College of Nursing, Catholic University of Pusan, Busan, South Korea.
Graduate School, College of Nursing, Pusan National University, Yangsan, South Korea.
Qual Life Res. 2020 Mar;29(3):721-732. doi: 10.1007/s11136-019-02360-0. Epub 2019 Nov 12.
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.
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.
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.
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.
随着人口老龄化，同时患有多种慢性疾病（两种或多种慢性疾病）的老年人数量迅速增加，这一现象值得关注。然而，在韩国，很少有研究采用综合方法来探讨与患有多种慢性疾病的老年人的健康相关生活质量（HRQoL）和疾病相关问题相关的因素。本研究旨在探讨多种变量与 HRQoL 的相关性，并探讨韩国社区居住的患有多种慢性疾病的老年人的疾病相关生活体验。
采用平行混合方法，对 310 名年龄在 65 岁以上、被诊断患有两种或多种慢性疾病且定期接受治疗的社区居住老年人进行了问卷调查。从 3 个焦点小组访谈中收集了 15 名参与者的定性数据。使用多元回归分析与 HRQoL 相关的因素，使用 NVivo Pro 12.0 进行内容分析。
在多元回归分析中，抑郁与 HRQoL 的相关性最强。抑郁、日常生活活动、工具性日常生活活动、来自朋友的支持、用药数量和主观健康状况解释了 HRQoL 变异的 41.0%。内容分析揭示了参与者生活中的 5 个主要与健康相关的主题：身体功能下降、焦虑的精神状态、社会支持结构重要性的变化、疾病管理的局限性、以及接受和忍耐。
基于研究结果，需要开展以社区为基础的项目和健康促进项目，考虑到心理状态（如抑郁），以提高患有多种慢性疾病的个体的 HRQoL。
