The Influences of Illness Uncertainty, Health Literacy, and Self-Care on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Purpose: This study examined the effects of illness uncertainty, health literacy, and self-care on quality of life (QoL) among patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 116 patients with COPD were recruited from a general hospital in Seoul. Data were collected using questionnaires covering demographics, illness uncertainty (Mishel’s Uncertainty in Illness Scale), health literacy (COPD-Specific Health Literacy Tool), self-care (Self-Care in COPD Inventory, SC-COPDI), and QoL (St. George’s Respiratory Questionnaire; higher scores indicate poorer QoL). Statistical analyses included the t-test, analysis of variance, Pearson correlation coefficients, and multiple linear regression. Results: QoL was significantly correlated with illness uncertainty (r=.59, p<.001), health literacy (r=-.40, p<.001), and self-care (r=-.25, p=.007). Multiple regression analysis revealed that illness uncertainty (β=.37, p<.001) and health literacy (β=-.20, p=.004) were significant independent predictors of QoL, whereas self-care was not a significant predictor. Conclusion: Illness uncertainty and health literacy were key factors influencing QoL, while self-care, although correlated, did not directly predict QoL. To improve QoL in COPD patients, nursing interventions should aim to reduce illness uncertainty and enhance health literacy. Developing and implementing tailored, repetitive, and digital-based educational programs suited to patients’ literacy levels may improve self-care performance and overall quality of life.