Journal List > J Korean Acad Community Health Nurs > v.27(4) > 1058439

Choi and Jeon: Effects of Frailty on Health-related Quality of Life of Rural Community-dwelling Elderly: Mediating and Moderating Effects of Fall-Related Efficacy and Social Support

Abstract

Purpose

The purpose of this study was to examine the mediating and moderating effects of fall-related efficacy and social support on the relationship between frailty and health-related quality of life among rural community-dwelling elderly.

Methods

A cross-sectional survey was conducted with a convenient sampling method, and data of 438 elderly residents living in a rural community was used. The structured questionnaire included items from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/ depression), fall-related efficacy and social support.

Results

Analysis of the mediating effect of fall-related efficacy and social support showed that there was significant mediating influence of fall-related efficacy on the relationship between frailty and health-related quality of life. There were no moderating effects of fall-related efficacy and social support.

Conclusion

The findings suggest that fall-related efficacy may play a role in reducing the effect of frailty on health-related quality of life and underscore the need to consider ways of enhancing fall-related efficacy in interventions for rural community-dwelling frail elderly.

Figures and Tables

Table 1

Socioeconomic and Health Characteristics of Rural Community Dwelling Elderly (N=419)

jkachn-27-380-i001
Variables Categories n (%) or M±SD
Age (year) 76.25±6.77
65~74 187 (44.6)
75~84 183 (43.7)
≥85 49 (11.7)
Gender (female) 340 (81.1)
Marital status (living alone) 238 (56.8)
Education ≤Elementary school 387 (92.4)
Middle school 18 (4.3)
≥High school 14 (3.3)
Job (yes) 123 (29.4)
Number of chronic disease 1.53±1.04
Frailty score 2.53±1.61
Robust 209 (49.9)
Pre-frail 162 (38.7)
Frail 48 (11.5)
Fall related efficacy 103.64±41.02
Social support 4.97±1.87
Quality of life 0.81±0.12
Table 2

Correlations between Frailty Score, Fall related Efficacy, and Social Support of Rural Community Dwelling Elderly (N=419)

jkachn-27-380-i002
Variables Frailty score Fall related efficacy Social support Health related quality of life
Frailty score 1
Fall related efficacy −.42*** 1
Social support −.08* 0.06 1
Health related quality of life −.46*** .54*** .13** 1

*p<.05 ; **p<.01 ; ***p<.001.

Table 3

Multiple Regression for Fall related Efficacy and Social Support of Rural Community Dwelling Elderly (N=419)

jkachn-27-380-i003
Variables Frailty → Fall related efficacy Frailty → Social support
β β
Frailty score −.35*** −.10*
Adjusted R2 .30 .01

Adjusted for age, gender, education, marital status, job status, number of chronic disease; *p<.05; **p<.01; ***p<.001.

Table 4

Multiple Regression for HRQoL of Rural Community Dwelling Elderly (N=419)

jkachn-27-380-i004
Variables Frailty→HRQoL Fall related efficacy, Social support→HRQoL Mediating effect Moderating effect
Model 1 β Model 2 β Model 3 β Model 4 β Model 5 β Model 6 β Model 7 β
Fraily score −.44*** −.29*** −.43*** −.29*** −.43***
Fall related efficacy .52*** .41*** .41***
Social support .13** .10* .09*
Frail × Fall related efficacy −.02
Frail × Social support .04
Sobel test (Z) −8.34*** −1.95
Adjusted R2 .20 .27 .07 .34 .23 .34 .23

Adjusted for age, gender, education, marital status, job status, number of chronic disease; *p<.05; **p<.01; ***p<.001.

Notes

This was supported by Mokpo National University in 2012 (No. 2012-0184) and Korea National University of Transportation in 2016.

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