Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL- BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.

Background: Researchers have previously commenced examining the degree of concordance between parent proxy and child self-reports on health-related quality of life (HRQOL) of many disease and impairment populations. Objects: To explore the differences between parent proxy and child self-reports on the HRQOL using Korean version of KIDSCREEN-10 questionnaires for applying to elementary school children and their parents who participated for a school-based wellness program. Methods: The focus groups were recruited for a school-based wellness program by implementing the following wellness services: 1) referring to a screening session for detecting potential posture-related musculoskeletal problems and 2) recommending home exercise programs. Before a primary field testing for the program, two focus groups were formed with a group of 9 parents and their 9 elementary school children aged 8–10 years of age. The parent proxy and child self-report versions of KIDSCREEN-10 questionnaires were administered to both groups after completion of the wellness program. Item level Rasch rating scale analysis was applied to compute logit scales of KIDSCREEN-10 questionnaire. Intraclass correlation coefficients (ICCs) and scatterplot of item difficulty between two reports were analyzed. Results: For fit statistics of parent proxy report, all items except 4 items (i.e., psychological well-being, mood/emotions, self-perception, parent relation) were found to be acceptable. For fit statistics of child self-report, all items except 3 items (i.e., psychological well-being, autonomy and home life) were acceptable. The relationship between two reports using ICCs were ranging from weak to very strong at p = 0.05 (i.e, ICCs = 0.011 to 0.905). Scatterplot analysis between two reports showed a major disparity on self-perception item at 95% confidence intervals. Conclusion: Both item level analyses and ICC comparisons provided a disparity between parent proxy and child self-reports of the HRQOL on self-perception item after competing a school-based wellness program. Therapist should consider the item as part of the HRQOL assessment.

Sodium intake has been associated with the health-related quality of life (HRQoL). This study examined the demographic factors related to HRQoL and whether there is an association between sodium intake and HRQoL in adults residing in rural areas. A total of 1,980 adults (aged ≥20 years) were selected from a cross-sectional study conducted between December 2013 and February 2014 in Gyeongju, South Korea. The sodium intake and HRQoL were measured using a validated food frequency questionnaire and the EuroQol Five-Dimension (EQ-5D) (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), respectively. The education levels (<5 years) were inversely associated with all five dimensions of HRQoL. Men had better EQ-5D scores for each of the five components examined. Adults living with spouses had better scores related to usual activities and anxiety/depression, whereas widowers had decreased scores of mobility and self-care. Unlike older adults aged 70-79 years, adults aged <60 years were more likely to have greater scores related to mobility, usual activities, and pain/discomfort. The income levels were also inversely related to the scores for self-care, usual activities, pain/discomfort, and anxiety/depression. Sodium intake was positively associated with the HRQoL related to self-care, usual activities, and pain/discomfort, but it was negatively associated with anxiety/depression. In conclusion, these findings suggest that the demographic factors and sodium intake were independently associated with HRQoL. The results highlight the need to provide tailored, targeted policies and interventions that consider personal characteristics and dietary intake to improve the overall HRQoL in adults residing in rural areas.

연구목적은 성인 지적장애인들의 수영 프로그램 참여에 따른 자아효능감과 운동 몰입, 건강관련 삶의 질의 변화를 분석하는 데 있다. 연구대상은 지적장애인 거주시설에서 거주하고 있는 성인 지적장애인 12명이며, 수영 프로그램에 12주간 참여하였다. 이에 따라 대상자들의 자아효능감과 운동 몰입, 건강 관련 삶의 질의 변화를 분석하였다. 자아효능감 평가는 전반적 자아효능감 척도를 활용하였으며, 일반적, 사회적 신체적 자아효능감을 평가하였다. 운동 몰입 평가는 스포츠 몰입척도를 활용하였으며, 인지몰입과 행위몰입의 수준을 평가하였다. 건강관련 삶의 질 평가는 건강관련 삶의 질 척도를 활용하여 전반적 건강 관련 삶의 질의 수준을 평가하였다. 그 결과, 대상자들은 수영 프로그램 참여에 따라 자아효능감과 운동 몰입, 건강관련 삶의 질의 수준이 통계적으로 유의미하게 향상되었다. 수영 프로그램의 참여는 성인 지적장 애인들의 자아효능감과 운동 몰입, 건강관련 삶의 질의 수준을 향상시키는 데 긍정적으로 작용한다. 이에 따라서, 성인 지적장애인들을 대상으로 수영 프로그램의 적용을 고려해볼 필요가 있을 것이다.

