Skip to main content

Advertisement

SpringerLink
Log in

Mediating effects on health-related quality of life in adults with osteoporosis: a structural equation modeling

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Participants with physical limitation and high degree of pain had poor mental and physical health-related quality of life. In addition, the more support and exercise that the participants had, the more likely theywere to report better health-related quality of life.

Introduction

Osteoporosis is a public health threat worldwide. The aim of this study is to examine the effects of individual demographics, disease characteristics, and social support on health-related quality of life (HrQoL) of adults with osteoporosis. Most psychosocial studies focused on the relationships but not the specific construct of social support on HrQoL.

Methods

In a correlational design, face-to-face, structured interviews were employed to collect information. Study questionnaires included a demographic sheet, the modified Social Support Inventory, and the Short-Form 36 scales on a convenience sample of 161 individuals recruited from four outpatient centers. Using the structural equation modeling approach, all relationships among factors, mediators, and HrQoL were analyzed.

Results

The mean duration of osteoporosis was longer than 5 years. Participants who exercised more than three times per week had greater HrQoL than individuals who exercised less frequently. Participants with physical limitation and high degree of pain had poor mental and physical HrQoL. The more support that the participants perceived, the more likely they were to report better HrQoL. The best fitted structural equation modeling (SEM) model included individual demographics and physical function, and social support as significant predictors on HrQoL, with informational support and physical function acting as mediators in those relationships. Moreover, this structural model explained 35, 42, and 40 % of the variance on activity of daily living (ADL), physical, and mental health-related quality of life.

Conclusions

The more informational support that individuals have, the more likely they were to report better HrQoL. Individuals with osteoporosis who have lower pain and more exercise are considered having better HrQoL. Further longitudinal research will help clarify the direction of these relationships.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Harvey N, Dennison E, Cooper C (2010) Osteoporosis: impact on health and economics. Nat Rev Urol 6(2):99–105

    Google Scholar 

  2. Wang Y, Tao Y, Hyman ME, Li J, Chen Y (2009) Osteoporosis in China. Osteoporosis Int 20(10):1651–1662

    Article  CAS  Google Scholar 

  3. Looker AC, Melton LJ, Harris TB, Borrud LG, Shepherd JA (2010) Prevalence and trends in low femur bone density among older US adults: NHANES 2005–2006 compared with NHANES III. J Bone Miner Res 25(1):64–71

    Article  PubMed Central  PubMed  Google Scholar 

  4. Guillemin F, Martinez L, Calvert M, Cooper C, Ganiats T, Gitlin M, Horne R, Marciniak A, Pfeilschifter J, Shepherd S, Tosteson A, Wade S, Macarios D, Freemantle N (2013) Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study. Osteoporos Int 24(12):3001–3010

    Article  CAS  PubMed  Google Scholar 

  5. Looker AC (2013) Femur neck bone mineral density and fracture risk by age, sex, and race or Hispanic origin in older US adults from NHANES III. Arch Osteoporos 8(1–2):141

    Article  PubMed  Google Scholar 

  6. Wilson S, Sharp CA, Davie MW (2012) Health-related quality of life in patients with osteoporosis in the absence of vertebral fracture: a systematic review. Osteoporos Int 23(12):2749–2768

    Article  CAS  PubMed  Google Scholar 

  7. Krum SA, Brown M (2008) Unraveling estrogen action in osteoporosis. Cell Cycle 7(10):1348–1352

    Article  CAS  PubMed  Google Scholar 

  8. Roux C, Wyman A, Hooven FH, Gehlbach SH, Adachi JD, Chapurlat RD, Compston JE, Cooper C, Diez-Perez A, Greenspan SL, Lacroix AZ, Netelenbos JC, Pfeilschifter J, Rossini M, Saag KG, Sambrook PN, Silverman S, Siris ES, Watts NB, Boonen S (2012) Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW). Osteoporos Int 23(12):2863–2871

    Article  CAS  PubMed  Google Scholar 

  9. Petronijevic M, Petronijevic N, Ivkovic M, Stefanovic D, Radonjic N, Glisic B, Ristic G, Damjanovic A, Paunovic V (2008) Low bone mineral density and high bone metabolism turnover in premenopausal women with unipolar depression. Bone 42(3):582–590

    Article  CAS  PubMed  Google Scholar 

  10. Chan HL, Liu CY, Chau YL, Chang CM (2011) Prevalence and association of suicide ideation among Taiwanese elderly—a population-based cross-sectional study. Chang Gung Med J 34(2):197–204

    PubMed  Google Scholar 

  11. Wu Q, Magnus JH, Liu J, Bencaz AF, Hentz JG (2009) Depression and low bone mineral density: a meta-analysis of epidemiologic studies. Osteoporosis Int 20(8):1309–1320

    Article  CAS  Google Scholar 

  12. de Oliveira FN, Arthuso M, da Silva R, Pedro AO, Neto AMP, Costa-Paiva L (2009) Quality of life in women with postmenopausal osteoporosis: correlation between QUALEFFO 41 and SF-36. Maturitas 62(1):85–90

    Article  Google Scholar 

  13. Liu N, Zeng LX, Li Z, Wang JE (2013) Health-related quality of life and long-term care needs among elderly individuals living alone: a cross-sectional study in rural areas of Shaanxi Province. BMC Public Health, China, 13

    Google Scholar 

  14. Yilmaz F, Sahin F, Ergoz E, Deniz E, Ercalik C, Yucel S, Kuran B (2008) Quality of life assessments with SF 36 in different musculoskeletal diseases. Clin Rheumatol 27(3):327–332

