Korean Journal of Health Promotion

Factors Affecting Health-related Quality of Life in Middle-aged Male Patients with Benign Prostatic Hyperplasia

Original Article

Published online: January 19, 2017

DOI: https://doi.org/10.15384/kjhp.2017.17.3.199

Factors Affecting Health-related Quality of Life in Middle-aged Male Patients with Benign Prostatic Hyperplasia

¹Daegu Fatima Hospital, Daegu, Korea

²College of Nursing, Keimyung University, Daegu, Korea

Corresponding author : Soo-Kyoung Lee, PhD College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea
Tel: +82-53-580-3919, Fax: +82-53-580-3916 E-mail: soo1005@kmu.ac.kr

Received March 13, 2017 Accepted 17 13, 2017

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 was conducted to provide a fundamental data and improve health-related quality of life (HRQoL) in increasing population of middle-aged male patients with benign prostatic hyperplasia (BPH) by investigating and analyzing the factors affecting the HRQoL.

Methods:: The survey was performed with 124 middle-aged male BPH patients of Fatima hospital located in Daegu city. The data were collected by questionnaires and were analyzed by using SPSS WIN ver. 18.0 (IBM Corp., New York, NY, USA).

Results:: Severity of BPH in participants was classified into moderate (54%), severe (31.5%), and mild (14.5%). The mean HRQoL score was 3.78 points. The scores in each section were 4.18 points for ‘disability of daily living activity’, 3.95 points for ‘discomfort due to BPH’, 3.69 points for ‘psychological state’, 3.65 points for ‘anxiety’ and 2.93 points for ‘sex life’. Perceived health state presented positive correlation with HRQoL and negative correlation with BPH symptoms. The BPH symptoms showed negative correlation with HRQoL. The level of BPH symptoms, perceived health status and prostate volume were revealed to influence the HRQoL in the order of the degree of influence. The factors’ determination value was 63.0%.

Conclusions:: It was confirmed that the lower the patient's level of BPH symptoms is, the better the perceived health status is and that the smaller the prostate volume is, the higher the HRQoL is. Therefore, administration of medicine that relieves BPH symptoms and reduces a volume of the prostate should be encouraged and sustainable education, customized treatment and nursing care should be provided.

Key words: Middle aged; Prostatic hyperplasia; Quality of life

Table 1.

Health-related quality of life of subjects (n=124)

Section	M±SD	Min	Max
Discomfort	3.95±0.99	1.25	5.92
Disability	4.18±1.12	1.43	6.00
General psychological state	3.69±0.87	1.20	6.00
Concerns/worries	3.65±1.22	1.00	5.75
Sex life	2.93±0.94	1.00	4.75
Total	3.78±0.82	1.22	5.54

Abbreviations: M, mean; SD, standard deviation.

Table 2.

Health-related quality of life by general characteristics and lifestyle (n=124)

