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Physical activity and quality of life in palliative care: An ethnographic study exploring patients' experiences of and views on participation in a hospice-based Tai-Chi programme

Bradshaw, Andrew Carl (2018) Physical activity and quality of life in palliative care: An ethnographic study exploring patients' experiences of and views on participation in a hospice-based Tai-Chi programme. PhD thesis, University of Leeds.

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Abstract

Living with a terminal illness presents multifaceted adversities that can undermine various domains of an individual’s well-being. In addressing these issues, palliative care adopts a holistic and multidisciplinary approach which seeks to improve the quality of life of patients. Mindful movement therapies are one way in which the goals of palliative care may be achieved. However, the ways through which patients with terminal illnesses view and experience these types of interventions within the context of hospice care is unclear. Thus, the aims of this thesis were to utilise a focused ethnography to explore: (a) how participation in hospice-based Tai Chi impacted patients’ perceptions of quality of life; and (b) patients’ views on Tai Chi, including the perceived barriers and facilitators that they experienced in relation to their participation. 19 patients who were diagnosed with an advanced, incurable illness were recruited to this study. Data was collected using multiple methods, including: semi-structured interviews, participant observations, and informal conversations. It was analysed using a thematic framework approach. With regards to the study’s first aim, three themes captured how taking part in Tai Chi impacted participants’ perceptions of their quality of life, including: (a) the pleasures of mind-body respite; (b) social engagements; and (c) case studies of outliers. With regards to the study’s second aim, five themes were constructed which demonstrated how the barriers and facilitators to taking part in hospice-based Tai Chi fell at multiple, inter-related levels of engagement (e.g., intrapersonal, interpersonal, and community). These included: (a) physical limitations; (b) enjoyable and worthwhile activity; (c) group practice; (d) autonomy and choice; and (e) supervision by professionals. Based on these findings, empirical, practical, and methodological implications are highlighted which make the case for the integration of Tai Chi (and other mindful movement/physical activity interventions) as an integral facet of rehabilitative palliative care practice as a means to improve quality of life in patients with life-limiting illnesses. Recommendations for health-care professionals working in this context on how to design and deliver Tai Chi programmes in clinical practice are discussed. Central to this discussion – and something that is laced throughout the findings of this thesis – is an emphasis on the importance of the cultural context of the hospice day therapy unit in which participants’ views and experiences of Tai Chi were located.

Item Type: Thesis (PhD)
Keywords: tai chi, quality of life, ethnography, physical activity, palliative care, hospice care
Academic Units: The University of Leeds > Faculty of Biological Sciences (Leeds)
Identification Number/EthosID: uk.bl.ethos.767258
Depositing User: Dr A Bradshaw
Date Deposited: 01 Mar 2019 12:34
Last Modified: 18 Feb 2020 12:49
URI: http://etheses.whiterose.ac.uk/id/eprint/22996

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