Background: Cross-culturally adapted questionnaires may not be comparable to their original version. Objects: To examine concurrent validity of two health-related quality of life (HRQOL) instruments for the Korean versions of EuroQOL-5 Dimension (EQ-5D) and the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Methods: A total of 139 cancer survivors from two rehabilitation institutes was recruited. All participants were registered for palliative rehabilitation care. Both instruments were concurrently administered by health care providers following the second bout of the rehabilitation cares. Rasch partial credit model and Spearman’s correlation analysis were used to investigate: 1) dimensionality, 2) hierarchical item difficulty, and 3) concurrent validity using correlations between two instruments. Results: For the WHOQOL-BREF, all items except negative feeling, pain, dependence of medical aid, were found to be acceptable, while all items of EQ-5D were acceptable. There was an evidence of negative correlations between EQ-5D and 4 domains of WHOQOL-BREF. Two correlations were strong (EQ-5D vs. physical health domain, ρ = –0.610, 95% CI = –0.716 to –0.475) and moderate (EQ-5D vs. psychosocial domain, ρ = –0.402, 95% CI = –0.546 to –0.236). Other two correlations were weak (EQ-5D vs. social relationship and environmental domains, ρ = –0.242, 95% CI = –0.401 to –0.075 and ρ = –0.364, 95% CI = –0.514 to –0.207, respectively). Item difficulty calibrations of the two measurements were ranged from –0.84 to 0.86 for the EQ-5D and –1.07 to 1.06 for the WHOQOL-BREF. Conclusion: The study provides some supports for the concurrent validity of the two Korean versions of HRQOL instrument, with evidences of weak to strong correlations between the EQ- 5D and four domains of the WHOQOL-BREF applied to various cancer survivors. Additionally, the cancer survivors appeared to have more of a tendency to view the EQ-5D items as being slightly more challenging than the WHOQOL-BREF items.

목적 : 본 연구는 지역사회중심재활(CBR)서비스 이용자의 만족도 및 몰입도가 건강 관련 삶의 질에 미치는 영향에 대해 알아보고 더 나아가 만족도와 몰입도의 어떠한 하위요인이 영향을 끼치는지 알아보고자 하였다. 연구방법 : 대전광역시 보건소에서 CBR서비스 이용자 45명을 대상으로 CBR서비스 만족도와 몰입도, SF-36 설문지를 이용하여 총 5주간에 걸쳐 자료를 수집하였다. 일반적인 특성에 따른 주요 변수의 차이를 알아보기 위해 기술통계, 독립 t검정, ANOVA 및 사후분석을 시행하였다. 이용해 본 서비스에 대해 다중응답 빈도분석을 시행하였고, 각 서비스 이용 유무에 따른 건강 관련 삶의 질 비교를 위해 독립t검정을 시행하였다. 건강 관련 삶의 질과 만족도와 몰입도 간의 상관관계를 확인하기 위해 Pearson 상관분석을 시행하였으며, 만족도와 몰입도가 건강 관련 삶의 질에 미치는 영향을 확인하기 위해 다중 회귀분석을 시행하였다. 결과 : 서비스 이용 기간이 6개월 이내인 대상자의 서비스 몰입도가 가장 높았고(F=3.89), 제공받은 서비스 중 장애인 재활교실 프로그램 이용 유무에 따라 건강 관련 삶의 질에 유의한 차이를 보였다(t=3.21). 만족도와 몰입도 간에 유의한 정적 상관관계가 나타났으며(p<.01), 신체건강 관련 삶의 질은 전문성 만족도(r=-.29)와 만족도 총합(r=-.29)과 유의한 부적 상관관계를 보였다. 만족도와 몰입도가 건강 관련 삶의 질에 영향을 미치지 않는 것으로 나타났다. 결론 : 연구결과를 바탕으로 CBR서비스 프로그램의 방향 설정을 위한 건강 관련 삶의 질에 영향을 미치는 변수에 대한 추가 연구가 필요하다.

