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Varis H, Heikkala E, Mikkola I, Nordström T, Taanila A, Keinänen-Kiukaanniemi S, Hagnäs M. Association between childhood family structure and health-related quality of life at middle age: A longitudinal study of Northern Finland Birth Cohort 1966. Scand J Public Health 2024:14034948241260765. [PMID: 39104253 DOI: 10.1177/14034948241260765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
AIMS This longitudinal study evaluated the association between childhood family structure and health-related quality of life (HRQoL) at middle age. METHODS The data on childhood family structure at the age of 14 years ('two-parent family', 'one parent not living at home/no information on father' and 'father or mother deceased') and HRQoL (measured by 15D (15-dimensional)) at the age of 46 were collected from the Northern Finland Birth Cohort 1966 using postal questionnaires. We used the binary logistic regression model to estimate the associations between childhood family structures and the lowest 15D quartile (reference: all other quartiles). The associations were adjusted for offspring mothers' factors during pregnancy (mothers' educational and occupational status). RESULTS Of the 6375 participants, the offspring belonging to the 'one parent not living at home/no information on father' family structure subgroup had higher odds ratio of belonging to the lowest 15D quartile than the offspring of 'two-parent families' (adjusted odds ratio (OR) 1.76, 95% confidence interval (CI) 1.31-2.36, p<0.001 for females; adjusted OR 1.86, 95% CI 1.28-2.70, p=0.001 for males). There were no statistically significant associations between the 'father or mother deceased' subgroup and the lowest 15D quartile among the offspring. CONCLUSIONS A single-parent family origin (due to reasons other than parental death) in childhood was significantly associated with impaired HRQoL at middle age. These results provide new perspectives for understanding the long-standing associations on living in a single-parent family.
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Affiliation(s)
- Heidi Varis
- Research Unit of Population Health, University of Oulu, Finland
- Wellbeing Services, County of Lapland, Rovaniemi, Finland
| | - Eveliina Heikkala
- Research Unit of Population Health, University of Oulu, Finland
- Wellbeing Services, County of Lapland, Rovaniemi, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Ilona Mikkola
- Wellbeing Services, County of Lapland, Rovaniemi, Finland
| | - Tanja Nordström
- Research Unit of Population Health, University of Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Finland
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Finland
| | - Anja Taanila
- Research Unit of Population Health, University of Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Research Unit of Population Health, University of Oulu, Finland
- Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Finland
- Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
| | - Maria Hagnäs
- Research Unit of Population Health, University of Oulu, Finland
- Wellbeing Services, County of Lapland, Rovaniemi, Finland
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Li J, Gao T, Zhao D, Chai S, Luo J, Wang X, Wang X, Sun J, Li P, Zhou C. Catastrophic health expenditure and health-related quality of life among older adults in Shandong, China: the moderation effect of daily care by adult children. Int J Equity Health 2024; 23:51. [PMID: 38468257 DOI: 10.1186/s12939-023-02057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/12/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Catastrophic health expenditure (CHE) has a considerable impact on older people in later life, but little is known about the relationship between catastrophic health expenditure and health-related quality of life (HRQOL). The aim of this study was to examine the relationship between catastrophic health expenditure and health-related quality of life in older people, and to explore whether the daily care provided by adult children is a moderator in this relationship. METHODS Data from the sixth National Health Services Survey in Shandong Province, China. The sample consisted of 8599 elderly people (age ≥ 60 years; 51.7% of female). Health-related quality of life was measured by the health utility value of EQ-5D-3 L. Interaction effects were analyzed using Tobit regression models and marginal effects analysis. RESULTS The catastrophic health expenditure prevalence was 60.5% among older people in Shandong, China. catastrophic health expenditure was significantly associated with lower health-related quality of life (β= - 0.142, P < 0.001). We found that adult children providing daily care services to their parents mitigated the effect of catastrophic health expenditure on health-related quality of life among older people (β = 0.027, P = 0.040). CONCLUSIONS Our findings suggested that catastrophic health expenditure was associated with health-related quality of life and the caring role of older adult children moderated this relationship. Reducing the damage caused by catastrophic health expenditure helps to improve health-related quality of life in older people. Adult children should increase intergenerational contact, provide timely financial and emotional support to reduce the negative impact of catastrophic health expenditure on health-related quality of life.
