Determinants of quality of life in chronic obstructive pulmonary disease: A nursing investigation

The purpose of this study was to determine the extent to which manifest symptom distress, physical functional alterations, self-esteem, social functional alterations and spiritual well being explain Quality of Life in Chronic Obstructive Pulmonary Disease (COPD) patients. An adapted version of the Graham-Cowan Theoretical Model of Quality of Life for Chronic Illness was used as the theoretical underpinning. After accounting for the influence of selected demographic and health characteristics and disease severity, the direct and indirect relationships between the independent variables and Quality of Life in COPD patients were examined. The sample consisted of one hundred and forty-eight participants aged 40 to 80 from a medical center in Massachusetts. The instrument for the study included a demographic and health characteristics profile, the Medical Outcomes Study Short Form - 36 Physical and Social Well Being Scales, the Symptom Distress Scale, the Rosenberg Self-Esteem Scale, the JAREL Spiritual Well Being Scale and the Quality of Life Scale. A path analysis was used to answer the research question and investigate the hypotheses. Disease severity stage, comorbid conditions, education level, manifest symptom distress and spiritual well being were found to be directly related to Quality of Life for COPD patients. Physical functional alterations and self-esteem were found indirectly related to Quality of Life through spiritual well being.