Clinical Scholarship Loneliness, Depression, and Social Support of Turkish Patients With Chronic Obstructive Pulmonary Disease and Their Spouses Magfiret Kara, Arzu Mirici Purpose: To identify the differences in loneliness, depression, and social support among Turk- ish patients with COPD and their spouses. Design: The convenience sample consisted of 30 patients with COPD and their spouses. Descriptive statistics, Student’s t tests, and Pearson product moment correlations were used to analyse the data. Methods: Data were collected during structured interviews in an outpatient clinic in Turkey by using the UCLA Loneliness Scale, the Beck Depression Inventory and Perceived Social Support from Friends and Family scales. Findings: Levels of loneliness, depression, and perceived social support from family and friends were similar for patients and spouses. Loneliness and depression were positively related, but both loneliness and depression were greater with less perceived social support from family and friends for both patients and their spouses. Conclusions: Patients’ and spouses’ psychologic reactions to COPD might include feelings of loneliness and depression, which might be alleviated by social support. JOURNAL OF NURSING SCHOLARSHIP , 2004; 36:4, 331-336. C 2004 SIGMA THETA TAU INTERNATIONAL. [Key words: loneliness, depression, perceived social support, COPD, spouses] * * * C hronic obstructive pulmonary disease (COPD) has become an increasingly important cause of morbidity and mortality in the modern world (American College of Chest Physicians/American Asso- ciation of Cardiovascular and Pulmonary Rehabilitation [ACCP/AACVPR], 1997). Worldwide information in the global burden of disease study (Murray & Lopez, 1997) in- dicated that COPD ranked 6th among the 30 leading causes of death, with estimates that it would be the third lead- ing cause of death by 2020. This trend is similar in Turkey. As many as 2.5 to 3 million Turkish people have COPD, and mortality rates and prevalence are increasing (Turkish Thoracic Society, 2000). COPD is a slow progressive condition with irreversible narrowing of small airways, increasing airflow obstruction, loss of pulmonary elastic recoil, trapped air, and impaired gas exchange, resulting in a syndrome of dyspnea, cough, sputum production, and possibly wheezing. People in more advanced stages have poor exercise tolerance, fatigue, loss of appetite, loss of weight, and sleep disturbance (Smeltzer & Bare, 2000; Weilitz & Sciver, 1996). In addition to these pathophysiologic changes and functional problems, patients with COPD must also strive to cope with psychosocial changes and problems such as loneliness, social isolation, and depression. Patients with COPD can experience a lack of control over daily life activities and recreational and social activities, loss of independence, early retirement, financial stress, role alterations, disruption in family life, altered self-image, and diminished self-esteem. As a result they also experience psychosocial problems, such as anxiety, depression, social isolation, loneliness, helplessness, and hopelessness (Kinsman, Yaroush, & Fernandez, 1983; Prigatono, Wright, & Levin, 1984; Williams & Bury, 1989; Schirer, Dekker, Kaptein, & Dikjman, 1990; Miller, 1983). All of these psychosocial and physical limitations can in- crease patients’ need for holistic care, including attention to the person’s environment and receiving support from family Magfiret Kara, RN, PhD, Assistant Professor, Fundamentals of Nursing Department; Arzu Mirici, MD, Professor, Department of Chest Disease, Medical Faculty; both at Atat¨ urk University, Erzurum, Turkey. The authors acknowledge the contributions of all patients and their spouses who took part in the study, and clerical staff of the outpatient clinic where these data were gathered. Correspondence to Dr. Kara, Atat¨ urk ¨ Universitesi, Hemsire- lik Y ¨ uksekokulu, 25240, Erzurum, T ¨ urkiye. E-mail: magfiret@atauni.edu.tr Accepted for publication May 19, 2004. Journal of Nursing Scholarship Fourth Quarter 2004 331