Skip to main content
Top
Gepubliceerd in:

12-11-2019

Health-related quality of life in South Korean community-dwelling older adults with multimorbidity: a convergent parallel mixed-methods approach

Auteurs: Hyun-Ju Lee, Jungmi Yun

Gepubliceerd in: Quality of Life Research | Uitgave 3/2020

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

Alongside population aging, the rapid increase in the number of older adults with multimorbidity—the existence of two or more chronic conditions—has been noteworthy. However, in South Korea, studies taking a comprehensive approach to the factors associated with health-related quality of life (HRQoL) and disease-related problems experienced by older adults with multimorbidity have been rare. This study examined the associations of several variables with HRQoL and explored disease-related life experiences of community-dwelling older adults with multimorbidity in South Korea.

Methods

A convergent parallel mixed-methods approach was used with survey data from 310 community-dwelling older adults aged over 65 diagnosed with two or more chronic diseases and who regularly received treatment. Qualitative data were collected from 3 focus group interviews with 15 participants. Factors correlated with HRQoL were analyzed using multiple regression, and NVivo Pro 12.0 was used for content analysis.

Results

In the multiple regression analyses, depression had the most significant association with HRQoL. Depression, activities of daily living, instrumental activities of daily living, support from friends, number of medications, and subjective health status explained 41.0% of the variance in HRQoL. Content analysis revealed 5 major health-related themes in the participants’ lives: reduced physical function, anxious mental state, changes in the importance of the social support structure, limitations of disease management, and acceptance and endurance.

