College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Center for Human-Caring Nurse Leaders for the Future by Brain Korea (BK21) four project, College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
BMC Geriatr. 2023 Aug 14;23(1):491. doi: 10.1186/s12877-023-04186-5.
While some studies have explored the health-related quality of life (HRQOL) of older adults with diabetes mellitus (DM) in South Korea using a theoretical framework, these studies suffer sample-related limitations, as they focus only on a specific subgroup of older adults. To address this gap, this study aimed to investigate the predictors of HRQOL of older adults with DM in South Korea, using extensive national data and based on the theory of Health-Related Quality of Life in South Korean Older Adults with Type 2 Diabetes (The HIKOD theory).
A secondary data analysis was conducted using data from 1,593 participants aged 65 years and older with DM sourced from the 2015-2019 Korea National Health and Nutrition Examination Survey (KNHANES). The variables included in this study are as follows: demographic factors (gender, age, household income, and education level), disease-specific factors (duration of DM, treatment of DM, and control of HbA1c), barriers (number of comorbidities), resources (living alone status), psychosocial factors (perceived stress), and health-promoting behaviors (physical activity and fundus examination). Considering the complex sampling design employed in this study, statistical analyses including Rao-Scott chi-square tests, correlation analysis, and hierarchical multiple regression analysis were conducted.
Mobility (45.0%) was the HRQOL dimension with which participants experienced the highest number of problems. Number of comorbidities (r = -0.36, p < 0.001), living alone status (r = 0.16, p < 0.001), perceived stress (r = 0.14, p < 0.001), and physical activity (r = 0.12, p < 0.001) were correlated with HRQOL. While adjusting for background factors, HRQOL was negatively predicted by higher number of comorbidities (estimate B = -0.03, p < 0.001), living alone (estimate B = -0.03, p = 0.043), higher perceived stress (estimate B = -0.09, p < 0.001), and lower physical activity (estimate B = -0.03, p < 0.001).
Complex and diverse factors influence HRQOL among older adults with DM in South Korea. To improve their HRQOL, intervention programs that integrally regard HRQOL, along with various predictors, are necessary.
虽然一些研究使用理论框架探讨了韩国老年糖尿病患者的健康相关生活质量（HRQOL），但这些研究受到样本相关的限制，因为它们仅关注老年人群体的特定亚组。为了解决这一差距，本研究旨在使用来自韩国全国健康和营养调查（KNHANES）的 2015-2019 年 1593 名 65 岁及以上糖尿病患者的扩展全国数据，基于韩国 2 型糖尿病老年人健康相关生活质量理论（The HIKOD 理论），调查韩国老年糖尿病患者的 HRQOL 预测因素。
使用 2015-2019 年韩国全国健康和营养调查（KNHANES）中 1593 名 65 岁及以上患有糖尿病的参与者的数据进行二次数据分析。本研究纳入的变量包括：人口统计学因素（性别、年龄、家庭收入和教育水平）、疾病特异性因素（糖尿病病程、糖尿病治疗和糖化血红蛋白控制）、障碍因素（共病数量）、资源因素（独居状态）、心理社会因素（感知压力）和促进健康行为（身体活动和眼底检查）。考虑到本研究采用的复杂抽样设计，进行了 Rao-Scott 卡方检验、相关分析和分层多元回归分析等统计分析。
活动能力（45.0%）是参与者体验到最多问题的 HRQOL 维度。共病数量（r=-0.36，p<0.001）、独居状态（r=0.16，p<0.001）、感知压力（r=0.14，p<0.001）和身体活动（r=0.12，p<0.001）与 HRQOL 相关。在调整背景因素后，更高的共病数量（估计 B=-0.03，p<0.001）、独居（估计 B=-0.03，p=0.043）、更高的感知压力（估计 B=-0.09，p<0.001）和更低的身体活动（估计 B=-0.03，p<0.001）与 HRQOL 呈负相关。
复杂多样的因素影响韩国老年糖尿病患者的 HRQOL。为了提高他们的 HRQOL，需要制定综合考虑 HRQOL 以及各种预测因素的干预计划。
