The Open Public Health Journal

ISSN: 1874-9445 ― Volume 13, 2020

The Factors Predicting the Health-Related Quality of Life Among Persons with Chronic Obstructive Pulmonary Disease in Public Health Region 4, Thailand: A Mixed-Methods Study

Atchanat Wangsom1, *Pranom Othaganont1Sigrid Ladores2
1 Faculty of Nursing, Thammasat University, Pathum Thani, Thailand
2 School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA



Health-Related Quality Of Life (HRQOL) is an important consideration for persons with Chronic Obstructive Pulmonary Disease (COPD). This convergent parallel mixed-methods study aimed to examine the factors predicting HRQOL and to explore a comprehensive in-depth understanding of the factors associated with HRQOL in persons with COPD.


For the quantitative arm, simple random sampling consisted of 240 persons with COPD in Public Health Region 4, Thailand and self-reported questionnaires were employed and analyzed by using SPSS version 22.0 software. For the qualitative arm, purposive sampling consisted of 30 participants that were interviewed and the transcripts analyzed using content analysis. Subsequently, a side-by-side joint display table was used to merge the data.


Social support was the strongest predictor of HRQOL, followed by nutritional status, pulmonary function, and functional performance with R2 = 0.801, p = 0.00. The participants perceived that social support can create encouragement, build convenience, and offer good recommendations. They also reported that the effects of COPD included poor nutritional status, deteriorating lung function, and activity limitations resulting in inadequate self-care in people living with COPD. Although age and gender were not found to be significant predictors of HRQOL, the participants perceived that differences in age and gender did not predict the prognosis of the disease.


Four factors were seen to be significant predictors of HRQOL and potential explanations for the identification of the factors predicting HRQOL. Nurses and healthcare teams can modify the predicting factors and implement appropriate care leading to increased HRQOL in persons with COPD.

Keywords: Health-related quality of life, Chronic obstructive pulmonary disease, Personal factors, Social support, Pulmonary function, Functional performance.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 13
First Page: 105
Last Page: 113
Publisher Id: TOPHJ-13-105
DOI: 10.2174/1874944502013010105

Article History:

Received Date: 19/11/2019
Revision Received Date: 20/02/2020
Acceptance Date: 21/02/2020
Electronic publication date: 24/04/2020
Collection year: 2020

© 2020 Wangsom et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Nursing, Thammasat University, Pathum Thani, Thailand; E-mail:

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