    Article  PubMed  Google Scholar 

  15. Tadic I, Vujasinovic Stupar N, Tasic L, Stevanovic D, Dimic A, Stamenkovic B, Stojanovic S, Milenkovic S (2012) Validation of the osteoporosis quality of life questionnaire QUALEFFO-41 for the Serbian population. Health Qual Life Out 10:74

    Article  Google Scholar 

  16. Ekstrom H, Ivanoff SD, Elmstahl S (2008) Restriction in social participation and lower life satisfaction among fractured in pain. Arch Gerontol Geriat 46(3):409–424

    Article  Google Scholar 

  17. Qvist N, Bergstrom I, Kronhed ACG, Karlesson S, Forss A (2011) Empowering the fragile body: experiences of a back muscle group training program in postmenopausal women with vertebral fractures. A qualitative interview study. Adv Physiother 13(2):63–70

    Article  Google Scholar 

  18. Ievers-Landis CE, Burant C, Drotar D, Morgan L, Trapl ES, Kwoh CK (2003) Social support, knowledge, and self-efficacy as correlates of osteoporosis preventive behaviors among preadolescent females. J Pediat Psychol 28(5):335–345

    Article  Google Scholar 

  19. Huang CY, Hsu MC, Hsu SP, Cheng PC, Lin SF, Chuang CH (2010) Mediating roles of social support on poststroke depression and quality of life in patients with ischemic stroke. J Clin Nurs 19(19–20):2752–2762

    Article  PubMed  Google Scholar 

  20. Muller R, Peter C, Cieza A, Geyh S (2012) The role of social support and social skills in people with spinal cord injury—a systematic review of the literature. Spinal Cord 50(2):94–106

    Article  CAS  PubMed  Google Scholar 

  21. Krause N (1986) Social support, stress, and well-being among older adults. J Gerontol 41(4):512–519

    Article  CAS  PubMed  Google Scholar 

  22. Barrera M Jr, Sandler I, Ramsay T (1981) Preliminary development of a scale of social support: studies on college students. Am J Commun Psychol 9(4):435–447

    Article  Google Scholar 

  23. Huang CY, Sousa VD, Tsai CC, Hwang MY (2008) Social support and adaptation of Taiwanese adults with mental illness. J Clin Nurs 17(13):1795–1802

    Article  PubMed  Google Scholar 

  24. Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Association, New Jersey

    Google Scholar 

  25. Shah S, Vanclay F, Cooper B (1989) Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 42(8):703–709

    Article  CAS  PubMed  Google Scholar 

  26. Chang CP, Tsai YF, Chen YC, Hwang SL (2001) Factors related to depression among burns patients. J Nurs 48(2):37–48. doi:10.6224/JN.48.2.37

    Google Scholar 

  27. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  28. Garver MS, Mentzer JT (1999) Logistics research methods: employing structural equation modeling to test for construct validity. J Bus Logist 20:33–57

    Google Scholar 

  29. Hoelter JW (1983) The analysis of covariance structures: goodness-of-fit indices. Sociol Method Res 11:325–344

    Article  Google Scholar 

  30. Hoe SL (2008) Issues and procedures in adopting structural equation modeling techniques. J Appl Quant Method 3:76–83

    Google Scholar 

  31. Byrne BM (2001) Structural equation modeling with AMOS: basic concepts, applications, and programming. Lawrence Erlbaum Associates Publishers, Mahwah

    Google Scholar 

  32. Hu LZ, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6(1):1–55

    Article  Google Scholar 

  33. Kline RB (2005) Principles and practice of structural equation modeling, 2nd edn. Guilford Press, New York

    Google Scholar 

  34. Cook DC, Campell DT (1979) Quasi-experimentation: design and analysis issues for field settings. Houghton Mifflin, Boston

    Google Scholar 

Download references

Acknowledgments

There is no funding for this study. We would like to thank the patients from the four medical centers who participated in this study.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Nursing, I-Shou University, No. 8, Yida Rd, Yanchao district, Kaohsiung, 82445, Taiwan

    C.-Y. Huang & C.-Y. Lu

  2. Nursing Department, MeiHo University, No23, Pingguang Rd, Neipu, Pingtung, Taiwan

    L.-C. Liao

  3. ChaoYang University of Technology, No.168, Jifong E. Rd, Taichung County, 41349, Taiwan

    K.-M. Tong

  4. Division of Joint Reconstruction Surgery, Department of Orthopaedics, Taichung Veterans General Hospital, 160, Section 3, TaichungKang Road, Taichung, Taiwan

    K.-M. Tong

  5. Department of Nursing, Tzu Chi University, Hualien, Taiwan

    H.-L. Lai

  6. Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

    H.-L. Lai

  7. College of Management, I-Shou University, No.1, Sec. 1, Syuecheng Rd, Kaohsiung, 84001, Taiwan

    W.-K. Chen

  8. Department of Industrial Management, I-Shou University, Kaohsiung, Taiwan

    C.-I. Chen

  9. Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan

    F.-J. Chen

Authors
  1. C.-Y. Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L.-C. Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K.-M. Tong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H.-L. Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W.-K. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C.-I. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C.-Y. Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. F.-J. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C.-Y. Huang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, CY., Liao, LC., Tong, KM. et al. Mediating effects on health-related quality of life in adults with osteoporosis: a structural equation modeling. Osteoporos Int 26, 875–883 (2015). https://doi.org/10.1007/s00198-014-2963-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-014-2963-3

Keywords

Search

Navigation