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Affiliation(s)
- Jiayan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Jingjing Luo
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Xuehong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Xueqing Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China
| | - Jingjie Sun
- Shandong Health Commission Medical Management Service Center, Jinan, 250012, China
| | - Peilong Li
- Shandong Health Commission Medical Management Service Center, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong, 250012, China.
- Institute of Health and Elderly Care, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University), Jinan, 250012, China.
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Fan YJ, Feng YJ, Meng Y, Su ZZ, Wang PX. The relationship between anthropometric indicators and health-related quality of life in a community-based adult population: A cross-sectional study in Southern China. Front Public Health 2022; 10:955615. [PMID: 36249240 PMCID: PMC9554305 DOI: 10.3389/fpubh.2022.955615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background This study was designed to analyze the relationship of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), relative fat mass (RFM), lipid accumulation product (LAP) and health-related quality of life (HRQoL) in the community-dwelling population of southern China and to explore the independent contribution of socio-demographic characteristics, number of chronic diseases and anthropometric indicators to HRQoL in that population. Methods This community-based cross-sectional survey studied 2,663 adults aged 18 years and older. HRQoL was assessed by the 3-level EuroQol 5-dimensional scale (EQ-5D-3L), and HRQoL were calculated using the Chinese EQ-5D-3L value set. The outcome variable was the EQ-5D-3L score (HRQoL). Cluster regression was used to analyse the independent contribution of each obesity indicator to HRQoL. Results A total of 2,663 people participated in this study, and their mean EQ-5D-3L score was 0.938 ± 0.072. In this study, according to the results of the one-way ANOVA, HRQoL was significantly different between the groups of WHtR, WHR, RFM and LAP, respectively. The independent contributions of socio-demographic factors, number of chronic diseases and anthropometric measures to HRQoL in the whole population accounted for 76.2, 7.9, and 15.9% of the total effect, respectively. Conclusion RFM and LAP were found to have a previously unreported negative impact on HRQoL in a community-dwelling population. In future studies, RFM and LAP could be used as new indicators of obesity to predict quality of life in humans.
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Affiliation(s)
- Yu-Jun Fan
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Yi-Jin Feng
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Ya Meng
- School of Medical, Huanghe Science and Technology University, Zhengzhou, China
| | - Zhen-Zhen Su
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
| | - Pei-Xi Wang
- School of Nursing and Health, Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China,General Practice Center, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China,*Correspondence: Pei-Xi Wang
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McCausland KL, Rizio AA, White MK, Bayliss MS, Quock TP. Associations between Health-Related Quality of Life and Self-Reported Emergency Room Department Visits and Inpatient Hospitalizations: Insights from a Secondary Data Analysis of Patients with Light-Chain (AL) Amyloidosis. PHARMACOECONOMICS - OPEN 2019; 3:367-375. [PMID: 30796725 PMCID: PMC6710312 DOI: 10.1007/s41669-019-0122-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Light-chain (AL) amyloidosis is a rare, progressive, and typically fatal disease. Health-related quality of life (HRQoL) has been shown to be a significant prognostic factor associated with clinical outcomes such as survival and response to treatment. A better understanding of how patterns of HRQoL may be prospectively associated with costly healthcare resource utilization, such as emergency department (ED) visits and inpatient hospitalizations, is warranted. METHODS A secondary data analysis of a non-interventional, longitudinal online study of patients with AL amyloidosis (n = 224) was conducted. Negative binomial regression models were used to examine whether initial HRQoL scores (as measured by the SF-36v2® Health Survey [SF-36v2], where higher scores reflect better HRQoL) and changes in HRQoL were associated with the number of ED visits and inpatient hospitalizations during a 12-month period. Incidence rate ratios were interpreted by 5-point decrements in initial HRQoL scores and minimally important changes in HRQoL change scores. RESULTS There were significant inverse associations between initial SF-36v2 scores and subsequent rates of ED visits and inpatient hospitalizations across all domains and summary components (p < 0.05 for all). In contrast, changes in physical, but not mental, functioning were associated with rates of ED visits and inpatient hospitalizations during a 12-month period of observation. CONCLUSION Scores from patient-reported HRQoL surveys may be helpful in identifying patients at risk of future ED visits and hospital admissions, and may serve as a proxy for disease severity. Such information can provide stakeholders with insight into the humanistic and societal cost associated with AL amyloidosis.
