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

Kyung Won Choi; Gyeong-Suk Jeon

doi:10.12799/jkachn.2016.27.4.380

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

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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

Original Article

Journal of Korean Academy of Community Health Nursing 2016; 27(4): 380-387.

Published online: 31 December 2016

DOI: https://doi.org/10.12799/jkachn.2016.27.4.380

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

Kyung Won Choi¹, Gyeong-Suk Jeon²

¹Department of Nursing, Korea National University of Transportation, Chungju, Korea.

²Department of Nursing, Mokpo National University, Muan, Korea.

Corresponding author: Jeon, Gyeong-Suk. Department of Nursing, Mokpo National University, 1666 Yeongsan-ro, Dorim-ri, Cheonggye-myeon, Muan 58554, Korea. Tel: +82-61-450-2675, Fax: +82-61-450-2679, gsj64@naver.com

Received 26 September 2016 Revised 8 December 2016 Accepted 10 December 2016

(open-access):

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

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.

Keywords: Frail elderly, Self efficacy, Social support, Quality of life

Figures and Tables

Table 1

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

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)

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)

Variables	Frailty → Fall related efficacy	Frailty → Social support
Variables	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)

Variables	Frailty→HRQoL	Fall related efficacy, Social support→HRQoL		Mediating effect		Moderating effect
Variables	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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