Conclusion

Based on the results, community-based programs and health promotion projects that consider psychological states (e.g., depression) are needed to boost the HRQoL of individuals with multimorbidity.
Literatuur
2.
go back to reference Gu, J., Chao, J., Chen, W., Xu, H., Zhang, R., He, T., et al. (2018). Multimorbidity and health-related quality of life among the community-dwelling elderly: A longitudinal study. Archives of Gerontology and Geriatrics,74, 133–140.PubMed Gu, J., Chao, J., Chen, W., Xu, H., Zhang, R., He, T., et al. (2018). Multimorbidity and health-related quality of life among the community-dwelling elderly: A longitudinal study. Archives of Gerontology and Geriatrics,74, 133–140.PubMed
3.
go back to reference Weale, R. A. (2009). A note on age-related comorbidity. Archives of Gerontology and Geriatrics,49(1), 93–97.PubMed Weale, R. A. (2009). A note on age-related comorbidity. Archives of Gerontology and Geriatrics,49(1), 93–97.PubMed
4.
go back to reference Oh, Y. H. (2015). The health status of older Koreans and policy considerations. Health and Welfare Policy Forum,223, 29–39. Oh, Y. H. (2015). The health status of older Koreans and policy considerations. Health and Welfare Policy Forum,223, 29–39.
5.
go back to reference Wallace, E., Salisbury, C., Guthrie, B., Lewis, C., Fahey, T., & Smith, S. M. (2015). Managing patients with multimorbidity in primary care. BMJ,350, h176.PubMed Wallace, E., Salisbury, C., Guthrie, B., Lewis, C., Fahey, T., & Smith, S. M. (2015). Managing patients with multimorbidity in primary care. BMJ,350, h176.PubMed
6.
go back to reference Marengoni, A., Rizzuto, D., Wang, H. X., Winblad, B., & Fratiglioni, L. (2009). Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society,57(2), 225–230.PubMed Marengoni, A., Rizzuto, D., Wang, H. X., Winblad, B., & Fratiglioni, L. (2009). Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society,57(2), 225–230.PubMed
7.
go back to reference Parker, L., Moran, G. M., Roberts, L. M., Calvert, M., & McCahon, D. (2014). The burden of common chronic disease on health-related quality of life in an elderly community dwelling population in the UK. Family Practice,31(5), 557–563.PubMed Parker, L., Moran, G. M., Roberts, L. M., Calvert, M., & McCahon, D. (2014). The burden of common chronic disease on health-related quality of life in an elderly community dwelling population in the UK. Family Practice,31(5), 557–563.PubMed
8.
go back to reference Min, S. H., & Kim, J. I. (2012). Construction of explanatory model for medication adherence in older people with chronic disease. The Korean Journal of Fundamentals of Nursing,19(4), 463–473. Min, S. H., & Kim, J. I. (2012). Construction of explanatory model for medication adherence in older people with chronic disease. The Korean Journal of Fundamentals of Nursing,19(4), 463–473.
9.
go back to reference Nam, S. K., & Shim, O. S. (2011). A study on the influence factors on quality of life of chronic disease elderly. Korean Journal of Gerontological Social Welfare,53, 196–216. Nam, S. K., & Shim, O. S. (2011). A study on the influence factors on quality of life of chronic disease elderly. Korean Journal of Gerontological Social Welfare,53, 196–216.
10.
go back to reference Schipper, H., Clinch, J., & Powell, V. (1990). Definitions and conceptual issues. In B. Spilker (Ed.), Quality of life assessments in clinical trials. New York: Raven Press. Schipper, H., Clinch, J., & Powell, V. (1990). Definitions and conceptual issues. In B. Spilker (Ed.), Quality of life assessments in clinical trials. New York: Raven Press.
11.
go back to reference Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life. JAMA,273(1), 59–65.PubMed Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life. JAMA,273(1), 59–65.PubMed
12.
go back to reference Borgaonka, M. R., & Irvine, E. J. (2000). Quality of life measurement in gastrointestinal and liver disorder. Gut,47(3), 444–454. Borgaonka, M. R., & Irvine, E. J. (2000). Quality of life measurement in gastrointestinal and liver disorder. Gut,47(3), 444–454.
13.
go back to reference Park, D. S., Ma, S. J., & Choi, K. E. (2010). Current situation of the rural vulnerable class and policy improvement measures: Centered on the elderly living alone and grandparents-grandchildren families. Seoul: Korea Rural Economic Institute. Park, D. S., Ma, S. J., & Choi, K. E. (2010). Current situation of the rural vulnerable class and policy improvement measures: Centered on the elderly living alone and grandparents-grandchildren families. Seoul: Korea Rural Economic Institute.
14.
go back to reference Chin, W. Y., Choi, E. P. H., Wan, E. Y. F., & Lam, C. L. K. (2015). Health-related quality of life mediates associations between multi-morbidity and depressive symptoms in Chinese primary care patients. Family Practice,33(1), 61–68.PubMedPubMedCentral Chin, W. Y., Choi, E. P. H., Wan, E. Y. F., & Lam, C. L. K. (2015). Health-related quality of life mediates associations between multi-morbidity and depressive symptoms in Chinese primary care patients. Family Practice,33(1), 61–68.PubMedPubMedCentral
15.
go back to reference Gunn, J. M., Ayton, D. R., Densley, K., Pallant, J. F., Chondros, P., Herrman, H. E., et al. (2012). The association between chronic illness, multimorbidity and depressive symptoms in an Australian primary care cohort. Social Psychiatry and Psychiatric Epidemiology,47(2), 175–184.PubMed Gunn, J. M., Ayton, D. R., Densley, K., Pallant, J. F., Chondros, P., Herrman, H. E., et al. (2012). The association between chronic illness, multimorbidity and depressive symptoms in an Australian primary care cohort. Social Psychiatry and Psychiatric Epidemiology,47(2), 175–184.PubMed
16.
go back to reference Ng, C. L., Luo, N., & Heng, B. H. (2014). Health status profiles in community-dwelling elderly using self-reported health indicators: A latent class analysis. Quality of Life Research,23(10), 2889–2898.PubMed Ng, C. L., Luo, N., & Heng, B. H. (2014). Health status profiles in community-dwelling elderly using self-reported health indicators: A latent class analysis. Quality of Life Research,23(10), 2889–2898.PubMed