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Affiliation(s)
| | - Avery A Rizio
- Optum, 1301 Atwood Ave, Suite 311N, Johnston, RI, 02919, USA
| | | | | | - Tiffany P Quock
- Prothena Biosciences Inc, 331 Oyster Point Boulevard, South San Francisco, CA, 94080, USA
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Hu Z, Qin L, Xu H. Association between diabetes-specific health literacy and health-related quality of life among elderly individuals with pre-diabetes in rural Hunan Province, China: a cross-sectional study. BMJ Open 2019; 9:e028648. [PMID: 31462471 PMCID: PMC6720152 DOI: 10.1136/bmjopen-2018-028648] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To examine the association between diabetes-specific health literacy (DSHL) and health-related quality of life (HRQoL) among elderly individuals with pre-diabetes in rural China. DESIGN, SETTING AND PARTICIPANTS This cross-sectional study included 434 elderly individuals with pre-diabetes from 42 villages in rural China. MAIN OUTCOME MEASURES HRQoL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. DSHL was measured by a validated questionnaire in China. Differences in HRQoL between groups with and without high DSHL were tested by multivariate analysis of covariance (MANCOVA). RESULTS The prevalence of pre-diabetes was 21.5%. The average age of participants (n=434) was 69.4±6.4 years, and 58.5% were female. Bivariate analysis showed that those with high DSHL had increases of 2.9 points in the physical health component score and 4.4 points in the mental health component score (MCS) compared with those without. After adjustment for potential confounders, a significant MANCOVA model (Wilks' λ=0.974, F=5.63, p=0.004) indicated that individuals with pre-diabetes who had high DSHL reported higher MCS (Mdiff=3.5, 95% CI 1.8 to 6.3, effect size=0.38). This remained significant across subscales: general health (p=0.028), vitality (p=0.014), social functioning (p=0.017) and mental health (p=0.005). CONCLUSIONS Low DSHL was associated with worsening HRQoL among elderly individuals with pre-diabetes in rural China, particularly in the mental health components. TRIAL REGISTRATION NUMBER ChiCTR-IOR-15007033.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Lulu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Li B, Liu N, Li B, Huang L, Wang X, Wu X, Fu L, Wu Y, Su Z, Wang P. Sexuality-Related Factors and Quality of Life Among Reproductive-Aged Married Female Migrant Workers: A Cross-Sectional Study in Southern China. Sex Med 2019; 7:384-395. [PMID: 31331761 PMCID: PMC6963124 DOI: 10.1016/j.esxm.2019.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/23/2019] [Accepted: 06/25/2019] [Indexed: 12/19/2022] Open
Abstract
Introduction Sexuality is a critical part of overall well-being. However, until now, studies on women’s health related to the effect of sexuality on physical and psychosocial outcomes have been seriously ignored, especially the health-related quality of life (QOL) of reproductive-aged married female migrant workers. Aim To analyze the associations between sexuality-related factors and QOL and explore the independent contributions of sexuality-related factors to QOL in this population group in southern China. Methods In this cross-sectional survey, 609 Chinese married female migrant workers aged 19–49 years were studied. Clustered multiple linear regressions were used to analyze the associations between sexuality-related variables and QOL. Outcomes QOL was measured using the Short Form (SF-36) Healthy Survey. Details of the participants (sociodemographic, health-related and sexuality-related factors) were obtained. Results Approximately 10.0% of respondents always felt a lack of sexual interest and lubrication difficulties, and 37.5% of respondents seldom or never experienced sexual satisfaction. Multiple regression analyses revealed that women who never felt lubrication difficulties obtained higher role physical, bodily pain, general health, and physical component summary scores in physical domains and higher vitality (VT), mental health (MH), and mental component summary (MCS) scores in mental domains compared with those who always felt lubrication difficulties. Compared with those who always experienced sexual satisfaction, women who never experienced sexual satisfaction had relatively lower role physical, bodily pain, and general health scores in physical domains, and women who never or seldom experienced sexual satisfaction had lower VT, MH, and MCS scores in mental domains. The independent contributions of sexuality-related factors in mental domains (VT, MH, and MCS) accounted for 50.0%, 52.4%, and 39.5%, respectively; more than that of all sociodemographic and health-related variables in the VT and MH domains. Conclusions Sexuality-related factors (lubrication difficulties and sexual satisfaction) were significant independent determinants of QOL among reproductive-aged Chinese married female migrant workers, especially in mental domains. Li BB, Liu N, Li B, et al. Sexuality-Related Factors and Quality of Life Among Reproductive-Aged Married Female Migrant Workers: A Cross-Sectional Study in Southern China. Sex Med 2019;7:384–395.
