Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
권호 표지
DOI QR코드

DOI QR Code

Prediction model of health-related quality of life in older adults according to gender using a decision tree model: a study based on the Korea National Health and Nutrition Examination Survey

의사결정나무 분석을 이용한 한국 노인의 성별에 따른 건강관련 삶의 질 취약군 예측: 국민건강영양조사 자료 분석

  • Hee Sun Kim (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University) ;
  • Seok Hee Jeong (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University)
  • 김희선 (전북대학교 간호대학.간호학연구소) ;
  • 정석희 (전북대학교 간호대학.간호학연구소)
  • Received : 2023.10.24
  • Accepted : 2024.01.05
  • Published : 2024.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to predict the subgroups vulnerable to poorer health-related quality of life (HRQoL) according to gender in older adults. Methods: Data from 5,553 Koreans aged 65 or older were extracted from the Korea National Health and Nutrition Examination Survey. HRQoL was assessed using the EQ-5D tool. Complex sample analysis and decision-tree analysis were conducted using SPSS for Windows version 27.0. Results: The mean scores of the EQ-5D index were 0.93 ± 0.00 in men and 0.88 ± 0.00 in women. In men, poorer HRQoL groups were identified with seven different pathways, which were categorized based on participants' characteristics, such as restriction of activity, perceived health status, muscle exercise, age, relative hand grip strength, suicidal ideation, the number of chronic diseases, body mass index, and income status. Restriction of activity was the most significant predictor of poorer HRQoL in elderly men. In women, the poorer HRQoL groups were identified with nine different pathways, which were categorized based on participants' characteristics, such as perceived health status, restriction of activity, age, education, unmet medical service needs, anemia, body mass index, relative hand grip, and aerobic exercise. Perceived health status was the most significant predictor of poorer HRQoL in elderly women. Conclusion: This study presents a predictive model of HRQoL in older adults according to gender and can be used to detect individuals at risk of poorer HRQoL.

