Functional status from the patient's perspective: The challenge of preserving personal integrity

The purpose of this naturalistic, qualitative study was to describe the mea ning of functional performance from the perspective of patients themselves. Twelve men and women with moderate to severe chronic obstructive pulmonary disease (COPD) participated in unstructured, tape-recorded interviews. The essential structure of the experience of finding purpose and meaning throu gh activity was derived through an adaptation of Colaizzi's phenomenologica l method and the consensus dialogue approach to concept clarification. Resu lts suggest people who are ill face an ongoing challenge of preserving thei r personal integrity, defined as a satisfying sense of wholeness, as they e ncounter a variety of physical changes that can interfere with day-to-day a ctivity. Qualities most salient to integrity are a sense of effectiveness, or "being able," and of connectedness, or "being with." Identifying persona l integrity as a motivating and explanatory factor in day-to-day activity p erformance may be an important consideration in designing effective interve ntion programs to improve capacity, strengthen performance, and enhance qua lity of life. (C) 1999 John Wiley & Sons, Inc.