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Affiliation(s)
- Bingbing Li
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China
| | - Nan Liu
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China
| | - Bo Li
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China
| | - Lingling Huang
- Institute of Nursing and Health, Shanghai Lida University, Shanghai, China
| | - Xiaoxiao Wang
- Nursing Department, Tongji Hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiao Wu
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China
| | - Liying Fu
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China
| | - Yanyan Wu
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China
| | - Zhenzhen Su
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China
| | - Peixi Wang
- Institute of Chronic Disease Risks Assessment, School of Nursing and Health, Henan University, Kaifeng, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China.
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Wong MY, Yang Y, Cao Z, Guo VYW, Lam CLK, Wong CKH. Effects of health-related quality of life on health service utilisation in patients with colorectal neoplasms. Eur J Cancer Care (Engl) 2018; 27:e12926. [DOI: 10.1111/ecc.12926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 09/27/2017] [Accepted: 08/19/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Man Yu Wong
- Department of Mathematics; The Hong Kong University of Science and Technology; Kowloon Hong Kong
| | - Yingsi Yang
- Department of Mathematics; The Hong Kong University of Science and Technology; Kowloon Hong Kong
| | - Zhiqiang Cao
- Department of Mathematics; The Hong Kong University of Science and Technology; Kowloon Hong Kong
| | - Vivian Y. W. Guo
- Department of Family Medicine and Primary Care; The University of Hong Kong; Ap Lei Chau Hong Kong
| | - Cindy L. K. Lam
- Department of Family Medicine and Primary Care; The University of Hong Kong; Ap Lei Chau Hong Kong
| | - Carlos K. H. Wong
- Department of Family Medicine and Primary Care; The University of Hong Kong; Ap Lei Chau Hong Kong
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Gender differences in the impact of mental disorders and chronic physical conditions on health-related quality of life among non-demented primary care elderly patients. Qual Life Res 2015; 25:1461-74. [DOI: 10.1007/s11136-015-1182-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2015] [Indexed: 12/21/2022]
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Lin WQ, Jing MJ, Tang J, Wang JJ, Zhang HS, Yuan LX, Wang PX. Factors Associated with Fatigue among Men Aged 45 and Older: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10897-909. [PMID: 26404346 PMCID: PMC4586650 DOI: 10.3390/ijerph120910897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 08/23/2015] [Accepted: 08/25/2015] [Indexed: 12/17/2022]
Abstract
Background and Purpose: Fatigue is one of the most common symptoms reported in several studies; but few studies have concentrated on the male population, especially for the middle-aged and older men who are exposed to greater fatigue risk. The purpose of this study was to explore the prevalence of fatigue and identify the risk factors of fatigue among men aged 45 and older in China. Methods: This study was part of a cross-sectional study on community health in Shunde (Guangdong Province, China). A total sample of 1158 men aged 45 and older were included. Sociodemographic characteristics, health and lifestyle factors and the Chalder Fatigue Scale (CFS) were measured by structured questionnaires through face-to-face interviews. Multivariate logistic regression was applied to determine the risk factors of fatigue. Results: Approximately 30% of participants experienced fatigue. Older age (≥75 years: adjusted OR 3.88, 95% CI 2.09–7.18), single marital status (1.94, 1.04–3.62), unemployed status (1.68, 1.16–2.43), number of self-reported chronic diseases (≥2 chronic diseases: 2.83, 1.86–4.31), number of individuals’ children (≥4 children: 2.35, 1.33–4.15), hospitalization in the last year (1.61, 1.03–2.52) were all significantly associated with increased risk of fatigue, while regular exercise (0.46, 0.32–0.65) was a protective factor against fatigue. Conclusions: Fatigue was usual in males and several factors were associated with the fatigue. These findings may have implication in risk assessment of fatigue and help in developing and implementing targeted interventions in middle-aged and elderly males.