Keywords

References

  1. Statistics Korea. Population status and outlook of the world and Korea reflecting future population estimates in 2021[Internet]. Dajeon: Statistics Korea; 2021 [cited 2023 Oct 1]. Available from: https://kostat.go.kr/board.es?mid= a10301020600&bid=207&act=view&list_no=420361
  2. Park S, Nam JY. Association between changes in multiple chronic conditions and health expenditures among elderly in South Korea: Korean longitudinal study of aging 2014-2018. Health Policy and Management. 2022;3(3):282-292. https://doi.org/10.4332/KJHPA.2022.32.3.282
  3. Lee YK, Kim SJ, Hwang NH, Lim JM, Ju BH, Namgoung EH, et al. Survey on the elderly in 2020. Final report. Seoul: Korea Institute for Health and Social Affairs; 2020 Nov. Report No.:11-1352000-000672-12.
  4. Marten O, Brand L, Greiner W. Feasibility of the EQ-5D in the elderly population: a systematic review of the literature. Quality of Life Research. 2022;31:1621-1637. https://doi.org/10.1007/s11136-021-03007-9
  5. Phyo AZZ, Freak-Poli R, Craig H, Gasevic D, Stocks NP, Gonzalez-Chica DA, et al. Quality of life and mortality in the general population: a systematic review and meta-analysis. BMC Public Health. 2020;20(1):1596. https://doi.org/10.1186/s12889-020-09639-9
  6. Ohta R, Sato M. The association between the self-management of mild symptoms and quality of life of elderly populations in rural communities: a cross-sectional study. International Journal of Environmental Research and Public Health. 2021;18(16):8857. https://doi.org/10.3390/ijerph18168857
  7. Blanco-Reina E, Valdellos J, Ocana-Riola R, Garcia-Merino MR, Aguilar-Cano L, Ariza-Zafra G. Factors associated with health-related quality of life in community-dwelling older adults: a multinomial logistic analysis. Journal of Clinical Medicine. 2019;8(11):1810. https://doi.org/10.3390/jcm8111810
  8. Moon H, Cha S. Multilevel analysis of factors affecting health-related quality of life of the elderly. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2022;31(3):391-401. https://doi.org/10.12934/jkpmhn.2022.31.3.391
  9. Back SH, Shin JE. Association between grip strength and health-related quality of life in elderly Korean. Korean Journal of Sports Science. 2019;28(3):703-712. https://doi.org/10.35159/kjss.2019.06.28.3.703
  10. Kim JH, Park S. A path analysis for health-related quality of life in long-term care insurance in-home service users. Research in Community and Public Health Nursing. 2023;34(1):1-11. https://doi.org/10.12799/rcphn.2022.00283
  11. Choi HY, Lee G. Factors influencing health-related quality of life in the Korean seniors with lower education level: focusing on physical activity types. Korean Journal of Adult Nursing. 2020;32(3):292-304. https://doi.org/10.7475/kjan.2020.32.3.292
  12. Zheng E, Xu J, Xu J, Zeng X, Tan WJ, Li J, et al. Health-related quality of life and its influencing factors for elderly patients with hypertension: evidence from Heilongjiang province, China. Frontiers in Public Health. 2021;16(9):654822. https://doi.org/10.3389/fpubh.2021.654822
  13. Sigeca F, Yip O, Mendieta MJ, Schwenkglenks M, Zeller A, Geest SD, et al. Factors associated with health-related quality of life among home-dwelling older adults aged 75 or older in Switzerland: a cross-sectional study. Health and Quality of Life Outcomes. 2022;20:166. https://doi.org/10.1186/s12955-022-02080-z
  14. Poursadeqiyna M, Arefi MF, Pouya AB, Jafari M. Quality of life in health Iranian elderly population approach in health promotion: a systematic review. Journal of Education and Health Promotion. 2021;10:1-9. https://doi.org/10.4103/jehp.jehp_1343_20
  15. Ryu D, Sok S. Prediction model of quality of life using the decision tree model in older adult single-person households: a secondary data analysis. Frontiers in Public Health. 2023;11:1224018. https://doi.org/10.3389/fpubh.2023.1224018
  16. Wratsangka R, Putri RANH. The importance of anemia and health-related quality of life in the elderly. Universa Medicina. 2020;39(2):135-149. https://doi.org/10.18051/UnivMed.2020.v39.135-149
  17. Ko H, Park YH, Cho B, Lim KC, Chang SJ, Yi YM, et al. Gender differences in health status, quality of life, and community service needs of older adults living alone. Archives of Gerontology and Geriatrics. 2019;83:239-245. https://doi.org/10.1016/j.archger.2019.05.009
  18. World Health Organization. Gender and health [Internet]. Geneva: WHO [cited 2023 Oct 1]. Available from: https://www.who.int/news-room/questions-and-answers/item/gender-and-health
  19. Lee S, Hong SH, Song HY. Factors associated with health-related quality of life among older adults in rural South Korea based on ecological model. International Journal of Environmental Research and Public Health. 2020;19:7021. https://doi.org/10.3390/ijerph19127021
  20. Lee KH, Xu H, Wu B. Gender differences in quality of life among community-dwelling older adults in low and middle-income countries: results from the study on global ageing and adult health (SAGE). BMC Public Health. 2020;20:14. https://doi.org/10.1186/s12889-020-8212-0
  21. Kwon MG, Park MK, Kim HJ, Kim JI, Kim SA. Factors influencing the muscle strength of the elderly without activity restrictions by gender. Journal of Korean Gerontological Nursing. 2021;23(1):43-53. https://doi.org/10.17079/jkgn.2021.23.1.43
