LINKING CLINICAL VARIABLES WITH HEALTH STATUS: TESTING A PATIENT OUTCOME MODEL IN PERSONS LIVING WITH AIDS (IMMUNE DEFICIENCY, QUALITY OF LIFE).
Contributors: University of California, San Francisco.
Published: 1996
Number of pages: 169
Subjects: Health Sciences, Nursing.; Health Sciences, Public Health.
Description: The purpose of this investigation was to provide empirical support for a theoretical model that proposes to predict health-related quality of life (HRQOL). Wilson and Cleary (1995) assert that HRQOL is determined by general health perception, functional status, symptom status, physiological/biological factors, characteristics of the environment and the individual. Data from 142 hospitalized patients from a study supported by a grant from the National Institute for Nursing Research, "Quality of Nursing Care of People with AIDS" (NRO2215), William L. Holzemer, principal investigator, was used to empirically test the Wilson and Cleary (1995) HRQOL model. The physiological/biological variables were converted into an APACHE III APS score, and a total symptom score was calculated from a 31-item symptom checklist. Functional status was measured by the HIV Quality Audit Marker (Holzemer, Henry, & Janson-Bjerklie, 1993) and two specific questions from the MOS-30 (Wu, et al., 1991) were used to measure general health status and overall health-related quality of life.

Path analysis, using multiple regression analysis, examined the fit between the conceptual model and the data. The first variable to enter the path model was general health perception. General health perception explained 10.72% of the variance in HRQOL. When functional status was added, 15.89% of the variance in HRQOL was explained. Symptom status scores increased the explained variance in HRQOL by 4.29% while physiological/biological factors did not add any increase explanation for the variance in HRQOL. The path model including physiological/biological factors, symptom status, functional status, and general health perception as predictors explained 20% (R$\sp2$ =.2018) of the variance in HRQOL. Thirty-two of the variance in HRQOL was explained when the environment and individual characteristics were included in the model. Symptom status had the greatest influence on HRQOL (Beta = $-$0.237) and uniquely accounted for 5% (R$\sp2\sb\□rm Y\□cdot2□ □$= 0.0470) of the variance in HRQOL.

Nursing has always focused on prevention, health promotion, symptom management and the alleviation of acute and chronic illness effects. HRQOL, as expressed by this model, may be an appropriate patient outcome for capturing the results of nursing interventions.
Notes: Source: Dissertation Abstracts International, Volume: 57-06, Section: B, page: 3660.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1996.

School code: 0034.