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Affiliation(s)
- Wei-Quan Lin
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China; E-Mails: (W.-Q.L.); (J.T.); (J.-J.W.); (H.-S.Z.)
| | - Meng-Juan Jing
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, 475004, China; E-Mail:
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China; E-Mails: (W.-Q.L.); (J.T.); (J.-J.W.); (H.-S.Z.)
| | - Jia-Ji Wang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China; E-Mails: (W.-Q.L.); (J.T.); (J.-J.W.); (H.-S.Z.)
| | - Hui-Shan Zhang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China; E-Mails: (W.-Q.L.); (J.T.); (J.-J.W.); (H.-S.Z.)
| | - Le-Xin Yuan
- Department of Nursing, School of Nursing, Guangzhou Medical University, Guangzhou, 510182, China; E-Mail:
| | - Pei-Xi Wang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 510182, China; E-Mails: (W.-Q.L.); (J.T.); (J.-J.W.); (H.-S.Z.)
- Institute of Public Health, School of Nursing, Henan University, Kaifeng, 475004, China; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +86-20-8134-0186; Fax: +86-20-8134-0196
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Wang C, Kane RL, Xu D, Meng Q. Health literacy as a moderator of health-related quality of life responses to chronic disease among Chinese rural women. BMC WOMENS HEALTH 2015; 15:34. [PMID: 25887361 PMCID: PMC4399716 DOI: 10.1186/s12905-015-0190-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/23/2015] [Indexed: 11/23/2022]
Abstract
Background Chronic disease is the leading global health threat and impairs patients’ health-related quality of life (HRQoL). Low health literacy is linked with chronic diseases prevalence and poor HRQoL. However, the interaction of health literacy with chronic disease on HRQoL remains unknown. Therefore, we examined how health literacy might modify the association between chronic disease and their HRQoL impacts. Methods We conducted a health survey of 913 poor rural women aged 23–57 years in Northwestern China. We assessed health literacy and HRQol using the revised Chinese Adult Health Literacy Questionnaire (R-CAHLQ) and Euroqol-5D (EQ-5D), respectively. Low health literacy was indicated by a cut-off of less than the mean of the factor score. Self-reported preexisting physician-diagnosed chronic disease and socio-demographic characteristics were also included. We fitted log-binomial regression models for each dimension of EQ-5D to examine its association with health literacy and chronic disease. We also ran linear regression models for EQ VAS scores and utility scores. Results The low health literacy group was 1.33 times more likely to have a chronic disease than the high health literacy group. Pain/discomfort was the most prevalent impairment, and was more common in the low health literacy group (PR [prevalence ratio] = 1.23; 95% CI = 1.01, 1.50). Chronic disease strongly predicted impairments in all the EQ-5D dimensions, with PRs ranging from 2.14 to 4.07. The association between chronic disease and pain/discomfort varied by health literacy level (health literacy × chronic disease: P = 0.033), and was less pronounced in the low health literacy group (PR = 2.15; 95% CI = 1.76, 2.64) than in the high health literacy group (PR = 3.19; 95% CI = 2.52, 4.05). The low health literacy group had lower VAS scores and utility scores, and slightly less decrement of VAS scores and utility scores associated with chronic disease. Conclusions Health literacy modified the impacts of chronic disease on HRQoL, and low health literacy group reported less HRQoL impacts related to chronic disease. Research should address health literacy issues as well as root causes of health disparities for vulnerable populations.
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Affiliation(s)
- Cuili Wang
- Shandong University School of Nursing, Jinan, 250012, China.
| | - Robert L Kane
- University of Minnesota School of Public Health, Minneapolis, 55455, US.
| | - Dongjuan Xu
- Shandong University School of Nursing, Jinan, 250012, China. .,University of Minnesota School of Public Health, Minneapolis, 55455, US.
| | - Qingyue Meng
- Peking University China Center for Health Development Studies, Beijing, 100191, China.
