A Path Analysis of Factors Influencing Health-related Quality of Life among Male Adults

Bo-Kyoung Cha

doi:10.12799/jkachn.2016.27.4.399

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Original Article
A Path Analysis of Factors Influencing Health-related Quality of Life among Male Adults: Bo-Kyoung Cha; Journal of Korean Academy of Community Health Nursing 2016;27(4):399-409.
DOI: https://doi.org/10.12799/jkachn.2016.27.4.399
Published online: December 31, 2016

Department of Nursing, Hanseo University, Seosan, Korea.

• Received: November 9, 2016 • Revised: December 20, 2016 • Accepted: December 20, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract

Abstract

Purpose
The purpose of this study was to analyze factors influencing health-related quality of life (HRQoL) among male adults.
Methods
Participants were 196 male adults who were recruited from June to July 2016. Seven variables related to HRQoL including age, perceived stress, physical activities, problem drinking, social support, self-esteem, depression were measured. Data were analyzed using the SPSS/WIN 20.0 program and Amos 18.0 for descriptive statistics, Pearson correlation coefficients and path analysis.
Results
The mean for HRQoL was 80.14. The path analysis showed that depression had the greatest direct effect on HRQoL. It was found that perceived stress had direct and total effects on HRQoL. It also mediated the paths of social support and self-esteem to HRQoL. These factors account for 68% of the total variance, and the fit indices of the model satisfied the criteria of fitness.
Conclusion
The results indicate that these factors influencing HRQoL should be considered when developing programs to improve HRQoL for male adults.
Key Words: Male; Quality of life; Depression; Social support; Alcohol drinking

Figure 1

Theoretical framework.

Figure 2

Path diagram for modified model.

Table 1

General Characteristics (N=196)

Characteristics	Classification	n (%) or M±SD
Age (year)		39.18±13.02
	20~29	57 (29.1)
	30~39	42 (21.4)
	40~49	35 (17.9)
	50~64	62 (31.6)
Education	≤Middle	3 (1.5)
	High	70 (35.7)
	≥College	121 (61.8)
	Missing	2 (1.0)
Marital status	Marriage	122 (62.2)
Marital status	Single	74 (37.8)
Religion	Yes	81 (41.3)
Religion	No	115 (58.7)
Region	Metropolis	85 (43.4)
	Small & medium cities	83 (42.3)
	Rural area	26 (13.3)
	Missing	2 (1.0)
Smoking	Smoker	62 (31.6)
	Ex-smoker	55 (28.1)
	No-smoker	79 (40.3)
Level of physical activity	Inactivity	49 (25.0)
	Minimal physical activity	71 (36.2)
	Health enhancing physical activity	76 (38.8)
Level of alcohol drinking	No-risk drinking	133 (66.3)
	Problem drinking	24 (12.2)
	Alcohol abuse disorders	35 (17.9)
	Alcohol dependence	7 (3.6)

Table 2

Descriptive Statistics and Correlations Matrix of Measurable Variables (N=196)

Variables	Depression	Self-esteem	Social support	Perceived stress	Age	M±SD	Skewness (CR)	Kurtosis (CR)
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	M±SD	Skewness (CR)	Kurtosis (CR)
HRQoL	−.72 (<.001)	.49 (<.001)	.61 (<.001)	−.75 (<.001)	−0.16 (.025)	80.14±12.05	−0.64 (−3.65)	0.07 (0.19)
Depression	1	−.64 (<.001)	−.59 (<.001)	.79 (<.001)	−.02 (.714)	11.82±0.63	1.02 (5.81)	1.02 (2.91)
Self-esteem		1	.68 (<.001)	−.58 (<.001)	−.11 (.139)	32.87±4.37	−0.47 (−2.66)	−0.36 (−1.04)
Social support			1	−.61 (<.001)	−.23 (.002)	95.37±15.93	−0.14 (−0.80)	−0.74 (−2.10)
Perceived stress				1	.03 (.702)	12.70±6.30	0.37 (2.13)	0.25 (0.72)
Age					1	39.18±13.02	−0.06 (−0.37)	−1.50 (−4.28)

HRQoL=health-related quality of life.

