PHYSIOLOGIC AND PSYCHOSOCIAL ATTRIBUTES OF QUALITY OF LIFE IN LUNG TRANSPLANT CANDIDATES (COPING ABILITY, OPTIMISM).
Contributors: University of Pittsburgh.
Published: 1993
Number of pages: 167
Subjects: Health Sciences, Nursing.; Psychology, Personality.
Description: The purpose of this study was to identify factors which account for variability in quality of life in patients with end-stage pulmonary disease seeking evaluation for lung transplantation. Interrelationships were explored among selected physiologic variables (age, gender, disease severity, exercise tolerance), psychosocial variables (dispositional optimism, self-esteem, coping ability) and quality of life prior to and following evaluation for placement on the lung transplant candidate list. Utilizing the strategy of a conceptual map, variables were ordered into a model based on an integration of Lazarus and Folkman's (1984) theory of stress and coping, and Carver and Scheier's model of behavioral self-regulation (1985).

Fifty-two subjects (35 women, 17 men) with a mean age of 46 $\pm$ 12 from one transplant center participated in the study. Subjects completed three self-report instruments designed to measure dispositional optimism (LOT), self-esteem (SES), and coping styles (COPE). Subjects also completed two instruments designed to measure quality of life, the quality of well-being scale (QWB) and the visual analogue scale (VAS). Spirometric values and six minute walk distance were obtained from data collected during evaluation for candidacy.

Predicted relationships between the physiologic and psychosocial variables and quality of life were examined using the Pearson product moment correlations. Comparisons between scores of subjects accepted and not accepted for placement on the lung transplant list showed no significant differences in LOT, COPE or QWB scores. Significant differences were seen for SES scores. Subjects selected for placement on the transplant list had a higher (p = 0.026) SES score prior to evaluation, than subjects not placed on the list. Scores for both groups decreased (p = 0.0001) following evaluation. VAS scores improved over time (p = 0.02), indicating improved perception of quality of life following evaluation as determined by the more subjective VAS, but had no affect on quality of life as determined by the QWB, a tool predominately designed to measure functional status.

There were no significant relationships between physiologic variables and quality of life with one exception. A significant negative association was found between age and the VAS (r = $-$.47; p = 0.01). As predicted, there were no significant relationships between physiologic and psychosocial variables. In contrast with the predicted change, no significant relationships were found between the psychosocial mediators and quality of life. When variables were analyzed using multiple regression, none of the variables included in the model explained a significant proportion of the variance in quality of life for this patient population. Findings of this study suggest that optimism and coping ability are stable traits which are not affected by major life altering events, such as evaluation for lung transplant candidacy.
Notes: Source: Dissertation Abstracts International, Volume: 54-07, Section: B, page: 3548.

Thesis (PH.D.)--UNIVERSITY OF PITTSBURGH, 1993.

School code: 0178.