Health Group and Disease Group's Perceptions of Health and Health-related Quality of Life: a Focus Group Study and In-depth Interviews

Hyeon-Jeong Lee; Minsu Ock; Soo Young Kim; Seon-Ha Kim; Sun Hee Kim; Min-Woo Jo

doi:10.15384/kjhp.2016.16.1.56

Korean J Health Promot > Volume 16(1); 2016 > Article

Lee, Ock, Kim, Kim, Kim, and Jo: Health Group and Disease Group's Perceptions of Health and Health-related Quality of Life: a Focus Group Study and In-depth Interviews

Original Article

Korean Journal of Health Promotion 2016;16(1):56-66.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.1.56

Health Group and Disease Group's Perceptions of Health and Health-related Quality of Life: a Focus Group Study and In-depth Interviews

Hyeon-Jeong Lee^1,¹, Minsu Ock¹, Soo Young Kim², Seon-Ha Kim³, Sun Hee Kim⁴, Min-Woo Jo¹

¹Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea

²Department of Family Medicine, Hallym University College of Medicine, Anyang, Korea

³Department of Nursing, Dankook University College of Health Sciences, Cheonan, Korea

⁴Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Corresponding author: Min-Woo Jo, PhD Department of Preventive Medicine, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-4264, Fax: +82-2-477-2898 E-mail: mdjominwoo@gmail.com

Received November 09, 2015 Accepted February 05, 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.

ABSTRACT

Background

This study aimed to understand and explore perception of healthy adults and chronically ill adults on health and health-related quality of life (HRQoL).

Methods

Data were collected by open questions using a focus group discussion for healthy adults (N＝6) and in-depth interviews for chronically ill adults (N＝6). Previously developed 34 HRQoL items also were offered and participants were asked to select the five most important HRQoL items among them.

Results

Findings were elicited along the following themes: health, HRQoL, health maintenance strategies, and elements affecting health. The definition on “being healthy” by healthy participants had a variety of standards and required several conditions to be fulfilled. Whereas chronically ill adults have more flexible perception about the coexistence of health and disease. Health dimensions were thought to affect each other, and physical and mental health dimension were selected as the most important items. As for the five most important HRQoL items, both group participants selected mental health dimension than physical or social health dimensions. Health maintenance strategies were similar in both groups except more healthcare service use in chronically ill adults.

Conclusions

This study shows the difference of perception on health and HRQoL between health group and disease group in Korea. It can be used for developing the HRQoL assessment tool reflecting the perception of Korean people.

Keywords: Health, Health-related quality of life, Qualitative study, Focus group discussion, In-depth interview

Table 1.

Guideline for conducting a focus group discussion and in-depth interviews

Opening	• Explaining the procedure and the purpose of focus group discussion/in-depth interview
	• Self-introduction
Introductory questions	• Thinking or feeling on health
	• One's own past and current health condition
Key questions	• Definition of health
	• Definition of health-related quality of life and its dimensions and items
	• Assessing one's own health-related quality of life using EQ-5D
	• Important items of health-related quality of life
Closure	• Thanks for participating

Table 2.

Characteristics of healthy group and disease group

		Healthy group		Disease group
Age (Mean, SD)		40.33 (6.28)		58.50 (6.89)
Female (n, %)		3 (50)		4 (33.3)
Education period^a (year)		All 16		F 1: 9, F 4: 12, F 2, F 3: 6
Self-rated health^b	M 1	Very good	M 1	Fair
	M 2	Good	M 2	Fair
	M 3	Good	F 1	Good
	F 1	Good	F 2	Very good
	F 2	Good	F 3	Fair
	F 3	Good	F 4	Good
EQ-5D–3L profile^c	M 1	11111	M 1	11111
	M 2	11112	M 2	21211
	M 3	11111	F 1	21122
	F 1	11111	F 2	11121
	F 2	11122	F 3	11222
	F 3	11112	F 4	21121
EQ-5D index (Mean, SD)		0.95 (0.06)		0.85 (0.09)
Morbidity		None	M 1	Diabetes mellitus
			M 2	Parkinson's disease
			F 1	Diabetes mellitus, Hypercholesterolemia
			F 2	Hypercholesterolemia
			F 3	Hypertension
			F 4	Diabetes mellitus, Anemia

Abbreviations: SD, standard deviation; M, male; F, female.

^aMale participants did not answer the question about education period.

^bParticipants responded on a 5-point Likert scale: excellent, very good, good, fair, and poor.

^cEQ-5D–3L descriptive system comprises 5 dimension: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems and extreme problems.

Table 3.

Selecting items of health-related quality of life

Health dimension	Healthy group		Disease group
	Items		Items
	n	%	n	%
Physical	14.5	50.3	15.7	58.8
Mental	11.2	38.7	8.8	33.1
Social	3.2	11.0	2.2	8.1
Total	28.8	100.0	26.7	100.0

Table 4.

Ranking orders of items of health-related quality of life

	Rank 1	Rank 2	Rank 3	Rank 4	Rank 5
Healthy group
M1	Belief, Faith	Positive feelings about life	Value for life and world	Easygoingness	Confidence
M2	Relationships with	Leisure activity	Concentration	Tranquilness, calmness	Climbing stairs
	co-workers
M3	Vitality	Relationships with family	Satisfaction with oneself	Easygoingness	Happiness, joy
			and life
F1	Belief, faith	Coping with stress	Relationships with family	Working	Symptoms that limit usual activities
F2	Walking	Vision	Happiness, joy	Relationships with family	Thinking
F3	Happiness, joy	Coping with stress	Keeping balance	Sexual activity	Relationships with family
Diseas	se group^a
M1	Easygoingness	Positive thinking	Walking	Working	Consideration
M2	Relationships with family	Appearance management	Thinking	Belief, faith	Thinking about suicide
F1	Relationships with family	Stamina	Memory	Sexual activity	Environmental pollution
F2	Walking	Taste sense	Easygoingness	Worthlessness	Relationships with
					co-workers
F4	Toileting	Sleep	Standing up from chair/	Recovery from fatigue	Difficulty with decision
			bed		making

Abbreviations: M, male; F, female.

^aFemale 3 participant did not complete ranking orders.

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