| This cross-sectional, observational study sought to identify factors influencing quality of life in chronic obstructive pulmonary disease (COPD), and to identify intervening variables that mediated the effects of these factors on life quality. Using a framework derived from the stress, coping, and adaptation theory of Lazarus and Folkman (1984), variables were placed in a proposed model of quality of life in COPD. The major study hypotheses were that demographic (age, socioeconomic status) and disease (disease severity, dyspnea, and functional status) variables would have only indirect effects on quality of life, and that the mediating variables (depression, anxiety, self-esteem, dispositional optimism, and social support) would have direct effects on quality of life.;A sample of 126 patients (mean age = 68.1 ;The model explained 53% of the variance in quality of life. The major study hypotheses were partially supported. Three mediating variables (depression, self-esteem, and social support) and one antecedent variable (age) had direct effects on quality of life. Two antecedent variables, disease severity and functional status, had significant total, though indirect effects on quality of life.;These findings are in agreement with those of Burckhardt (1985), who found that psychosocial variables mediated the relationships between disease and demographic variables and quality of life in arthritis patients. The findings suggest that nurses in clinical practice with COPD patients must attend to the psychosocial aspects of care, particularly, when little improvement is possible in the physiologic state of the patient. Specifically, nurses must develop interventions to enhance self-esteem and improve perceived social support in COPD patients. |
