Factors influencing on the Quality of Life in Older Adults after Total Knee Replacement: The Relevance to Pain, Range of Motion, Depression, Social Support and Sense of Coherence

Mijin Yu; HeeJung Kim

doi:10.12799/jkachn.2017.28.4.494

Journal List > J Korean Acad Community Health Nurs > v.28(4) > 1058492

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Yu and Kim: Factors influencing on the Quality of Life in Older Adults after Total Knee Replacement: The Relevance to Pain, Range of Motion, Depression, Social Support and Sense of Coherence

Original Article

J Korean Acad Community Health Nurs 2017;28(4):494-503.

Published online: 12 December 2017

DOI: https://doi.org/10.12799/jkachn.2017.28.4.494

Factors influencing on the Quality of Life in Older Adults after Total Knee Replacement: The Relevance to Pain, Range of Motion, Depression, Social Support and Sense of Coherence

Mijin Yu¹, HeeJung Kim²

¹Department of Nursing, Gumi University, Gumi, Korea

²College of Nursing, Catholic University of Daegu, Daegu, Korea

Corresponding author: Yu, Mijin Department of Nursing, Gumi University, 37 Yaeun-ro, Gumi 39213, Korea. Tel: +82-54-440-1308, Fax: +82-54-440-1219, E-mail: rmjin74@gmail.com

Received 18 August 2017 Revised 26 November 2017 Accepted 27 November 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

Purpose

This study is to grasp factors influencing the quality of life in older adults after total knee replacement.

Methods

This study was conducted with 165 older adults who had TKR at four orthopedic hospitals in D city. Data were analyzed using one-way ANOVA, independent t-test, Pearson’s correlation, and stepwise multiple linear regression with SPSS 19.0 software.

Results

Pain and depression were negatively correlated with range of motion, social support, while sense of coherence was positively correlated with quality of life. Sense of coherence (43%, β =.40), pain (8%, β=-.30), and depression (3%, β=-.20) on the Physical Component Summary in the quality of life have significant explanatory power of 54%. Sense of coherence (49%, β=.44), social support (6%, β=.25), and depression (3%, β=-.22) on the Mental Component Summary in the quality of life have significant explanatory power of 58%.

Conclusion

This study suggests developing a program to improve the quality of life in older adults who had TKR, considering factors such as sense of coherence.

Keywords: Quality of life, Sense of coherence, Pain, Depression, Social support

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Table 1.

The Differences of the Quality of Life according to General Characteristics of Subjects (N=165)

Characteristics	Categories	n (%)	PCS		MCS
Characteristics	Categories	n (%)	M±SD	t or F (p)	M±SD	t or F (p)
Gender	Male	43 (26.1)	41.85±18.79	0.60	45.56±20.03	1.12
	Female	122 (73.9)	44.55±19.81	(.438)	49.46±21.01	(.291)
Age (year)	65~69	57 (34.5)	63.69±19.11	197.89	71.09±16.93	279.03
(range: 66~97)	70~79	108 (65.5)	33.38±8.54	(＜.001)	36.49±9.68	(＜.001)
Education level	Uneducated^a	65 (39.4)	37.27±13.60	12.66	41.15±14.74	16.75
	Elementary^b	51 (30.9)	40.02±17.34	(＜.001)	43.56±19.41	(＜.001)
	Middle school^c	35 (21.2)	54.63±20.29	a, b＜c, d	59.70±17.79	a, b＜c, d
	≥High school^d	14 (8.5)	61.38±27.35		71.94±28.28
Monthly pocket money (10,000 won)	＜100^a	93 (56.4)	32.92±7.58	52.13	35.57±9.22	68.36
	100~＜200^b	38 (23.0)	49.83±19.06	(＜.001)	57.83±17.91	(＜.001)
	200~＜300^c	21 (12.7)	66.27±21.63	a＜b＜c, d	74.20±20.73	a＜b＜c, d
	≥300^d	13 (7.9)	68.32±17.40		71.54±15.35
Household type	Alone^a	66 (40.0)	33.21±8.81	50.96	35.96±10.72	62.74
	A couple^b	40 (24.2)	66.30±20.82	(＜.001)	73.12±17.87	(＜.001)
	With children^c	42 (25.5)	44.37±15.71	b＞c＞a, d	50.25±17.21	b＞c＞a, d
	With the other partner^d	17 (10.3)	31.00±1.23		34.38±5.87
Care givers	Spouse^a	34 (20.6)	71.34±17.91	67.98	77.06±15.81	69.56
	Children^b	50 (30.3)	40.97±15.28	(＜.001)	46.07±17.18	(＜.001)
	Relative^c	53 (32.1)	31.40±1.66	a＞b＞c a＞d	33.62±7.02	a＞b, d＞c
	Other^d	28 (17.0)	39.16±14.18		46.00±14.32
Period of diagnosis (year)	＜5^a	5 (3.0)	62.08±25.87	33.85	69.17±27.03	51.67
	5~＜10^b	55 (33.3)	59.50±20.55	(＜.001)	66.81±18.55	(＜.001)
	10~＜15^c	52 (31.5)	36.81±13.32	a, b＞c, d	42.44±13.83	a, b＞c＞d
	≥15^d	53 (32.1)	32.79±8.57		33.32±9.60
Taking painkillers	Yes	131 (79.4)	43.26±19.12	0.57	47.47±20.36	1.39
	No	34 (20.6)	46.10±21.17	(.451)	52.19±22.19	(.240)
Associated disease	Yes	99 (60.0)	36.73±13.42	40.95	40.38±13.87	48.02
	No	66 (40.0)	54.53±22.30	(＜.001)	60.54±23.47	(＜.001)

