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The APN wants to evaluate the effectiveness of a protocol change that has lessened the waiting time for patients with acute symptoms of an exacerbation of COPD to be seen in a primary care practice. He is interested in whether the change reflects an improvement in prevention of hospitalization for COPD as well as the patient's quality of life.

What does he need to consider if he wants to utilize the Health-related quality of life (HRQOL) theory to guide his evaluation?

a. There are multiple frameworks and models to choose from

b. Only biological and physiological variables and symptoms are included

c. An individual's perceptions are not addressed in the theory

d. Quality of life and HRQOL are interchangeable concepts

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