Background: Health-related quality of life (HRQOL) is a construct of quality of life relevant to health. HRQOL can be measured multiple ways including self-perceived interpretation of one’s health status. Research has shown value in understanding self-perceived or person-centered HRQOL. Thus, these types of assessments have been integrated into health care systems, used to help patients set personal goals and to determine treatment success. The purpose of this study was to describe the group, examine the relationship between HRQOL and functional independence, and then determine the impact of standard care on the HRQOL (index and visual analog scale [VAS]). Methods: Retrospective clinical observation study. Descriptive statistics used to describe the stroke sample. Comparison was performed to explore the correlation between the EuroQol 5-Dimensions Questionnaire (EQ-5D) and the Functional Independence Measure (FIM) at admission and discharge. Paired-samples t-test was conducted to evaluate the impact of standard therapy on HRQOL on EQ-5D. Results: n=1325; mean age of 72 years (SD=13.28) and 65% females. A weak, positive correlation found at admission (r=.15, n=1325, p<.000) and discharge (r=.04, n=1325, p<.000). A paired-samples t-test revealed a statistically significant increase in HRQOL index and VAS scores (p’s<.000) overtime, with a large effect size (η2=.74 and .70), respectively. Conclusion: A weak relationship was present between HRQOL and functional independence, thus suggesting these assessments should be used independent of each other. Statistically significant change in scores suggest improvement in HRQOL overtime, supported by large effect sizes and mean scores higher than the minimal important difference range.

본 논문은 전후기 여성 독거노인의 건강관련 삶의 질 영향 요인을 알아보고자 하는 서술적 조사 연구로 2017년 <여성 독거노인의 통증, 영양위험, 외로움, 지각된 건강상태가 건강관련 삶의 질에 미치는 영향>인 일차연구 자료와 추가 수집한 자료 총 85부를 이용한 이차분석 연구이다. SPSS/WIN 18.0 program을 이용하여 분석한 결과, 전기 여성 독거노인의 건강관련 삶의 질 영향 요인은 통증, 규칙적인 운동, 사회적지지 순으로 설명력 70.6%이며 후기 여성 독거노인의 건강관련 삶의 질 영향 요인은 규칙적인 운동, 일상생활수행능력, 통증 순으로 건강관련 삶의 질에 영향을 주는 것으로 설명력은 69.7%로 나타났 다. 따라서 통증 감소를 위한 방안과 사회적지지 체계의 강화, 생활체육 활성화 및 그에 따른 일상생활 수행 유지를 위한 노력 등의 모색을 통해 건강관련 삶의 질을 향상 시킬 필요가 있다.

본 연구는 한방기공운동에 참여하는 여성노인들의 재미요인이 건강관련 삶의 질에 미치는 영향력을 검증하기 위하여 수행되었다. 구체적으로는 한방기공운동에 참여하는 여성노인들의 인구통계학적인 내용에 따라 연령, 학력, 운동경력에 따른 두 변인과의 영향력을 분석하였고, 준거변인인 건강관련 삶의 질과 예언변인인 재미요인에 관계는 어떠한 관계로 형성되어 있는가를 알아보았다. 분석 결과는 한방기공운동의 재미요인이 건강관련 삶의 질에 영향을 미치고 있다는 실질적인 효과를 규명하였으며, 한방기공운동이 여성노인운동의 긍정적인 프로그램으로 활용될 수 있다는 근거를 제공하였다.

