A good life, despite my troubles

An exploration of quality of life in older people with Chronic Obstructive Pulmonary Disease

Research output: ThesisDoctoral Thesis

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Abstract

The purpose of this hermeneutic study was to explore the conceptualisation of quality of life for older people with Stage IV (end-stage) Chronic Obstructive Pulmonary Disease (COPD). Eleven people aged between 63 – 89 years living in a large rural centre in New South Wales, were recruited through a local Respiratory Coordinated Care Program to participate in narrative-style interview. Audio and video recording were transcribed verbatim and analysed using an inductive thematic analysis to identify core ideas and themes. The analysis and interpretation of the text was underpinned by Gadamer’s philosophy of hermeneutic phenomenology (1975; 2004) and the Gadamerian-style research method proposed by Fleming, Gaidys, and Robb (2003).
The thematic analysis revealed four core themes: ‘Accepting Change’, ‘Mind over Matter’, Being in the World Together’, and ‘Quality over Quantity’. In accepting the changes occurring in their bodies, as opposed to the diagnosis and label of COPD, the participants spoke of an identity grounded in their past experiences of both suffering and change. It was from this identity as a person both subject to, and capable of change that they fought to maintain independence in the face of mounting dependence. Critical to their acceptance of, and adaption to, change was their use of self-regulatory coping strategies to establish control over their symptoms. This in turn fed into a cycle of change and adaption that built confidence to face future change with resilience.
There were implications of the ongoing change on their core familial relationships, as this is where the burden of physical care lay. These implications manifested not only in the way they coped with increasing disability and burden, but in their decision making processes regarding their future, particularly Advanced Care planning. The drive to maintain independence, and in so doing, protect their loved ones from the full emotional and physical impact of COPD, sat at the core of the participants’ understanding and expression of quality of life; that it was not just their own quality of life, but the quality of lives of those they loved.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Charles Sturt University
Supervisors/Advisors
  • Crockett, Judith, Principal Supervisor
  • Burton, Deborah, Principal Supervisor
  • Gullifer, Judith, Principal Supervisor
Publisher
Publication statusPublished - 2017

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quality of life
Disease
hermeneutics
video recording
decision making process
phenomenology
resilience
research method
coping
acceptance
confidence
disability
narrative
interpretation
planning
human being
interview
experience

Cite this

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title = "A good life, despite my troubles: An exploration of quality of life in older people with Chronic Obstructive Pulmonary Disease",
abstract = "The purpose of this hermeneutic study was to explore the conceptualisation of quality of life for older people with Stage IV (end-stage) Chronic Obstructive Pulmonary Disease (COPD). Eleven people aged between 63 – 89 years living in a large rural centre in New South Wales, were recruited through a local Respiratory Coordinated Care Program to participate in narrative-style interview. Audio and video recording were transcribed verbatim and analysed using an inductive thematic analysis to identify core ideas and themes. The analysis and interpretation of the text was underpinned by Gadamer’s philosophy of hermeneutic phenomenology (1975; 2004) and the Gadamerian-style research method proposed by Fleming, Gaidys, and Robb (2003).The thematic analysis revealed four core themes: ‘Accepting Change’, ‘Mind over Matter’, Being in the World Together’, and ‘Quality over Quantity’. In accepting the changes occurring in their bodies, as opposed to the diagnosis and label of COPD, the participants spoke of an identity grounded in their past experiences of both suffering and change. It was from this identity as a person both subject to, and capable of change that they fought to maintain independence in the face of mounting dependence. Critical to their acceptance of, and adaption to, change was their use of self-regulatory coping strategies to establish control over their symptoms. This in turn fed into a cycle of change and adaption that built confidence to face future change with resilience. There were implications of the ongoing change on their core familial relationships, as this is where the burden of physical care lay. These implications manifested not only in the way they coped with increasing disability and burden, but in their decision making processes regarding their future, particularly Advanced Care planning. The drive to maintain independence, and in so doing, protect their loved ones from the full emotional and physical impact of COPD, sat at the core of the participants’ understanding and expression of quality of life; that it was not just their own quality of life, but the quality of lives of those they loved.",
author = "Phillipa Southwell",
year = "2017",
language = "English",
publisher = "Charles Sturt University",
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}

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N2 - The purpose of this hermeneutic study was to explore the conceptualisation of quality of life for older people with Stage IV (end-stage) Chronic Obstructive Pulmonary Disease (COPD). Eleven people aged between 63 – 89 years living in a large rural centre in New South Wales, were recruited through a local Respiratory Coordinated Care Program to participate in narrative-style interview. Audio and video recording were transcribed verbatim and analysed using an inductive thematic analysis to identify core ideas and themes. The analysis and interpretation of the text was underpinned by Gadamer’s philosophy of hermeneutic phenomenology (1975; 2004) and the Gadamerian-style research method proposed by Fleming, Gaidys, and Robb (2003).The thematic analysis revealed four core themes: ‘Accepting Change’, ‘Mind over Matter’, Being in the World Together’, and ‘Quality over Quantity’. In accepting the changes occurring in their bodies, as opposed to the diagnosis and label of COPD, the participants spoke of an identity grounded in their past experiences of both suffering and change. It was from this identity as a person both subject to, and capable of change that they fought to maintain independence in the face of mounting dependence. Critical to their acceptance of, and adaption to, change was their use of self-regulatory coping strategies to establish control over their symptoms. This in turn fed into a cycle of change and adaption that built confidence to face future change with resilience. There were implications of the ongoing change on their core familial relationships, as this is where the burden of physical care lay. These implications manifested not only in the way they coped with increasing disability and burden, but in their decision making processes regarding their future, particularly Advanced Care planning. The drive to maintain independence, and in so doing, protect their loved ones from the full emotional and physical impact of COPD, sat at the core of the participants’ understanding and expression of quality of life; that it was not just their own quality of life, but the quality of lives of those they loved.

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