The final model supports the hypothesis that quality of life is the outcome of a complex interplay among contextual factors (severity of illness), antecedent variables (Stuifbergen & Rogers, 1997), and health-promoting behaviors. The strength of direct and indirect paths suggests that interventions to enhance social support, decrease barriers, and increase specific self-efficacy for health behaviors would result in improved health-promoting behaviors and quality of life. Further research using a longitudinal design is needed to clarify the effects of the interaction between health-promoting behaviors and trajectory of illness on quality of life for persons with chronic disabling conditions.

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