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Lee YS, Lee IS, Kim SY, Lee H, Park HJ, Lee H, Kim SH, Chae Y. Identification of determinants of the utilisation of acupuncture treatment using Andersen's behavioural model. Acupunct Med 2014; 33:129-35. [PMID: 25421709 DOI: 10.1136/acupmed-2014-010661] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The utilisation of healthcare services is the result of a complex decision-making process with different determinants. This study aims to identify the determinants of the utilisation of acupuncture treatment using Andersen's behavioural model and quality of life. METHODS In this study we reviewed Korean Health Panel data, a nationally representative set of data, and analysed the utilisation of outpatient acupuncture services during 2011. A two-part model, which included predisposing, enabling and need factors of Andersen's behavioural model in model 1 and the additional factor of health-related quality of life (HRQOL, EQ-5D Korean index) in model 2, was analysed by logistic analysis to identify determinants of acupuncture service usage among subjects who visited traditional Korean medical clinics. RESULTS The higher frequency of acupuncture service usage among patients who visited traditional Korean medical clinics was associated with gender, age, number of chronic diseases, physical disabilities and HRQOL of the subjects. CONCLUSIONS This study shows that the important determinants of the frequency of acupuncture treatment utilisation are gender, age, number of chronic diseases and the presence of physical disabilities. Our findings contribute to understanding the characteristics of patients who use acupuncture treatment and may be used as a basic resource for related policy making by government officials and medical professionals.
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Affiliation(s)
- Ye-Seul Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - In-Seon Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Song-Yi Kim
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyangsook Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hi-Joon Park
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyejung Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sung-Hoon Kim
- Cancer Preventive Material Development Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Younbyoung Chae
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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12
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Predictors of healthcare service utilization for mental health reasons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10559-86. [PMID: 25321874 PMCID: PMC4210995 DOI: 10.3390/ijerph111010559] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 09/24/2014] [Accepted: 09/25/2014] [Indexed: 01/04/2023]
Abstract
This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.
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13
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Lu CH, Wang PX, Lei YX, Luo ZC. Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers. Health Qual Life Outcomes 2014; 12:121. [PMID: 25123983 PMCID: PMC4168158 DOI: 10.1186/s12955-014-0121-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/01/2014] [Indexed: 11/14/2022] Open
Abstract
Background Rural-to-urban migrant workers have been increasing rapidly in China over recent decades. Health related quality of life (HRQOL) may affect health service utilization. There is a lack of data on HRQOL in relation to health service utilization in Chinese rural-to-urban migrant workers. This study was aimed to explore the influence of HRQOL on health service utilization in Chinese rural-to-urban female migrant workers. Methods This was a cross-sectional survey of 1,438 female rural-to-urban migrant workers in Shenzhen-Dongguan economic zone, China in 2013. HRQOL was assessed by the 36-items Health Survey Short Form (SF-36). Health service utilization was measured by any physician visit over the recent two weeks and any hospitalization over the last 1-year (annual hospitalization). Clustered logistic regression was used to analyze the influence of HRQOL on health service utilization. Results Lower scores in three HRQOL domains (bodily pain, general health, role physical) were associated with more frequent health service utilization in female rural-to-urban migrant workers. Bodily pain and general health were associated with an independent influence of 15.6% on the risk of recent two-week physician visit, while role physical and general health were associated with an independent influence of 21.2% on the risk of annual hospitalization. The independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and health-related variables. Conclusions HRQOL may have a modest influence on health service utilization in Chinese rural-to-urban female migrant workers - an underprivileged population in urban China.
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Affiliation(s)
| | - Pei-Xi Wang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China.
