J Korean Acad Nurs.  2017 Feb;47(1):60-70. 10.4040/jkan.2017.47.1.60.

Prediction Model for Health-Related Quality of Life in Hospitalized Patients with Pulmonary Tuberculosis

• Jang KS
• Jeon GS

• KMID: 2425937
• DOI: http://doi.org/10.4040/jkan.2017.47.1.60

Abstract

PURPOSE
This study was conducted to construct and test a structural equation model of health-related quality of life (HRQoL) among hospitalized patients with pulmonary tuberculosis (PTB).
METHODS
Participants were 256 patients with PTB who were 20 years or older and admitted in two national tuberculosis hospitals. The patients participated in pulmonary function testing and responded to structured questionaries.
RESULTS
The goodness-of-fit statistics of the final hypothetical model were as follows: χ2/df=2.19, RMSEA=.07, SRMR=.05, GFI=.95, NFI=.95, CFI=.96, TLI=.92, and PCFI=.52. Symptoms and general health perception had significant direct effects, and subjective economic status, social support and stigma had significant indirect effect on HRQoL of hospitalized patients with PTB. These variables explained 64% of variance in the prediction model.
CONCLUSION
Findings suggest that strategies and intervention for physical symptoms and depressive symptoms are crucial to improve the quality of life in hospitalized patients with PTB. The development of various social support programs is also recommended.

Keyword

Pulmonary tuberculosis; Quality of life; Depression; Social support; Social stigma

MeSH Terms

Adult
Aged
Female
Humans
Male
Middle Aged
*Models, Theoretical
*Quality of Life
Social Class
Social Stigma
Social Support
Surveys and Questionnaires
Tuberculosis, Pulmonary/*psychology

Figure

• 

  Figure 1 Path diagram for the hypothetical model.

Reference

1. World Health Organization. Global tuberculosis report 2016. Geneva, CH: Author;2015.

2. Lienhardt C, Espinal M, Pai M, Maher D, Raviglione MC. What research is needed to stop TB? Introducing the TB Research Movement. PLoS Med. 2011; 8(11):e1001135. DOI: 10.1371/journal.pmed.1001135.

3. Sharma R, Yadav R, Sharma M, Saini V, Koushal V. Quality of life of multi drug resistant tuberculosis patients: A study of north India. Acta Med Iran. 2014; 52(6):448–453.

4. Marra CA, Marra F, Colley L, Moadebi S, Elwood RK, Fitzgerald JM. Health-related quality of life trajectories among adults with tuberculosis: Differences between latent and active infection. Chest. 2008; 133(2):396–403. DOI: 10.1378/chest.07-1494.

5. Shin S. Patterns of health-related quality of life and factors associated with health risks among Korean adults [dissertation]. Seoul: Seoul National University;2010.

6. Bauer M, Leavens A, Schwartzman K. A systematic review and meta-analysis of the impact of tuberculosis on health-related quality of life. Qual Life Res. 2013; 22(8):2213–2235. DOI: 10.1007/s11136-012-0329-x.

7. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995; 273(1):59–65.

8. Guo N, Marra F, Marra CA. Measuring health-related quality of life in tuberculosis: A systematic review. Health Qual Life Outcomes. 2009; 7:14. DOI: 10.1186/1477-7525-7-14.

9. Bakas T, McLennon SM, Carpenter JS, Buelow JM, Otte JL, Hanna KM, et al. Systematic review of health-related quality of life models. Health Qual Life Outcomes. 2012; 10:134. DOI: 10.1186/1477-7525-10-134.

10. Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL. Conceptual model of health-related quality of life. J Nurs Scholarsh. 2005; 37(4):336–342. DOI: 10.1111/j.1547-5069.2005.00058.x.

11. Park SJ, An M, So HS. Relationships of stigma, family support, and quality of life in tuberculosis patients. J Korea Contents Assoc. 2015; 15(9):285–294. DOI: 10.5392/JKCA.2015.15.09.285.

12. Song K, Ha C, Kim H. A study on the factors influencing the quality of life among hospital patients with tuberculosis. Korean J Hum Dev. 2010; 17(1):325–348.

13. Cho MJ. A predictive model of health promotive behaviors for pulmonary tuberculosis patients [dissertation]. Gwangju: Chonnam National University;2007.

14. Atif M, Sulaiman SA, Shafie AA, Asif M, Sarfraz MK, Low HC, et al. Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: A follow-up study. Health Qual Life Outcomes. 2014; 12:19.

15. Bae MH. Prediction model the health related quality of life in patients suffering from pneumoconiosis [dissertation]. Seoul: Korea University;2003.

16. Yu JP. The misunderstanding and prejudice of structural equation models. Seoul: Hannare Publishing Co.;2014.

17. Ware JE Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30(6):473–483.

18. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988; 52(1):30–41. DOI: 10.1207/s15327752jpa5201_2.

19. Shin JS, Lee YB. The effects of social supports on psychosocial well-being of the unemployed. Korean J Soc Welf. 1999; 37(1):241.

20. Van Rie A, Sengupta S, Pungrassami P, Balthip Q, Choonuan S, Kasetjaroen Y, et al. Measuring stigma associated with tuberculosis and HIV/AIDS in southern Thailand: Exploratory and confirmatory factor analyses of two new scales. Trop Med Int Health. 2008; 13(1):21–30. DOI: 10.1111/j.1365-3156.2007.01971.x.

21. Park SJ. Symptom experience and quality of life in patients with chronic lung disease: With a special reference to bronchial asthma and bronchiectasis. J Korean Acad Adult Nurs. 2002; 14(3):470–478.

22. Cho MJ, Kim KH. Diagnostic validity of the CES-D(Korean version) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc. 1993; 32(3):381–399.

23. Lawton MP, Moss M, Fulcomer M, Kleban MH. A research and service oriented multilevel assessment instrument. J Gerontol. 1982; 37(1):91–99. DOI: 10.1093/geronj/37.1.91.

24. Kim KJ. Prediction model for health promotion behaviors in middle-aged men [dissertation]. Seoul: Hanyang University;2000.

25. Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York, NY: The Guilford Press;2011.

26. Kim GS. Analysis structural equation modeling. Seoul: Hannarae Publishing Co.;2010.

27. Wheaton B, Muthén B, Alwin DF, Summers GF. Assessing reliability and stability in panel models. In : Heise DR, editor. Sociological Methodology. San Francisco, CA: Jossey-Bass, Inc.;1977. p. 84–136.

28. Oh J, Yi M. Structural equation modeling on quality of life in older adults with osteoarthritis. J Korean Acad Nurs. 2014; 44(1):75–85. DOI: 10.4040/jkan.2014.44.1.75.

29. Bruwer B, Sorsdahl K, Harrison J, Stein DJ, Williams D, Seedat S. Barriers to mental health care and predictors of treatment dropout in the South African stress and health study. Psychiatr Serv. 2011; 62(7):774–781. DOI: 10.1176/ps.62.7.pss6207_0774.

30. Charles B, Jeyaseelan L, Pandian AK, Sam AE, Thenmozhi M, Jayaseelan V. Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA) in South India: A community based cross sectional study. BMC Public Health. 2012; 12:463. DOI: 10.1155/2012/352850.

31. Tasnim S, Rahman A, Hoque FM. Patient's knowledge and attitude towards tuberculosis in an urban setting. Pulm Med. 2012; 2012:352850. DOI: 10.1155/2012/352850.

32. Jeon GS, Jang SN, Park SJ. Social support, social network, and frailty in Korean elderly. J Korean Geriatr Soc. 2012; 16(2):84–94. DOI: 10.4235/jkgs.2012.16.2.84.