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 Lee1,1, Minsu Ock1, Soo Young Kim2, Seon-Ha Kim3, Sun Hee Kim4, Min-Woo Jo1
- Received November 09, 2015 Accepted February 05, 2016
- 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.
Table 1.
Guideline for conducting a focus group discussion and in-depth interviews
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 perioda (year) | All 16 | F 1: 9, F 4: 12, F 2, F 3: 6 | ||
| Self-rated healthb | 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 profilec | 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 |
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 groupa | ||||
| 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 | ||||
- REFERENCES
- REFERENCES
References
1. Ministry of health and welfare. The third national health promotion plan (2011∼2020). Sejong: Ministry of health and welfare; 2011.2. Statistics Korea. The 0-year-old life expectancy and healthy life expectancy. Daejeon: Statistics Korea; 2015. [Accessed October 23, 2015].. http://www.index.go.kr/potal/main/EachDtlPage. Detail.do?idx_cd=2758..3. Koh SJ. Calculation of healthy life expectancy in Korea. Health & Welfare Issue & Focus 2014;247:3-8.4. Whitehead SJ, Ali S. Health outcomes in economic evaluation: the QALY and utilities. Br Med Bull 2010;96:5-21.
[Article] [PubMed]5. Padilla GV, Grant MM, Ferrell BR, Presant CA. Quality of life: Cancer. In. (Ed.) Spilker B. Quality of life and pharmacoeconomics in clinical trials. 2nd edition.. New York: Raven Pressk; 1996.6. Shim JY, Lee JK, Kim SY, Won JW, Sun WS, Park HK, et al. The development of Korean health related quality of life scale. J Korean Acad Fam Med 1999;20(10):1197-208.7. König HH, Bernert S, Angermeyer MC, Matschinger H, Martinez M, Vilagut G, et al. Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire. Med Care 2009;47(2):255-61.
[PubMed]8. Jo MW. Exploratory study for Korean preference-based health related quality of life instrument. Seoul: Korea health promotion foundation; 2012.9. Kim SH, Jo SJ, Jo MW. Effect of duroQol-5 dimension on visual analogue scale in Korean population. Korean J Health Promot 2013;13(2):69-75.10. Curry LA, Nembhard IM, Bradley EH. Qualitative and mixed methods provide unique contributions to outcomes research. Circulation 2009;119(10):1442-52.
[Article] [PubMed]11. Shim HW. A study on concepts of health in older Korean women-Q methodological approach. J Korean Acad Fundam Nurs 2010;17(1):6-15.12. Shim HW. Spiritual health in Korean culture-Q methodological approach. J Korean Acad Fundam Nurs 2015;22(2):129-38.
[Article]13. Han DH, Lee HS, Kim JH, Lee SW. Korean males attitudes and behaviors on men's health and erectile dysfunction: a qualitative study. Korean J Androl 2005;23(2):61-70.14. Lee YH. An ethnographic study of health concept and health behavior in urban, poor elderly. Korean J Adult Nurs 1995;7(2):141-65.15. World Health Organization. Constitution of the World Health Organization. Geneva: World Health Organization; 2006. [Accessed October 23, 2015].. http://www.who.int/governance/eb/who_constitution_en.pdf.16. Lee YK, Nam HS, Chuang LH, Kim KY, Yang HK, Kwon IS, et al. South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health 2009;12(8):1187-93.
[Article] [PubMed]17. Carlsen B, Glenton C. What about N? A methodological study of sample-size reporting in focus group studies. BMC Med Res Methodol 2011;11:26.
[Article] [PubMed] [PMC]18. Jo SN, Lee HJ, Joo YJ, Kim NY. Qualitative research design & practice. Seoul: Green; 2011. p. 95-8.19. Park JS. A survey for the construction of nursing theory according to Korean culture-about concepts of health and illness, and health behavior–. Korean J Adult Nurs 1996;8(2):375-93.20. Mishra SK, Togneri E, Tripathi B, Trikamji B. Spirituality and religiosity and its role in health and diseases. J Relig Health 2015 Sep 7 [Epub ahead of print]..21. Larson JS. The World Health Organization's definition of health: social versus spiritual health. Social Indicators Research 1996;38(2):181-92.
[Article]22. Patrick DL, Erikson P. Health Status and Health Policy: Allocating Resources to Health Care. New York: Oxford University Press; 1993.23. Gurková E. Issues in the definitions of HRQoL. J Nurs Soc Stud Publ Health Rehab 2011;3–4:190-7.