PCS=physical component summary in the quality of life; MCS=mental component summary in the quality of life.

Table 2.

The Degrees of Research Variables in Subjects (N=165)

Variables		M±SD	Possible range	Observed range
Pain		5.20±2.90	1~10	1.00~9.00
Range of motion	Right knee ROM (°)	103.18±7.79	0~130	90.00~118.00
	Left knee ROM (°)	103.44±7.67		94.00~119.00
Depression		6.08±3.34	0~15	1.00~13.00
Social support		41.32±25.13	0~100	14.47~92.11
Sense of coherence		52.15±6.60	13~91	40.00~64.00
PCS in the quality of life		43.85±19.53	0~100	31.00~97.50
MCS in the quality of life		48.44±20.77	0~100	13.13~94.38

PCS=physical component summary; MCS=mental component summary.

Table 3.

Correlations among Quality of Life and Other Variables in Subjects (N=165)

Variables	PCS	MCS	Pain	Right knee ROM	Left knee ROM	Depression	Social support
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
PCS	1
MCS	.91 (＜.001)	1
Pain	-.58 (＜.001)	-.55 (＜.001)	1
Right knee ROM	.37 (＜.001)	.33 (＜.001)	-.68 (＜.001)	1
Left knee ROM	.41 (＜.001)	.37 (＜.001)	-.70 (＜.001)	.99 (＜.001)	1
Depression	-.53 (＜.001)	-.57 (＜.001)	.38 (＜.001)	-.34 (＜.001)	-.37	1
Social support	.56 (＜.001)	.59 (＜.001)	-.72 (＜.001)	.64 (＜.001)	.66 (＜.001)	-.45 (＜.001)	1
Sense of coherence	.66 (＜.001)	.70 (＜.001)	-.51 (＜.001)	.31 (＜.001)	.34 (＜.001)	-.55 (＜.001)	.56 (＜.001)

PCS=physical component summary in the quality of life; MCS=mental component summary in the quality of life.

Table 4.

The Influencing Factors on the Quality of Life (N=165)

Variable	Categories	B	SE	β	t	p	Adj. R²
PCS in the quality of life	(Constant)	-22.32	16.98		-1.31	＜.001
	Sense of coherence	1.55	0.27	.40	5.71	＜.001	.43
	Pain	-2.68	0.56	-.30	-4.82	＜.001	.08
	Depression	-1.54	0.50	-.20	-3.08	.002	.03
		Adj. R²=.54, F=63.23, p＜.001
MCS in the quality of life	(Constant)	-58.27	15.72		-3.71	＜.001
	Sense of coherence	1.86	0.28	.44	6.53	＜.001	.49
	Social support	0.27	0.07	.25	3.89	＜.001	.06
	Depression	-1.81	0.52	-.22	-3.48	.001	.03
		Adj. R²=.58, F=73.43, p＜.001

PCS=physical component summary; MCS=mental component summary.

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