Variable	N (%)	Health-related quality of life
		Discomfort		Disability		General Pyschological state		Concerns/worries		Sex life		Overall state
		M±SD	P	M±SD	P	M±SD	P	M±SD	P	M±SD	P	M±SD	P
Age,Y			0.331		0.091		0.664		0.276		0.018		0.328
40.49^a	15(12.1)	4.14±0.80		4.34±0.77		3.72±O.72		3.57±1.1O		3.40±O.68	C<a	3.92±0.67
50-59^b	55(44.4)	3.81±1.17		3.93±1.22		3.61±0.87		3.48±1.26		3.40±0.89		3.66±0.89
60-64^c	54(43.5	4.04±0.83		4.38±1.07		3.76±0.91		3.85±1.19		2.69±0.99		3.87±0.77
Education level			0.109		0.207		0.002		0.351		0.001		0.019
							d,e<g				d<f		d<F
<<Elementary School^d	19(15.3)	3.71±1.06		3.93±1.38		3.57±0.91		3.79±1.52		2.38±0.99		3.58±0.77
Middle and high school^c	74(59.7)	3.89±0.99		4.12±1.10		3.53±0.83		3.52±1.12		2.90±0.89		3.58±0.91
>>College±	31(25.0)	4.76±0.90		4.47±0.97		4.16±0.78		3.87±1.24		3.35±0.86		4.13±0.70
Religion			0.287		0.063		0.293		0.591		0.181		0.262
Have	73(58.9)	4.03±0.88		4.33±1.09		3.76±0.84		3.70+1.13		2.84±0.92		3.85±0.74
Don't have	51(41.1)	3.84±1.13		3.95±1.14		3.59±0.90		3.58±1.35		3.07±0.95		3.68±0.92
Spouse			0.261		0.145		0.259		0.360		0.757		0.183
Have	107(86.3)	3.99±0.96		4.24±1.08		3.730.87		3.59±1.22		2.94±0.94		3.82±0.79
Don't Have	17(13.7)	3.70±1.13		3.81±1.33		3.47±0.88		3.40±1.21		2.87±0.94.		3.54±0.97
Occupation			0.035		0.003		<0.001		0.034		<0.001		<0.001
Yes	92(74.2)	4.06±0.95		4.35±1.05		3.90±0.81		3.79±1.22		3.14±0.85		3.94±0.75
No	32 (25.8}	3.64±1.05		3.68±1.19		3.09±0.74		326:1‘14		2.34:0.94		3.32±0.84
Smoking			0.864		0327		0.348		0.621		0.411		0.439
Yes	20(16.1)	3.92±1.06		3.95±1.20		3.53±0.77		3.53±1.26		2.78±0.98		3.65±0.87
No	104(33.9)	3.96±0.97		4.22+1.11		3.73±0.89		3.67±1.22		2.96±0.93		3.81±0.81
Drinking			0.110		0.550		0.124		0.390		0.036		0.104
Yes	63(50.8)	4.09±0.90		4.24±1.08		3.81±0.78		3.74±1.25		3.11±0.94		3.90±0.75
No	61(49.7)	3.81±1.06		4.11±1.17		3.57±0.94		3.55±1.19		2.34±0.94		3.66±0.87
Coffee intake			0.956		0.487		0.847		0687		0.322		0.664
Yes	89(71.8)	3.95±1.06		4.21±1.23		3.70±0.92		3.68±1.22		2.99+0.93		3.80±0.89
No	35(28.2)	3.96±0.78		4.08±0.81		3.67±0.74		3.58±1.22		2.80±0.96		3.74±0.62
Exercise			0.016		0.098		0.043		0.045		0.328		0.016
Yes	69(55.6)	4.14±1.04		4.33±1.14		3.83±0.91		3.84±1.1.17		3.01±0.89		‘1 044.“ Q:
No	*55(44.4)*	3.71±0.86		3.99±1.08		3.52±0.78		3.40±1.25		2.84±1.00		3.58±0.73
Sleeping per day			0.168		0.294		0.380		0.091		0.535		0157
<7 hours	60(48.4)	3.83±0.88		4.07±1.05		3.62±0.82		3.46±1.20		2.88±0.91		3.67±0.73
>>7 hours	64(51.6)	4.07±1.07		4.25±1.18		3.76±0.92		3.83±1.22		2.98±0.97		3.88±0.88

Abbreviations: M, mean; SD, standard deviation. Values are presented as number (%) 0r mean±standard deviation unless otherwise indicated.

^aAge group: 40—49.

^bAge group: 50—59.

^cAge group: 60—64.

^dEducational level group: Selementary school.

^eEducational level group: middle and high school.

^fEducational level group: >>college.

Table 3.

Health-related quality of life by disease-related characteristics and triage of BPH symptoms (n=124)