This study aimed to determine the effect of depression between the healthrelated quality of life and pain in elderly persons with physical disabilities. A total of 111 patients who were treated at hospital B (Seoul, Daejeon, Daegu, Gwangju, and Busan) participated in the Survey. The SF-36 Health Assessment was used to determine the quality of life of subjects, the Korean version of the Geriatric Depression Scale-Short form to assess the level of depression, and Numeric Rating Scale to determine the level of pain. To determine the moderating effect of depression on the relationship between quality of life and pain, simple regression analysis, and the Sobel test were performed. There was a significant negative correlation between health-related quality of life and pain (r<-.3, p<.05), and a significant positive correlation between depression and pain (r=.251, p<.05). Thus, health-related quality of life had a simple regression relationship with depression and pain. Depression also showed a mediating effect between health-related quality of life and pain. The results of this study suggest that depression mediates between pain and quality of life.

Objective : The main purpose of this study was to analyze the structural relationship among factors that have an impact on Health-Related Quality of Life (HRQOL) in three groups: A stroke patient group (Exp 1), high-risk stroke patient group (Exp 2), and a normal control group.Methods : For this survey, we conducted a secondary analysis using ‘the fifth Korea national health and nutrition examination survey (2010-2011)’, and investigated 2,293 elderly people over 65 years in age.Results :The results were as follows: HRQOL had a significant difference among groups (control›Exp2›Exp1) (p<.05). In the total effect of the experimental 1 groups, their HRQOL was significantly affected by their mental health (β=.425), self-rated health (β=.391), and medical health (β=.290)(p<.05). In the total effect of the experimental 2 group, their HRQOL was significantly by their self-rated health (β=.425), medical health (β =.272), mental health (β=.249), and functional health (β=.234) (p<.05). In the total effect of the control group, their HRQOL was significantly affected by their self-rated health (β=.398) and mental health (β=.184)(p<.05).Conclusion : In conclusion, this study suggested two matters to improve the HRQOL in people with or without a stroke. First, to improve the HRQOL in people suffering from senility, a different approach is needed according to whether the person has had or not had a stoke. Particularly in stroke patients, we should treat both their physical disability and mental health. Second, regardless of whether they have had a stroke, their HRQOL is influenced strongly by their self-rated level of health, and therefore an improvement of HRQOL will be induced by promoting positive health behaviors.

This study was carried out to analyze the relationship between body mass index (BMI) and general characteristics, psychological factors, eating habits, dietary behaviors, and health related quality of life using survey of 335 women aged 20 to 29 years in the Seoul and Kyungin areas. The 335 study subjects were divided into 4 groups by BMI (㎏/㎡) levels; normal group(18.5≤BMI≤22.9), overweight group(23.0≤BMI≤24.9), mild obesity group(25.0≤BMI≤29.9), and heavy obesity group (BMI≥30) by Asian-Pacific obesity index criteria. The family income of the heavy obesity group was significantly (p<0.05) less than that of the normal weight group. Psychological factors, such as stress and depression of the normal weight group tended to be higher than those of overweight and obesity groups. The higher BMI level had the lower self-efficacy(p<0.05) among all subjects. As the BMI level increased, the preference for sweet, salty, and hot taste was significantly high. We found that normal weight women had healthier eating habits and dietary behaviors and a higher level of health-related quality of life than did those who were overweight, mildly obese, and heavily obese women. Overweight and mildly and heavily obese women were strongly associated with decreased physical and mental health related quality of life. Therefore, weight loss is desirable, and is likely to be beneficial for health-related quality of life in obese adult women. In conclusion, this study contains evidence to suggest that obesity management programs including different strategies according to obesity are required to determine the types of programs that are suitable for adult women, prior to their initiation of a program. The findings are helpful to inform researchers and practitioners who are seeking to implement appropriate strategies to create positive changes in the health behaviors of obese adult women.

