Social stressors, social supports, and self-esteem as predictors of morbidity in adults with chronic lung disease.

Psychosocial correlates of morbidity and functional status were examined in 44 white adults with chronic lung disease. Demographic characteristics, functional status, stressful life changes, social supports, and self-esteem were assessed at baseline by a self-administered questionnaire. Hospital days, bed-disability days, restricted-activity days, and physician visits were then measured prospectively by mailed questionnaire over the next 6 months. There were no cross-sectional associations of psychosocial variables with demographic characteristics. Better functional status (measured by the Sickness Impact Profile) was associated with a lower 12-month life-change score (measured by the Social Readjustment Rating Scale), with stronger social supports (measured by a 13-item index), and with higher self-esteem (measured by the Rosenberg Scale). On bivariate analysis, higher life-change score predicted higher levels of all four morbidity variables; low social supports predicted increased bed days, restricted-activity days, and physician visits; and low self-esteem predicted high restricted-activity. After controlling for demographic characteristics and baseline function by multivariate analysis, low social supports continued to predict higher rates of physician visits, but the other associations of psychosocial variables with morbidity were no longer statistically significant. The results suggest that patients with weak social supports have increased use of physician services.