  22. Noh K, Park S. Effects of resistance exercise on older individuals with sarcopenia: sex differences in humans. Exercise Science. 2023;32(3):255-265. https://doi.org/10.15857/ksep.2023.00346
  23. Curran E, Rosato M, Ferry FR, Leavey G. Prevalence and factors associated with anxiety and depression in older adults: gender differences in psychosocial indicators. Journal of Affective Disorders. 2020;267:114-122. https://doi.org/10.1016/j.jad.2020.02.018
  24. Huh MI. SPSS statistics classification analysis. Seoul: Data Solution; 2012. p. 107-175.
  25. Kim HS, Jeong SH. Identification of subgroups with poor glycemic control among patients with type 2 diabetes mellitus: based on the Korean National Health and Nutrition Examination Survey from KNHANES VII (2016 to 2018). Journal of Korean Biological Nursing Science. 2021;23(1):31-42. https://doi.org/10.7586/jkbns.2021.23.1.31
  26. Korean Society for The Study of Obesity. Clinical Practice Guidelines for Obesity 2022 [Internet]. Seoul: Korean Society for The Study of Obesity; 2022 [cited 2023 Dec 10]. Available from: https://general.kosso.or.kr/html/?pmode=BBBS0001300003& page=1&smode=view&seq=1383&searchValue=&searchTitle=strTitle
  27. Lee HY. New definition for hypertension. Journal of the Korean Medicical Association. 2018;61(8):485-492. https://doi.org/10.5124/jkma.2018.61.8.485
  28. Korean Diabetes Association. 2023 Clinical practice guidelines [Internet]. Seoul: Korean Diabetes Association; 2023 [cited 2023 Dec 10]. Available from: https://www.diabetes.or.kr/bbs/?code=guide&-mode=view&number=1284&page=1&code=guide
  29. Cappellinin MD, Motta I. Anemia in clinical practice-definition and classification: does hemoglobin change with aging? Seminars in Hematology. 2015;52(4):261-269. https://doi.org/10.1053/j.seminhematol.2015.07.006
  30. Korea Disease Control and Prevention Agency. Korea National Health & Nutrition Examination Survey. Data Analysis guidline [Internet]. Osong: Korea National Health & Nutrition Examination Survey; 2023 [cited 2023 Dec 12]. Available from: https://knhanes.kdca.go.kr/knhanes/sub03/sub03_06_02.do
  31. Song Y, Ying LU. Decision tree methods: applications for classification and prediction. Shanghai Archives of Psychiatry. 2015;27(2):130-135. https://doi.org/10.11919/j.issn.1002-0829.215044
  32. Jo HH, Seo YH. Effects of equipment pilates reformer exercise on changes in body composition and abdominal muscle strength in adult women. The Korean Journal of Growth and Development. 2023;31(1):25-29. http://doi.org/10.34284/KJGD.2023.02.31.1.25
  33. Kang JC, Lee CH. The effect of older adults' regular physical activity on mental health. The Korean Journal of Physical Education. 2000;39(4):209-216.
  34. Kim MJ, Yoo JI. The relationships between physical activity participation, exercise identity, and mental health among university students. The Korean Journal of Physical Education. 2017;56(3):57-68. http://doi.org/10.23949/kjpe.2017.05.56.3.6
  35. So WY, Hhong JY, Jun EJ, Choi DH, Kim KH. Effects of aquarobics exercise on body composition, fitness and health related quality of life (SF-36) in elderly women. Journal of the Korean Gerontological Society. 2010;30(3):683-694.
  36. Shen Y, Shi Q, Nong K, Li S, Yue J, Huang J, et al. Exercise for sarcopenia in older people: a systematic review and network-meta-analysis. Journal of Cachexai, Sarcopenia and Muscle. 2023;14:1199-1211. https://doi.org/10.1002/jcsm.13225
  37. Yeun YR. Resistance training on muscle strength among community-dwelling older adults: a systematic review and meta-analysis. Journal of the Korea Society of Computer and Information. 2018;23(3):71-77. https://doi.org/10.9708/jksci.2018.23.03.071
  38. Sayer AA, Kirkwood TB. Grip strength and mortality: a biomarker of ageing? Lancet. 2015;386(9990):226-227. https://doi.org/10.1016/S0140-6736(14)62349-7
  39. Jeon HS, Kahng SK. Age differences in the predictors of medical service use between young-old and old-old: implications for medical service in aging society. Health and Social Welfare Review. 2012;32(1):28-57. https://doi.org/10.15709/hswr.2012.32.1.28
  40. Sung HY, Lee SK, Na JH. A study on factors associated with suicidal ideation of older people: focused on the group comparisons by objective and subjective health status. Korean Journal of Social Welfare Research. 2021;69:117-143. https://doi.org/10.17997/SWRY.69.1.5
  41. Sim HI, Hong SI. Moderating effect of social ties on the relationships between elder abuse, depression, and suicidal ideation. Korean Criminal Psychology Review. 2019;15(4):37-54. https://doi.org/10.25277/KCPR.2019.15.4.37
  42. Son M. Factors associated with levels of health-related quality of life in elderly women: secondary data analysis of the Korea National Health and Nutrition Examination Survey 2019. Korean Journal of Women Health Nursing. 2022;28(3):187-196. https://doi.org/10.4069/kjwhn.2022.06.17
  43. World Health Organization. Guidance note on integrating health equity, gender equality, disability inclusion and human rights in WHO evaluations [Internet]. Geneva: WHO Evaluation Office; 2023 [cited 2023 Oct 20] Available from: https://bit.ly/403GTbS
  44. Cho SI. Health equity. Journal of the Korean Medical Association. 2015;58(12):1104-1107. https://doi.org/10.5124/jkma.2015.58.12.1104