A nomadic exploration of quality of life in long-term conditions
The nature of quality of life and its consensual definition has eluded researchers and philosophers ever since Aristotle. While social indicators researchers seek to model it in order to inform policy, it is used as an outcome measure of health care. Although studied from a variety of perspectives, the concept has, as yet, been largely untouched by postmodernists. In this thesis, quality of life is studied through the frame of long¬term conditions. Within this, I use the Deleuzo-Guattarian concepts of the body without organs, its territorialisation by societal forces and the emancipatory promise of nomadism. Three health service developments for people with multiple sclerosis, a sample of television programming, a Disney Classic feature and the National Service Framework for long-term conditions form the case material for the study. I take the reader through a deterritorialising textual journey, so that quality of life may be approached differently. Qualitative research chapters are alternated with those analysing the political and cultural background to their making. These texts are woven into a deconstruction of quality of life in the five oppositional pairs of life and death, health and illness, independence and dependence, empowerment and disempowerment and certainty and uncertainty. This deconstructive thread informs and is informed by the texts studied, in a (rhizomatic) dis-order used to blur boundaries between established categories. A temporary reterritorialisation of quality of life emerges, which highlights the construction of the self as an endless process. Powerful discourses, such as medicine, shape a quality of life text for people with long-term conditions. Deterritorialisation, as a process, enables the acknowledgement of such territorialising forces and encourages a different engagement with life. The body as a dys-organ-ised entity with erratically evolving possibilities becomes a territory, and quality of life the potential to engage in a liberating process of deterritorialisation.