Factors associated with health-related quality of life among overweight and obese Korean women

Obesity Indicators and Health-related Quality of Life - Insights from a Cohort of Morbidly Obese, Middle-aged South Indian Women

OBJECTIVE

The global prevalence of obesity is increasing and has nearly doubled in the last decade, disproportionately impacting less-developed countries. The aim of this cross-sectional study was to analyse health-related quality of life (HRQOL) in morbidly obese women attending a bariatric clinic in India, and assess potential obesity indicators that can be utilised in under-resourced settings, to better understand HRQOL of individual patients.

METHODS

Anthropometric measurements were collected, including waist circumference, hip circumference, waist-hip ratio, waist-height ratio and body mass index (BMI). HRQOL was assessed using an obesity-related quality-of-life questionnaire focused on the impact of obesity on physical distress, self-esteem, sexual life and work life.

RESULTS

The average BMI of study participants was 39.6 kg/m2, with an average HRQOL of 40.2%. The strongest correlation was noted between BMI and HRQOL (R2=0.16). Exploratory analyses demonstrated that patients with higher BMI quartiles had lower scores for physical impact and psychosocial impact, and higher scores for sexual health, comfort with food, and experience with dieting compared to patients in lower quartiles.

CONCLUSION

In South Indian, middle-aged, morbidly obese women, HRQOL is lower than average and is highly correlated with BMI, with different BMI levels having higher impacts in different subcategories, supporting the need for an individualised therapeutic focus for each patient.

Social-Ecological Analysis of the Factors Influencing Shanghai Adolescents' Table Tennis Skills: A Cross-Sectional Study

The main purpose of this study was to explore the factors that affect adolescents’ table tennis skills (ATTS) among adolescents in Shanghai from the social ecological perspective, including individual factors, social support, and physical environment. 1,526 students from Shanghai primary and secondary schools were included in this study (age = 12.31 ± 1.32 years). Participants completed a questionnaire based on social ecological theory after taking the ATTS test. A structural equation model was applied to test the relationships among the study variables. The relationship model incorporating individual factors, social support, physical environment, and ATTS test score fit the data well (χ² = 1415.754, χ²/df = 4.96, p < 0.001; CFI = 0.914; IFI = 0.930; NFI = 0.921; RMSEA = 0.032). The investigation results showed that social support and physical environment promote adolescents’ scores on the ATTS test. At all levels of social ecology, individual factors were the most important factors for the improvement of ATTS. The level impacting most significantly on ATTS was individual factors, followed by social support, and, finally, the physical environment. Therefore, cultivating intrinsic interest is an important way to facilitate the continuous activities of adolescents. In addition, friends should support each other, and parents should give adolescents appropriate encouragement regarding table tennis exercise. Schools should provide more table tennis facilities. PE teachers should respect adolescents’ ideas, listen to students’ opinions, and encourage them to participate in table tennis training.

Development of a scale to measure quality of life of overweight women

PURPOSE

This study presents the results of methodological research that derives evaluation items and tests the validity and reliability of the scale to measure quality of life of the overweight women.

METHODS

The scale items were developed by the current researchers directly from the consultation data following a group interviewing process aiming to capture the women's experiences, who are currently receiving primary health care. Pretest interviews were used to ensure that the questions were understood correctly. Six experts determined items for content validity of the scale and the evaluations of experts were scored using a content validity index. The scale is a Likert-type scale, ranging from 1 to 5. The items were tested on a sample of 506 healthy women. The body mass indices of participants were 30 and above. Psychometric analyses included explanatory factor analysis (EFA) and item response theory. Parallel analysis was used to extract factors in EFA. Internal consistency and Spearman Brown split-half test correlation were used for testing reliability.

RESULTS

The scale was refined as four final dimensions, comprising 40 items as a whole. The result of Bartlett's Test of Sphericity was found sufficient (χ² = 14164.92; p < 0.001) and the KMO value was 0.959. This statistically significant value (p < 0.001) indicates that the sampling was sufficient and data had normal distribution. Cronbach's alpha was 0.967. The Spearman Brown coefficient was found to be 0.884.

CONCLUSION

It was found that the scale is a valid and reliable assessment tool that can be used to measure the quality of life of overweight women.

LEVEL OF EVIDENCE

Methodological study, Level V.

The Roles of Individual and Psychosocial Factors in Predicting Quality of Life Among Working Women in Shanghai

Working women are at a high risk of suffering from occupational stress and burnout, which can result in reducing Quality of Life (QoL). Guided by the QoL construct and Luban et al.’s conceptual framework, this study aimed to (a) investigate the roles of individual factors (i.e., age) and psychosocial factors (i.e., occupational stress, burnout) on QoL among working women, and (b) examine the age differences among study variables (young versus middle-aged groups). Participants were 375 working women (M_age = 42.06) recruited in Shanghai, China. They completed previously validated questionnaires assessing their occupational stress, burnout (emotional exhaustion, cynicism, and reduced professional efficacy), and QoL (physical health, psychological health, social relationship, and living environment). Confirmatory factor analysis, Pearson product-moment correlation, hierarchical regressions, and factorial multivariate analyses of variance (MANOVA) were used to examine the relationships and differences between occupational stress, burnout, and QoL among working women. Correlation and regression analyses indicated that occupational stress and burnout were significantly associated with QoL among these participants. Two one-factor MANOVAs demonstrated that young-aged working women had higher occupational stress and burnout, but lower levels of QoL than middle-aged women. These results suggest that adopting specific coping strategies to reduce or prevent occupational stress and burnout are needed to improve QoL among working women.