17.
go back to reference Wicke, F. S., Güthlin, C., Mergenthal, K., Gensichen, J., Löffler, C., Bickel, H., et al. (2014). Depressive mood mediates the influence of social support on health-related quality of life in elderly, multimorbid patients. BMC Family Practice,15(1), 62.PubMedPubMedCentral Wicke, F. S., Güthlin, C., Mergenthal, K., Gensichen, J., Löffler, C., Bickel, H., et al. (2014). Depressive mood mediates the influence of social support on health-related quality of life in elderly, multimorbid patients. BMC Family Practice,15(1), 62.PubMedPubMedCentral
18.
go back to reference Henchoz, Y., Abolhassani, N., Büla, C., Guessous, I., Goy, R., & Santos-Eggimann, B. (2019). Change in quality of life among community-dwelling older adults: Population-based longitudinal study. Quality of Life Research,28(5), 1305–1314.PubMed Henchoz, Y., Abolhassani, N., Büla, C., Guessous, I., Goy, R., & Santos-Eggimann, B. (2019). Change in quality of life among community-dwelling older adults: Population-based longitudinal study. Quality of Life Research,28(5), 1305–1314.PubMed
19.
go back to reference Garvey, J., Connolly, D., Boland, F., & Smith, S. M. (2015). OPTIMAL, an occupational therapy led self-management support programme for people with multimorbidity in primary care: A randomized controlled trial. BMC Family Practice,16, 59.PubMedPubMedCentral Garvey, J., Connolly, D., Boland, F., & Smith, S. M. (2015). OPTIMAL, an occupational therapy led self-management support programme for people with multimorbidity in primary care: A randomized controlled trial. BMC Family Practice,16, 59.PubMedPubMedCentral
20.
go back to reference Markle-Reid, M., Ploeg, J., Fraser, K. D., Fisher, K. A., Bartholomew, A., Griffith, L. E., et al. (2018). Community program improves quality of life and self-management in older adults with diabetes mellitus and comorbidity. The Journal of the American Geriatrics Society,66(2), 263–273.PubMed Markle-Reid, M., Ploeg, J., Fraser, K. D., Fisher, K. A., Bartholomew, A., Griffith, L. E., et al. (2018). Community program improves quality of life and self-management in older adults with diabetes mellitus and comorbidity. The Journal of the American Geriatrics Society,66(2), 263–273.PubMed
21.
go back to reference Jung, Y. H. (2014). Distribution and types of multiple chronic condition in Korea. Seoul: Korea Institute for Health and Social Affairs. Jung, Y. H. (2014). Distribution and types of multiple chronic condition in Korea. Seoul: Korea Institute for Health and Social Affairs.
22.
go back to reference Kim, C. H., Lee, M. R., & Yoo, W. S. (2014). Common combinations of chronic diseases in multimorbidity and their effect on healthcare cost in Korea. The Korean Association of Health Economics and Policy,20(4), 81–102. Kim, C. H., Lee, M. R., & Yoo, W. S. (2014). Common combinations of chronic diseases in multimorbidity and their effect on healthcare cost in Korea. The Korean Association of Health Economics and Policy,20(4), 81–102.
23.
go back to reference Kim, J. I. (2013). Levels of health-related quality of life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. Journal of Korean Academy of Community Health Nursing,24(1), 99–109. Kim, J. I. (2013). Levels of health-related quality of life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. Journal of Korean Academy of Community Health Nursing,24(1), 99–109.
24.
go back to reference Park, B., Ock, M., Lee, H. A., Lee, S., Han, H., Jo, M. W., et al. (2018). Multimorbidity and health-related quality of life in Koreans aged 50 or older using KNHANES 2013–2014. Health and Quality of Life Outcomes,16, 186.PubMedPubMedCentral Park, B., Ock, M., Lee, H. A., Lee, S., Han, H., Jo, M. W., et al. (2018). Multimorbidity and health-related quality of life in Koreans aged 50 or older using KNHANES 2013–2014. Health and Quality of Life Outcomes,16, 186.PubMedPubMedCentral
25.
go back to reference No, J. Y., Kim, S. Y., Kwon, I. S., & Nam, H. S. (2014). Effect of arthritis and comorbid chronic conditions on health-related quality of life in Korean elderly. Journal of the Korea Academia-Industrial Cooperation Society,15(6), 3751–3758. No, J. Y., Kim, S. Y., Kwon, I. S., & Nam, H. S. (2014). Effect of arthritis and comorbid chronic conditions on health-related quality of life in Korean elderly. Journal of the Korea Academia-Industrial Cooperation Society,15(6), 3751–3758.
26.
go back to reference Jo, S., Lee, I., & Park, B. (2016). Factors influencing health-related quality of life of young adults and elderly with multimorbidity: A secondary analysis of the 2013 Korea Health Panel Data. Journal of Korean Academy Community Health Nursing,27(4), 358–369. Jo, S., Lee, I., & Park, B. (2016). Factors influencing health-related quality of life of young adults and elderly with multimorbidity: A secondary analysis of the 2013 Korea Health Panel Data. Journal of Korean Academy Community Health Nursing,27(4), 358–369.
27.
go back to reference Lee, H. J., Kim, C., & Paik, S. B. (2011). Effects of group intervention program on depression and quality of life in Korean elderly with chronic disease. Korean Journal of Health Promotion,11(4), 217–226. Lee, H. J., Kim, C., & Paik, S. B. (2011). Effects of group intervention program on depression and quality of life in Korean elderly with chronic disease. Korean Journal of Health Promotion,11(4), 217–226.
28.
go back to reference Creswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed methods research (2nd ed.). Thousand Oaks, CA: Sage. Creswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed methods research (2nd ed.). Thousand Oaks, CA: Sage.
29.
go back to reference Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher,33(78), 14–26. Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher,33(78), 14–26.