This study was carried out to analyze any possible changes in the heart rate variability(HRV) of white-collar workers of a manufacturing firm based in Chollabuk-do Province when they are stressed due to their daily job performance and thereby to help them seek a more effective method of the management of their health and help them form more desirable habits of living by finding out how seriously his or her stresses from his or her job performance affect their quality of life(QOL). As a process of the above-mentioned manufacturer's plan to do an Oriental health examination on its white-collar workers, each of the workers of the firm was given a copy of questionaires. The questionaires carried questions regarding each of the workers' general characteristics, clinical history, health-related lifestyle and the QOL and each of the workers was asked to provide his answers to the questions listed on the questionaire. The examination progressed to measure any possible changes in the HRV of an individual worker. Among all of the questionaires filled out and collected from the workers, a total of 423 data were used as the data of the research except those that had answers which were not appropriate for the purpose of the research. The analysis of each of the workers' health related quality of life(HRQOL) showed that the younger, the lower the standard of education is, each of the subjects was found to tend to show a relatively higher QOL if only he is healthy. With regard to the worker's habits of living, those who exercise on a regular basis and who get a good sleep were also found to have a comparatively higher QOL With reference to the HRV, young workers, those who have spouses, those with a high level of academic background, those with a short work experience were found to tend to have a relatively higher HRV. As regards each worker's habits of living, those who do exercise on a regular basis were found to have a comparatively higher index of HRV. RMSSD was found to have an impact on workers' general health, on the other hand TP was found to have an impact on workers' role of emotion. This result was based on findings through analyzing interrelation between HRV and QOL that stresses have an impact on the QOL. Taking a look at the above results, it was learned that individual worker's efforts to promote his or her health, along with establish desirable habits of living, these two qualities are important methods to improve the quality of life. In addition, control of stresses is necessary to improve the QOL, which is possible through emotional stabilization.

The purpose of this study was to determine the relationship between activities of daily living and health-related quality of life in ambulatory stroke patients. This was a cross-sectional survey study of 60 patients who had survived one year or more after a stroke in community. Activities of daily living were assessed using the Functional Independence Measure (FlM) and health-related quality of life using the Stroke Impact Scale (SIS). The association between FIM and SIS was examined using Pearson' s correlation. The FIM score was higher than the SIS score. Most domains of FIM exhibited a high rate (45-85%) of ceiling effects. However, only the communication and memory domain of SIS exhibited of ceiling effects. The correlation coefficients were .835 (p<.01) for FIM-motor vs. SIS-ADL, .257 (p<,05) for FIM-motor vs. SIS-communication, .596 (p<.01) for FIM-motor vs. SIS-social participation, .635 (p<.01) for FIM-cognition vs. SIS-memory, .369 (p<.01) for FIM-cognition vs. SIS-ADL, and .289 (p<.05) for FlM-cognition vs. SIS-social participation. In conclusion, the correlation between FIM-motor and SIS-social participation was higher than that of FlM-cognition and SIS-social participation. The domains of emotion and hand function of SIS showed no correlation coefficients with FIM-total. To examine the activities of daily living and the quality of life in ambulatory stroke patients in community, it is necessary to use both the FIM and SIS.

Purpose: The purpose of the study is to identify structural relationship among exercise imagery, physical activity, and health-related quality of life of adults. Methods: Five hundred questionnaires were initially distributed to college students, company employees and sports center members(male: 273, female: 194, Mage=39.21). Among them, total 467 were finally used in this study. Exercise imagery scale, weekly leisure-time exercise questionnaire and short-form health survey-36 were revised into Korean and applied in the study. Frequency analysis, correlation analysis, and structural equation modeling were carried out to test the possible relationship among exercise imagery, physical activity, and health-related quality of life. All analyses were conducted by SPSS 18.0 and AMOS 18. Results: Results indicated that there were positive relationship among exercise imagery, physical activity, and health-related quality of life of adults. In specific, exercise imagery and physical activity had significant positive relationship with vitality which was sub-factor of psychological health-related quality of life. Additionally, exercise imagery was significant factor to physical health-related quality and physical activity. The finding ultimately revealed that a hypothesized research model showed the significant model fit after modification. But it was showed the difference with sex. Conclusion: This study suggests that cognitive intervention strategies aimed at exercise imagery could be significant to promote physical activity and its related health-related quality of life. As it was existed the difference with sex, there will be necessary another studies which is concerned about various variables.