Ann Rehabil Med.  2024 Apr;48(2):155-162. 10.5535/arm.23109.

Applying ICF Framework to Explore the Factors That Influence Quality of Life in Patients After Lung Surgery

• Li X
• Chen Y
• Liu S
• Zhang M

• KMID: 2554791
• DOI: http://doi.org/10.5535/arm.23109

Abstract

Objective
To explore the relationship between pulmonary function, physical activity, and health-related quality of life (QoL) in resected lung cancer patients based on the International Classification of Functioning, Disability, and Health (ICF) framework developed by the World Health Organization to describe health and health-related states.
Methods
A quantitative study was designed with postoperative lung cancer survivors to assess personal characteristics. We also assessed functional impairment related to the lung using forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV₁), activity limitations using maximal oxygen consumption (VO_2max), anaerobic threshold (AT) and 6-minute walking distance (6MWD), and participation restriction using the 36-item Short Form Health Survey V1 (SF-36). Data analyses were conducted using the multivariate method and Smart- PLS to examine path coefficient among the measures.
Results
Forty-one patients were enrolled in this study. FVC and FEV₁ were poorly correlated with QoL, and 6MWD, AT, or VO_2max were positively associated with QoL. AT or VO_2max showed a significant (p<0.01) direct path with SF-36 in the ICF model. Although age and body mass index were not strongly correlated with QoL, these personal factors had a medium to large effect on perceived QoL.
Conclusion
Disability is a complex in patients with lung resection, and physical activity plays an important role in enabling participation. Improving VO_2max and AT is needed to improve the QoL of resected lung cancer patients. We should also pay more attention to contextual factors that have a significant impact on social participation.

Keyword

Structural equation modeling; Lung cancer; Quality of life; International Classification of Functioning; Disability and Health; Factors

Figure

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  Fig. 1. International Classification of Functioning, Disability and Health categorization of outcome measures used in this study.

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  Fig. 2. The hypothetical model based on International Classification of Functioning, Disability and Health framework. FVC, forced vital capacity; FEV1, forced expiratory volume at 1 second; 6MWD, 6-minute walking distance; AT, anaerobic threshold; VO2max, maximal oxygen consumption; SF-36, the 36-item Short Form Health Survey V1; BMI, body mass index.

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  Fig. 3. The summary of workflow in this study. SF-36, the 36-item Short Form Health Survey V1; PLS-SEM, partial least squares structural equation modeling.

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  Fig. 4. Structural equation model exploring the basic paths of the International Classification of Functioning, Disability and Health model for patients with lung resection. FVC, forced vital capacity; FEV1, forced expiratory volume at 1 second; 6MWD, 6-minute walking distance; AT, anaerobic threshold; VO2max, maximal oxygen consumption; SF-36, the 36-item Short Form Health Survey V1; BMI, body mass index.

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