Purpose The purpose of this study was to elucidate the quality of life (QOL) of home oxygen therapy (HOT) patients and the contribution of changes in related factors and selfcare actions to QOL, on the basis of two surveys. Based on them we assessed the internal constructs of the QOL of HOT patients and associations with related factors and selfcare actions by covariance structureanalysis.Method A questionnaire was used to survey the HOT patients, and the subjects of the analysis were 126 patients surveyed the first time and 203 patients surveyed this time.Conclusions1. The results of the two surveys showed that the characteristics of the HOT patients tended to be almost the same, but the results of the second survey showed that the use of medical and welfare services had increased.2. Validity and reliability of the "HOT Patient QOL Scale" used to measure overall QOL in this study were obtained in the second survey, and it was possible to confirm its reproducibility.3. The scores for 4 factors extracted as QOL related factors in the first survey, i.e., "severity of dyspnea", "independence of daily activities", "stress awareness", and"psychological support by close relatives"were the similar in the second survey, and correlations with QOL were observed in the second survey as well.4. "Selfcare actions" were not directly associated with the QOL of HOT patients, but they contributed to maintenance of daily activities and decreases in stress awareness.5. The relations between component factors according to the covariance structure analysis of QOL showed that "stress awareness" directly affected QOL, and that "stress awareness", "severity of dyspnea", "independence of daily activities", and "psychological support by close persons" were interrelated and effected QOL through "stress awareness".