30.
go back to reference Morse, J. M., & Niehaus, L. (2009). Mixed method design: Principles and procedures. New York: Left Coast Press. Morse, J. M., & Niehaus, L. (2009). Mixed method design: Principles and procedures. New York: Left Coast Press.
31.
go back to reference Creswell, J. W. (2014). A concise introduction to mixed methods research. Thousand Oaks, CA: Sage Publications. Creswell, J. W. (2014). A concise introduction to mixed methods research. Thousand Oaks, CA: Sage Publications.
32.
go back to reference Stewart, D. W., & Shamdasani, P. M. (2014). Focus groups. Theory and practice. London: Sage Publications. Stewart, D. W., & Shamdasani, P. M. (2014). Focus groups. Theory and practice. London: Sage Publications.
34.
go back to reference Oh, J. Y., Yang, Y. J., Kim, B. S., & Kang, J. H. (2007). Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. Journal of the Korean Academy of Family Medicine,28(7), 532–541. Oh, J. Y., Yang, Y. J., Kim, B. S., & Kang, J. H. (2007). Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. Journal of the Korean Academy of Family Medicine,28(7), 532–541.
35.
go back to reference Won, C. W., Yang, K. Y., Rho, Y. G., Kim, S. Y., Lee, E., Yoon, J. L., et al. (2002). The development of Korean Activities of Living(K-ADL) and Korean Instrumental Activities of Living(K-IADL) Scale. Journal of the Korean Geriatrics Society,6(2), 107–120. Won, C. W., Yang, K. Y., Rho, Y. G., Kim, S. Y., Lee, E., Yoon, J. L., et al. (2002). The development of Korean Activities of Living(K-ADL) and Korean Instrumental Activities of Living(K-IADL) Scale. Journal of the Korean Geriatrics Society,6(2), 107–120.
36.
go back to reference Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of American Geriatric Association,31, 721–727. Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of American Geriatric Association,31, 721–727.
37.
go back to reference Lawton, M. D., & Brody, E. (1963). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist,9, 179–186. Lawton, M. D., & Brody, E. (1963). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist,9, 179–186.
38.
go back to reference Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist,5(2), 165–173. Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist,5(2), 165–173.
39.
go back to reference Kee, B. S. (1996). A preliminary study for the standardization of the Geriatric Depression Scale short form-Korea version. Journal of the Korean Neuropsychiatric Association,35(2), 298–307. Kee, B. S. (1996). A preliminary study for the standardization of the Geriatric Depression Scale short form-Korea version. Journal of the Korean Neuropsychiatric Association,35(2), 298–307.
40.
go back to reference Shin, J. S., & Lee, Y. B. (1999). The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare,37, 241–269. Shin, J. S., & Lee, Y. B. (1999). The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare,37, 241–269.
41.
go back to reference Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment,52(1), 30–41. Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment,52(1), 30–41.
42.
go back to reference Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Research in Nursing,62(1), 107–115. Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Research in Nursing,62(1), 107–115.
43.
go back to reference Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today,24(2), 105–112.PubMed Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today,24(2), 105–112.PubMed
44.
go back to reference Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage Publications. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage Publications.
45.
go back to reference Bayliss, E. A., Ellis, J. L., & Steiner, J. F. (2007). Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. The Annals of Family Medicine,5(5), 395–402.PubMed Bayliss, E. A., Ellis, J. L., & Steiner, J. F. (2007). Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. The Annals of Family Medicine,5(5), 395–402.PubMed
46.
go back to reference Nam, K. M., & Park, H. J. (2010). The influence of participation in religious and social activities of the elderly on their life satisfaction-Focusing on depression and death anxiety. Journal of Welfare for the Aged,49, 405–428. Nam, K. M., & Park, H. J. (2010). The influence of participation in religious and social activities of the elderly on their life satisfaction-Focusing on depression and death anxiety. Journal of Welfare for the Aged,49, 405–428.
47.
go back to reference Heo, C. M., & Ahn, S. H. (2014). Relationship among subjective health, psychological well-being, and successful aging of elderly participating in physical activity. Journal of Korean Society for the Study of Physical Education,53(6), 357–369. Heo, C. M., & Ahn, S. H. (2014). Relationship among subjective health, psychological well-being, and successful aging of elderly participating in physical activity. Journal of Korean Society for the Study of Physical Education,53(6), 357–369.
48.
go back to reference Rodrigues, L. R., Tavares, D. S., Dias, F. A., Pegorari, M. S., Marchiori, G. F., & Tavares, D. M. (2017). Quality of life of elderly people of the community and associated factors. Journal of Nursing,11(Suppl. 3), 1430–1438. Rodrigues, L. R., Tavares, D. S., Dias, F. A., Pegorari, M. S., Marchiori, G. F., & Tavares, D. M. (2017). Quality of life of elderly people of the community and associated factors. Journal of Nursing,11(Suppl. 3), 1430–1438.
Metagegevens
Titel
Health-related quality of life in South Korean community-dwelling older adults with multimorbidity: a convergent parallel mixed-methods approach
Auteurs
Hyun-Ju Lee
Jungmi Yun
Publicatiedatum
12-11-2019
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 3/2020
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02360-0

Andere artikelen Uitgave 3/2020

Quality of Life Research 3/2020 Naar de uitgave