 93% Caucasian, and 76.2% lived with someone. Onethird of sample (33.3%) was diagnosed with prostate cancer, followed by breast, lung, and colon cancer. Surgery was the predominate treatment (31.3%). Most of the cancer patients did not experience substantial Activities of Daily Living limitations. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. However, vigorous functioning, measured by a Physical Function Subscale of SF-36 showed a precintious decline in means from a high of 2.60 (S.D. = .58) at Recall to a low of 1.61 (S.D. = .58) at Wave II. Possible answers ranged from one (limited a lot) to three (not limited). Three-quarters of the cancer patients reported two or more comorbid conditions. Data were analyzed using Repeated Measures Analysis of Covariance. There was a significant decline in physical functioing regardless physical functioning regardless of time (p < .005) and over time (p < .008). Decline in physical functioning was greater among the patient group with fewer comorbid conditions when compared to the patient group with two or more comorbid conditions. Cancer site had no effect on physical functioning. There was no difference in symptom experience and depression scores based upon the patient’s number of comorbid conditions.

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Dissertation-Open Access

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Health Policy Commons