Identifying variables in relation to health-related quality of life among married women of reproductive age in Sivas Turkey

A cross-sectional study was performed to identify the factors associated with health-related quality of life (HRQoL) among 1,236 married Turkish women aged 15-49 years, in the urban area of Sivas, between January and July 2017. Multiple logistic regression analyzes showed that being unemployed [adjusted odds ratio (AOR) = 1.73, 95% confidence interval (CI) = 1.18-2.25], and having an unsatisfying sexual life (AOR = 1.54, 95% CI = 1.17-2.03), a chronic illness (AOR = 1.66, 95% CI = 1.27-2.17), more than three children (AOR = 1.38, 95% CI = 1.03-1.86), and experienced domestic violence (AOR = 2.15, 95% CI = 1.55-2.98) were associated with worse mental HRQoL. Having less than a high school education (AOR = 2.00, 95% CI = 1.33-3.02), a chronic illness (AOR = 2.49, 95% CI = 1.88-3.30), a history of abortion (AOR = 1.59, CI = 1.09-2.31), and experienced domestic violence (AOR = 1.71, 95% CI = 1.21-2.40) were associated with worse physical HRQoL. These findings suggest that health care providers or policy makers should pay special attention to unemployed women who are less educated, have more than three children and those having unsatisfied sexual lives, chronic illness, domestic violence experience and abortion history to enhance their HRQoL.

Development of a clinical trials version of the Impact of Weight on Quality of Life-Lite questionnaire (IWQOL-Lite Clinical Trials Version): results from two qualitative studies

Existing measures of health-related quality of life and patient functioning in obesity, such as the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, lack the developmental rigour required by the Food and Drug Administration (FDA) to support product labelling. Two iterative qualitative studies informed development of a version of the IWQOL-Lite questionnaire optimized for use in obesity clinical trials: the IWQOL-Lite Clinical Trials Version. Study 1 included 42 patients with body mass index (BMI) ≥ 30 kg m-2 (obesity); and Study 2 included 29 patients with type 2 diabetes and BMI ≥ 27 kg m-2 (overweight). Candidate items were selected and/or modified from the IWQOL-Lite or developed de novo based on concept elicitation and cognitive debriefing interviews, as well as input from clinical experts and the FDA. Participants consistently reported that excess weight limited physical activity and comfort, energy/stamina and self-confidence/self-esteem. Impacts on emotional, social and sexual functioning, as well as productivity and overall health, were also reported. Each concept addressed in the 22-item pilot IWQOL-Lite Clinical Trials Version was consistently reported as salient and likely to change with 10% weight loss. Data from ongoing and planned clinical trials will be used to finalize and conduct psychometric evaluations of the pilot measure in several patient populations.

Ecological analysis of college women's physical activity and health-related quality of life

Despite significant health benefits of regular physical activity, over 60 percent of college women do not meet recommended physical activity guidelines to promote their health and health-related quality of life (HRQoL), a comprehensive construct including physical and psychosocial health functioning. The major purpose of this study was to examine the influences of individual (e.g., self-efficacy, enjoyment), social (e.g., family and friend support), and physical environmental factors (e.g., crime safety) on college women's physical activity and HRQoL. Participants were 235 (Mean age = 21.0 years) college women from a public research university located in the southwest region of the United States. They completed validated surveys assessing their perceptions of physical activity, HRQoL, and social ecological factors during the spring semester of 2012. The findings of three multiple linear regressions, entering individual factors first, followed by social and physical environmental factors, revealed that self-efficacy and crime safety were significantly related to physical activity. For HRQoL-physical functioning, significant factors were self-efficacy, enjoyment, and crime safety. Enjoyment was the only factor related to HRQoL-psychosocial functioning. These findings indicated that physical activity professionals need to foster safe environments, enhance self-efficacy, and provide enjoyable activities to promote college women's physical activity and HRQoL.

Obesity, metabolic abnormality, and health-related quality of life by gender: a cross-sectional study in Korean adults

PURPOSE

This study sought to compare the association between health-related quality of life (HRQoL) and four body health types by gender.

METHODS

The study included 6217 men and 8243 women over 30 years of age chosen from a population-based survey. Participants were grouped by body mass index and metabolic abnormality into four types: metabolically healthy normal weight, metabolically abnormal but normal weight (MANW), metabolically healthy obesity (MHO), and metabolically abnormal obesity (MAO). HRQoL was measured using the EQ-5D health questionnaire. The outcomes encompassed five dimensions (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression), and the impaired HRQoL dichotomized by the EQ-5D preference score. Complex sample multivariate binary logistic regression analyses were conducted to adjust for sociodemographic variables, lifestyle factors, and disease comorbidity.

RESULTS

Among men, those in the MANW group presented worse conditions on all dimensions and the impaired HRQoL compared to other men. However, no significant effect remained after adjusting for relevant covariates. For women, those in the MAO group had the most adversely affected HRQoL followed by those females in the MHO group. The domain of mobility and impaired HRQoL variable of the MAO and MHO groups remained significant when controlling for all covariates in the model.

CONCLUSIONS

The MANW is the least favorable condition of HRQoL for men, suggesting that metabolic health may associate with HRQoL more than obesity for males. In women, the MAO and MHO groups had the most adversely affected HRQoL, implying that MHO is not a favorable health condition and that obesity, in general, may be strongly associated with HRQoL in women.