Table 3

Estimates and Effects of Predictor Variables in Hypothetical Model and Modified Model

Variables	Categories	Modified model				Modified model
Variables	Categories	SDE (p)	SIE (p)	STE (p)	SMC (R²)	SDE (p)	SIE (p)	STE (p)	SMC (R²)
Social support	Age	−.20 (.009)	−	−.20 (.009)	.44	−.22 (.010)	−	−.22 (.010)	.46
	Perceived stress	−.60 (.009)	−	−.60 (.009)		−.60 (.009)	−	−.60 (.009)
	Level of physical activity	.12 (.050)	−	.12 (.050)		.12 (.050)	−	.12 (.050)
Self-esteem	Age	−.25 (.009)	−.11 (.009)	−.11 (.009)	.50	−.25 (.012)	−.11 (.008)	−.11 (.008)	.50
	Level of physical activity	.53 (.009)	.06 (.045)	.06 (.045)		.53 (.014)	.07 (.053)	.07 (.053)
	Perceived stress		−.32 (.006)	−.57 (.012)			−.32 (.006)	−.56 (.015)
	Social support		−	.53 (.009)			−	.53 (.014)
Depression	Age	−.10 (.016)	.04 (.005)	−.06 (.159)	.69	−	.02 (.007)	.02 (.007)	.71
	Level of physical activity	−.04 (.356)	−.02 (.021)	−.06 (.270)		−	−.01 (.031)	−.01 (.031)
	Social support	−.06 (.383)	−.11 (.005)	−.17 (.013)		−	−.10 (.007)	−.10 (.007)
	Perceived stress	.62 (.009)	.15 (.014)	.77 (.012)		.67 (.006)	.11 (.011)	.78 (.011)
	Level of Drinking	.10 (.043)	−	.10 (.043)		.14 (.016)	−	.14 (.016)
	Self-esteem	−.21 (.009)	−	−.21 (.009)		−.20 (.014)	−	−.20 (.014)
HRQoL	Level of physical activity	.01 (.843)	.04 (.101)	.05 (.243)	.66	−.11 (.047)	.03 (.045)	.03 (.045)	.68
	Level of Drinking	−.04 (.154)	−.04 (.029)	−.08 (.030)		−.35 (.012)	−.05 (.005)	−.05 (.005)
	Self-esteem	−.12 (.081)	.08 (.004)	−.04 (.601)		.18 (.022)	.07 (.006)	.07 (.006)
	Age	−.11 (.017)	−.01 (.559)	−.13 (.012)		−.37 (.015)	−.05 (.004)	−.16 (.014)
	Perceived stress	−.37 (.007)	−.35 (.008)	−.72 (.009)			−.39 (.008)	−.74 (.012)
	Social support	.23 (.010)	.00 (.966)	.23 (.012)			.04 (.007)	.22 (.015)
	Depression	−.36 (.012)	−	−.36 (.012)			−	−.37 (.015)

SDE=standardized direct effect; SIE=standardized indirect effect; STE=standardized total effect; HRQoL=health related quality of life;

SMC=squared multiple correlation.

This work was supported by Hanseo University in 2014.

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Citations

Citations to this article as recorded by

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A Path Analysis of Factors Influencing Health-related Quality of Life among Male Adults

Figure 1 Theoretical framework.

Figure 2 Path diagram for modified model.

Figure 1

Figure 2

A Path Analysis of Factors Influencing Health-related Quality of Life among Male Adults

Characteristics	Classification	n (%) or M±SD
Age (year)		39.18±13.02
	20~29	57 (29.1)
	30~39	42 (21.4)
	40~49	35 (17.9)
	50~64	62 (31.6)
Education	≤Middle	3 (1.5)
	High	70 (35.7)
	≥College	121 (61.8)
	Missing	2 (1.0)
Marital status	Marriage	122 (62.2)
Marital status	Single	74 (37.8)
Religion	Yes	81 (41.3)
Religion	No	115 (58.7)
Region	Metropolis	85 (43.4)
	Small & medium cities	83 (42.3)
	Rural area	26 (13.3)
	Missing	2 (1.0)
Smoking	Smoker	62 (31.6)
	Ex-smoker	55 (28.1)
	No-smoker	79 (40.3)
Level of physical activity	Inactivity	49 (25.0)
	Minimal physical activity	71 (36.2)
	Health enhancing physical activity	76 (38.8)
Level of alcohol drinking	No-risk drinking	133 (66.3)
	Problem drinking	24 (12.2)
	Alcohol abuse disorders	35 (17.9)
	Alcohol dependence	7 (3.6)