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14
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Honorato dos Santos de Carvalho VC, Rossato SL, Fuchs FD, Harzheim E, Fuchs SC. Assessment of primary health care received by the elderly and health related quality of life: a cross-sectional study. BMC Public Health 2013; 13:605. [PMID: 23800179 PMCID: PMC3704970 DOI: 10.1186/1471-2458-13-605] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 06/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Population aging leads to increased burden of chronic diseases and demand in public health. This study aimed to assess whether the score of Primary Health Care (PHC) is associated with a) the model of care - Family Health Strategy (FHS) vs. traditional care model (the Basic Health Units; BHU); b) morbid conditions such as - hypertension, diabetes mellitus, mental disorders, chronic pain, obesity and central obesity; c) quality of life in elderly individuals who received care in those units. METHODS A survey was conducted among the elderly between August 2010 and August 2011, in Ilheus, Bahia. We interviewed elderly patients - 60 years or older - who consulted at BHU or FHS units in that day or participated in a group activity, and those who were visited at home by the staff of PHC, selected through a random sample. Demographic and socioeconomic characteristics, services' attainment of primary care attributes, health problems and quality of life were investigated. The Short Form Health Survey (SF-12) was used to assess quality of life and PCATool to generate PHC scores. In addition, weight, height and waist circumference were measured. Trained research assistants, under supervision performed the data collection. RESULTS A total of 511 elderly individuals were identified, two declined to participate, resulting in 509 individuals interviewed. The health care provided by the FHS has higher attainment of PHC attributes, in comparison to the BHU, resulting in lower prevalence of score below six. Except for hypertension and cardiovascular disease, other chronic problems were not independently associated with low scores in PHC. It was observed an independent and positive association between PHC score and the mental component of quality of life and an inverse association with the physical component. CONCLUSIONS This study showed higher PHC attributes attainment in units with FHS, regardless of the health problem. The degree of orientation to PHC increased the mental component score of quality of life.
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Affiliation(s)
- Vivian C Honorato dos Santos de Carvalho
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2600, Porto CEP, 90035-003, Alegre, RS, Brazil
| | - Sinara L Rossato
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2600, Porto CEP, 90035-003, Alegre, RS, Brazil
| | - Flávio D Fuchs
- National Institute for Science and Technology for Health Technology Assessment, (IATS), Hospital de Clinicas de Porto Alegre, Ramiro Barcelos 2350, Clinical Research Center, CEP, 90035–003, Porto Alegre, RS, Brazil
| | - Erno Harzheim
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2600, Porto CEP, 90035-003, Alegre, RS, Brazil
- National Institute for Science and Technology for Health Technology Assessment, (IATS), Hospital de Clinicas de Porto Alegre, Ramiro Barcelos 2350, Clinical Research Center, CEP, 90035–003, Porto Alegre, RS, Brazil
| | - Sandra C Fuchs
- Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2600, Porto CEP, 90035-003, Alegre, RS, Brazil
- National Institute for Science and Technology for Health Technology Assessment, (IATS), Hospital de Clinicas de Porto Alegre, Ramiro Barcelos 2350, Clinical Research Center, CEP, 90035–003, Porto Alegre, RS, Brazil
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15
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Liu HB, Yan B, Han B, Sun JK, Yang Y, Chen J. Determination of Ameliorable Health Impairment Influencing Health-Related Quality of Life among Patients with Silicosis in China: A Cross-Sectional Study. J Int Med Res 2011; 39:1448-55. [PMID: 21986147 DOI: 10.1177/147323001103900433] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The association between health-related quality of life (HRQOL) and ameliorable health impairment was examined in 208 Chinese in-patients with silicosis, in April 2010. Median St George's Respiratory Questionnaire scores for symptom and activity impairment, social support rating scale and geriatric depression scale scores for patients were 57.24, 59.45, 35 and 5, respectively. Median 36-item short-form health survey physical component (PCS) and mental component (MCS) scores were 47.17 and 51.05, respectively. Lower than median PCS scores (< 47) were significantly associated with high levels of symptom and activity impairment. Lower than median MCS scores (< 51) were significantly associated with high levels of depression and activity impairment. Encouraging patients to participate in daily activities may alleviate activity impairment. Reasonable financial compensation may help to maintain and improve social support levels.
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Affiliation(s)
- HB Liu
- Division of Pneumoconiosis, School of Public Health, China Medical University, Shenyang, China
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - B Yan
- Department of Pneumoconiosis, Shenyang No. 9 Hospital, Shenyang, China
| | - B Han
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - JK Sun
- Department of Pneumoconiosis, Shenyang No. 9 Hospital, Shenyang, China
| | - Y Yang
- Department of Pneumoconiosis, Shenyang No. 9 Hospital, Shenyang, China
| | - J Chen
- Division of Pneumoconiosis, School of Public Health, China Medical University, Shenyang, China
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