Variable	N(%)	Health-related quality of life
		Discomfort		Disability		General psychological		Concerns/worries		Sex life		Overall state
		M±SD	p	M±SD	p	M±SD	p	M±SD	p	M±SD	p	M±SD	p
Perceived Health			0.001		0.019		<0.001		0.091		0.002		<0.001
status			c<a,b		c<b		c<a,b						c<a,b
Satisfied^a	15(12.1)	4.43±0.97		4.34±1.02		4.11±0.89		3.98±1.40		3.33±0.96		4.16±0.73
Moderate^b	74 (59.7)	4.09±0.96		4.36±1.05		3.87±0.78		3.75±1.21		3.06±0.90		3.93±0.76
Dissatisfied^c	35(28.2)	3.46±0.88		3.73±1.22		3.13±0.78		3.29±1.10		2.49±0.87		3.30±0.77
Dysuria duration of symptoms. Y			0.223		0.327		0.108		0.515		0.031 f<d		0.269
1-2^d	39(31.5)	4.18±0.80		4.18±0.91		3.71±0.65		3.79±1.15		3.22±0.92		3.91±0.62
2-3^e	29(23.4)	3.80±0.95		4.18±1.00		3.96±0.92		3.72±1.28		2.97±0.74		3.86±0.79
>3†	56(45.2)	3.87±1.11		4.04±1.30		3.51±0.95		3.51±1.24		2.71±0.99		3.65±0.94
Prostate operation			0.395		0.865		0.261		0.965		0.002		0.748
Have	9(7.3)	4.22±1.08		4.24±0.96		3.38+0.61		3.67±0.93		2.00±0.71		3.70±0.67
Don't have	115(92.7)	3.93±0.98		4.17±1.14		3.72±0.88		3.65±1.24		3.01±0.92		3.79±0.83
Family history			0.253		0.373		0.222		0.546		0.865		0.272
Have	10(8.1)	4.30±0.89		3.87±1.16		3.37±0.61		3.43±1.40		3.00±1.29		3.51±0.79
Don't have	14(91.9)	3.98+0.99		4.20±1.12		3.72±0.89		3.67±1.21		2.93±0.91		3.81±0.82
Prostate volume, mL			0.021		0.404		0.214		0.243		0.989		0.096
Normal(<25)	31(25.0)	4.30±0.89		4.32±0.96		3.86±0.71		3.87±1.14		2.94±0.99		3.99±0.67
Abnormal (>25)	93 (75.0)	3.83±0.99		4.13±1.17		3.64±0.91		3.58±1.24		2.93±0.93		3.71±0.85
Maximum ﬂow rate, mL/sec			0.277		0.292		0.111		0.905		0.041		0.153
Normal (>15)	45(36.3)	4.08±0.92		4.32±1.04		3.86±0.75		3.67±1.14		3.16±0.91		3.92±0.69
Abnormal(<15)	79 (63.7)	3.88±1.02		4.10±1.17		3.60±0.92		3.64±1.27		2.80±0.93		3.70±0.88
Amount of re-siduao of mL			0.386		0.494		0.251		0.174		0.586		0.257
Normal (<50)	101(81.5)	3.99:1 A01		421±1.14		3.74±088		372±1.20		296±0.93		382±0.82
Abnormal (>50)	23(18.5)	3.79±0.87		4.03±1.06		3.50±0.81		3.34±1.25		2.84±0.99		3.61±0.77
Triage of BPH			<0.001		<0.001		<0.001		<0.001		0.031		<0.001
Symptoms			h<j<g		i<h<g		i<h<g		i<h<g		i<g		i<h<g
Mild^g	18(14.5)	5.13±0.62		5.10±0.68		4.36±0.79		4.67±0.71		3.93±0.61		4.68±0.48
Moderate^h	67(54.0)	4.15±0.72		4.45±0.92		3.77±0.79		3.93±1.00		2.95±0.95		3.95±0.63
Severeⁱ	39(31.5)	3.07±0.74		3.27±1.01		3.25±0.82		2.21±1.14		2.69±0.97		3.08±0.65

Abbreviations: BPH, benign prostatic hyperplasia; M, mean; SD, standard deviation. Values are presented as number (%) or mean±standard deviation unless otherwise indicated.

^aCategories of perceived health status: satisfied.

^bCategories of perceived health status: moderate.

^cCategories of perceived health status: dissatisfied.

^dCategories of dysuria duration of symptoms: 1—2 years.

^eCategories of dysuria duration of symptoms: 2—3 years.

^fCategories of dysuria duration of symptoms: >3 years.

^gCategories of triage: mild.

^hCategories of triage: moderate. iCategories of triage:severe

Table 4.

Factors affecting health-related quality of life

Variable	B	SE	β	F	P
Symptoms of BPH	-0.07	0.01	-0.71	165.15	<0.001
Perceived health status^a	0.22	0.06	0.20	94.40	0.001
Prostate volume	-0.01	0.00	-0.16	69.45	0.005
R²=0.64, adjusted R²=0.63

Abbreviations: BPH, benign prostatic hyperplasia; SE, standard error. Calculated by multiple linear regression analysis adjusted for education level, occupation, exercise.

^aDummy variables: perceived health status: satisfied=1, moderate=0, dissatisfied=0.

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