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Advisory Committee Chair

Karen Heaton

Advisory Committee Members

Peng Li

Wayne Sanderson

Pariya Wheeler

Cheryl Witt

Document Type

Dissertation

Date of Award

2023

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Farmers are susceptible to both Chronic Obstructive Pulmonary Disease (COPD) and psychological distress. It is known that psychological distress is associated with increased respiratory symptoms and triggers COPD exacerbation. Therefore, farmers who have COPD may experience worsening respiratory symptoms as a result of psychological distress. Since no known studies revealed the association between the frequency of respiratory symptoms and the level of psychological distress among farmers with COPD, this study aimed to explore (1) the frequency of respiratory symptoms and the level of psychological distress, (2) the factors related to increased respiratory symptoms and psychological distress, and (3) the association between respiratory symptoms and psychological distress among farmers living with COPD in the US. This cross-sectional research study was conducted online. The participants (n = 101) were recruited from both on-site and online methods. Standard self-reported measures were used to evaluate the frequency of respiratory symptoms and level of psychological distress among farmers with COPD. Both simple and multiple linear regression were used to evaluate the association between respiratory symptoms and psychological distress. The respondents had a higher score for the frequency of respiratory symptoms (61.6 [SD = 13.3]) than the reference score (12) and had a high level of psychological distress (25.9 [SD = 10.6]). Factors associated with the frequency of respiratory symptoms were years of having COPD, income, smoking, and ED visits, while those associated with iv psychological distress were age, years of having COPD, income, smoking, pesticide exposure, and type of farm. The frequency of respiratory symptoms was found significantly associated with the level of psychological distress after controlling for age, smoking, and pesticide exposure (β = 0.46, p < 0.001). The frequency of respiratory symptoms is significantly associated with the level of psychological distress after controlling for other related factors. Even though this finding is consistent with existing literature, a longitudinal study is needed in future research to evaluate the causal association between these two variables.

Available for download on Monday, September 01, 2025

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