Wednesday, July 11, 2007
This presentation is part of : Chronic Illness Strategies
The congruence of subjective psychosocial factors and measured symptom severity in chronic illness
Cheryl Delgado, PhD, RN, C-ANP, School of Nursing, Cleveland State University, Cleveland, OH, USA
Learning Objective #1: recognize the lack of congruence between subjective and objective symptom severity ratings for persons with chronic obstructive pulmonary disease.
Learning Objective #2: discuss the relationship between subjective and objective measures of symptom severity and quality of life.

The purpose of this research was to examine the correlation between two psychosocial factors and their relationship to perceived stress and quality of life within the context of chronic illness. Chronic Obstructive Pulmonary Disease (COPD) served as an exemplar for chronic illness as it affects persons in both technologically advanced and developing countries. One hundred and eighty-one outpatients aged 30 to 87, recruited from the United States and the Caribbean, completed the Orientation to Life Questionnaire, the Spiritual Transcendence Scale, the Perceived Stress Scale, The Quality of Life Index (Pulmonary Version), a demographic sheet and self rated their own shortness of breath and ability to function. Pulmonary function test data were retrieved from their medical records. All had been treated for COPD at a large medical center in the Midwestern United States with an international reputation for cardiopulmonary excellence. Statistics for the study included Pearson r correlation coefficients, multiple regressions, and ANOVA. Psychosocial factors had a negative correlation with stress and a positive correlation with quality of life. Both had significant negative correlations to self rated SOB and impaired function but no significant correlation with the objective pulmonary function test results. None of the pulmonary function test scores were significantly correlated to quality of life. Most participants considered themselves able to care for themselves and rated their shortness of breath and ability to functions as only somewhat impaired despite the fact that more than half (53%) used oxygen at home. The majority exhibited a wide range of pulmonary function results indicating moderate to severe disease. Persons with strong psychosocial factors rated their quality of life as better regardless of the pulmonary function test results. Psychosocial factors in this study buffered the effects of stress and the participant’s subjective and objective symptom severity ratings were not congruent.