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

The purpose of this naturalistic, qualitative study was to describe the meaning 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 through activity was derived through an adaptation of Colaizzi's phenomenological method and the consensus dialogue approach to concept clarification. Results suggest people who are ill face an ongoing challenge of preserving their personal integrity, defined as a satisfying sense of wholeness, as they encounter a variety of physical changes that can interfere with day-to-day activity. Qualities most salient to integrity are a sense of effectiveness, or "being able," and of connectedness, or "being with." Identifying personal integrity as a motivating and explanatory factor in day-to-day activity performance may be an important consideration in designing effective intervention programs to improve capacity, strengthen performance, and enhance quality of life.