Variables	Depression	Self-esteem	Social support	Perceived stress	Age	M±SD	Skewness (CR)	Kurtosis (CR)
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	M±SD	Skewness (CR)	Kurtosis (CR)
HRQoL	−.72 (<.001)	.49 (<.001)	.61 (<.001)	−.75 (<.001)	−0.16 (.025)	80.14±12.05	−0.64 (−3.65)	0.07 (0.19)
Depression	1	−.64 (<.001)	−.59 (<.001)	.79 (<.001)	−.02 (.714)	11.82±0.63	1.02 (5.81)	1.02 (2.91)
Self-esteem		1	.68 (<.001)	−.58 (<.001)	−.11 (.139)	32.87±4.37	−0.47 (−2.66)	−0.36 (−1.04)
Social support			1	−.61 (<.001)	−.23 (.002)	95.37±15.93	−0.14 (−0.80)	−0.74 (−2.10)
Perceived stress				1	.03 (.702)	12.70±6.30	0.37 (2.13)	0.25 (0.72)
Age					1	39.18±13.02	−0.06 (−0.37)	−1.50 (−4.28)

Variables	Categories	Modified model				Modified model
Variables	Categories	SDE (p)	SIE (p)	STE (p)	SMC (R²)	SDE (p)	SIE (p)	STE (p)	SMC (R²)
Social support	Age	−.20 (.009)	−	−.20 (.009)	.44	−.22 (.010)	−	−.22 (.010)	.46
	Perceived stress	−.60 (.009)	−	−.60 (.009)		−.60 (.009)	−	−.60 (.009)
	Level of physical activity	.12 (.050)	−	.12 (.050)		.12 (.050)	−	.12 (.050)
Self-esteem	Age	−.25 (.009)	−.11 (.009)	−.11 (.009)	.50	−.25 (.012)	−.11 (.008)	−.11 (.008)	.50
	Level of physical activity	.53 (.009)	.06 (.045)	.06 (.045)		.53 (.014)	.07 (.053)	.07 (.053)
	Perceived stress		−.32 (.006)	−.57 (.012)			−.32 (.006)	−.56 (.015)
	Social support		−	.53 (.009)			−	.53 (.014)
Depression	Age	−.10 (.016)	.04 (.005)	−.06 (.159)	.69	−	.02 (.007)	.02 (.007)	.71
	Level of physical activity	−.04 (.356)	−.02 (.021)	−.06 (.270)		−	−.01 (.031)	−.01 (.031)
	Social support	−.06 (.383)	−.11 (.005)	−.17 (.013)		−	−.10 (.007)	−.10 (.007)
	Perceived stress	.62 (.009)	.15 (.014)	.77 (.012)		.67 (.006)	.11 (.011)	.78 (.011)
	Level of Drinking	.10 (.043)	−	.10 (.043)		.14 (.016)	−	.14 (.016)
	Self-esteem	−.21 (.009)	−	−.21 (.009)		−.20 (.014)	−	−.20 (.014)
HRQoL	Level of physical activity	.01 (.843)	.04 (.101)	.05 (.243)	.66	−.11 (.047)	.03 (.045)	.03 (.045)	.68
	Level of Drinking	−.04 (.154)	−.04 (.029)	−.08 (.030)		−.35 (.012)	−.05 (.005)	−.05 (.005)
	Self-esteem	−.12 (.081)	.08 (.004)	−.04 (.601)		.18 (.022)	.07 (.006)	.07 (.006)
	Age	−.11 (.017)	−.01 (.559)	−.13 (.012)		−.37 (.015)	−.05 (.004)	−.16 (.014)
	Perceived stress	−.37 (.007)	−.35 (.008)	−.72 (.009)			−.39 (.008)	−.74 (.012)
	Social support	.23 (.010)	.00 (.966)	.23 (.012)			.04 (.007)	.22 (.015)
	Depression	−.36 (.012)	−	−.36 (.012)			−	−.37 (.015)

Table 1 General Characteristics (N=196)

Table 2 Descriptive Statistics and Correlations Matrix of Measurable Variables (N=196)

HRQoL=health-related quality of life.

Table 3 Estimates and Effects of Predictor Variables in Hypothetical Model and Modified Model

SDE=standardized direct effect; SIE=standardized indirect effect; STE=standardized total effect; HRQoL=health related quality of life;

SMC=squared multiple correlation.