Factors associated with Health-related Quality of Life in Patients with Peripheral Arterial Disease

Da El Jang; Yeon Soo Jang; Eui Geum Oh; Young Guk Ko

doi:10.7475/kjan.2018.30.3.266

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Jang, Jang, Oh, and Ko: Factors associated with Health-related Quality of Life in Patients with Peripheral Arterial Disease

Original Article

Korean J Adult Nurs 2018;30(3):266-276.

Published online: 21 June 2018

DOI: https://doi.org/10.7475/kjan.2018.30.3.266

Factors associated with Health-related Quality of Life in Patients with Peripheral Arterial Disease

Da El Jang¹, Yeon Soo Jang^2,, Eui Geum Oh², Young Guk Ko³

¹Severance Hospital, Seoul, Korea

²College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea

³Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea

Corresponding author: Jang, Yeon Soo https://orcid.org/0000-0002-1898-025X College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3343, Fax: +82-2-392-5440, E-mail: ysjang517@yuhs.ac

Received 19 March 20189 May 2018 Accepted 4 June 2018

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 characteristics of Health-Related Quality of Life (HRQoL) and its influencing factors in Koreans with Peripheral Artery Disease (PAD).

Methods

One hundred and four participants were recruited from Severance hospital in Seoul, Korea. A PAD-specific quality of life questionnaire was used to measure HRQoL. The relevant knowledge, social support, and demographic and clinical characteristics were also measured. Descriptive analysis and multiple linear regression analysis were performed.

Results

The mean scores of PAD-related knowledge and social support were high, while those of the HRQoL were low. The HRQoL was significantly higher among university graduates than those who had completed only middle school, and among those with coronary artery disease. The HRQoL in patients with PAD was significantly correlated with duration of diagnosis, the Rutherford classification, rest pain, walking pain, medical staff support, and family support. It was significantly affected by walking pain, duration of diagnosis, medical staff support, and rest pain. The regression model accounted for 38.4% of the HRQoL in this study.

Conclusion

Pain and medical staff support might influence HRQoL among patients with PAD. Understanding the characteristics of HRQoL may be important in developing tailored management strategies to improve HRQoL among Koreans with PAD.

Keywords: Peripheral artery disease, Quality of life, Pain, Social support

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Table 1.

Sociodemographic and Clinical Characteristics of Patients (N=104)

Characteristics	Categories	n (%) or M± SD
Gender	Men	96 (92.3)
Gender	Women	8 (7.7)
Age (year)	60	27 (26.0)
	60~69	25 (24.0)
	70~79	40 (38.5)
	≥80	12 (11.5)
		66.40±13.26
Spouse	Yes	84 (80.8)
Spouse	No	20 (19.2)
Education	Elementary school	16 (15.4)
	Middle school	18 (17.3)
	High school	42 (40.4)
	College	28 (26.9)
Employment	Unemployed	61 (58.7)
Employment	Employed	43 (41.3)
Monthly income (10,000 won)	100	31 (29.8)
	100~199	12 (11.5)
	200~299	14 (13.5)
	300~399	10 (9.6)
	400~499	8 (7.7)
	≥500	22 (21.2)
	No response	7 (6.7)
Current smoking	Never	29 (27.9)
	Quit	50 (48.1)
	Current	25 (24.0)
Current drinking	Never	43 (41.3)
	Quit	26 (25.0)
	Current	35 (33.7)
Patient type	Outpatient	91 (87.5)
Patient type	Inpatient	13 (12.5)
Comorbidity^†	Dyslipidemia	76 (73.1)
	Hypertension	75 (72.1)
	Diabetes	60 (57.7)
	Coronary artery disease	51 (49.0)
	Others	75 (72.1)
Duration of diagnosis (year)		4.99±4.87
PTA or surgery	Yes	70 (67.3)
PTA or surgery	No	34 (32.7)
Ankle brachial index	Right	0.87±0.23
Ankle brachial index	Left	0.90±0.25
Rutherford's classification	0	15 (14.4)
	1	13 (12.5)
	2	15 (14.4)
	3	26 (25.0)
	4	27 (26.0)
	5	5 (4.8)
	6	3 (2.9)
Pain	Resting pain	1.11±2.11
Pain	Walking pain	4.03±3.25

PTA=percutaneous transluminal angioplasty;

^† Multiple responses.

Table 2.

The Knowledge of Peripheral Arterial Disease, Social Support, Health-related Quality of Life of Patients (N=104)

Variables	M± SD	Min	Max
Peripheral arterial disease related knowledge	12.13±2.52	2	15
Social support	99.89±15.46	49	120
Family support	50.99±9.86	14	60
Medical staff support	48.90±7.37	27	60
Health related quality of life	47.90±18.20	14.21	94.74
Intimate relationship	68.65±25.35	0	100
Positive adaptation	66.73±15.80	37.14	100
Job	48.27±31.85	0	100
Self-concept and feelings	45.30±26.09	0	100
Fear and uncertainty	45.29±28.04	0	100
Social relationships and interactions	44.73±23.92	0	100
Symptoms and limitations	37.31±22.41	2.50	100
Sex	36.73±24.94	0	100

Table 3.

Differences in Health-Related Quality of Life according to Patients’ Characteristics (N=104)

Characteristics		Categories (n)	M± SD	t or F	p
Gender		Men (96)	48.56±18.28	1.30	.196
Gender		Women (8)	39.87±16.17
Spouse		Yes (84)	48.20±18.47	0.34	.732
Spouse		No (20)	46.63±17.43
Education		Elementary school ^a (16)	41.22±14.20	3.88	.011^†
		Middle school ^b (18)	40.53±17.50		d＞ b
		High school ^c (42)	48.16±15.93
		≥ College ^d (28)	56.05±21.04
Employment		Unemployed (61)	46.69±18.22	-0.81	.423
Employment		Empleyed (43)	49.61±18.26
Monthly income (10,000 won)		100 (31)	44.01±17.77	1.47	.196
		100~199 (12)	46.50±12.60
		200~299 (14)	49.40±17.75
		300~399 (10)	43.47±16.45
		400~499 (8)	59.61±19.16
		≥500 (22)	53.30±22.06
		no response (7)	40.45±11.17
Patient type		Outpatient (91)	47.97±17.92	0.11	.912
Patient type		Inpatient (13)	47.37±20.88
Current smoking		Never (29)	43.07±16.22	1.75	.179
		Quit (50)	50.94±18.31
		Yes (25)	47.41±19.58
Current drinking		Never (43)	44.81±17.26	1.69	.189
		Quit (26)	47.06±19.15
		Yes (35)	52.30±18.27
PTA or surgery		Yes (70)	46.35±18.58	1.24	.217
PTA or surgery		No (34)	51.06±17.23
Ankle brachial index-Right		0.9~1.3 (61)	48.90±18.68	0.67	.507
Ankle brachial index-Right		＞0.9 or＜1.3 (43)	46.47±17.63
Ankle brachial index-Left		0.9~1.3 (62)	49.58±18.24	1.15	.252
Ankle brachial index-Left		＞0.9 or＜1.3 (42)	45.40±18.08
Comorbidity^‡	Dyslipidemia	Yes (76)	49.70±19.05	-1.68	.097
	Dyslipidemia	No (28)	43.01±14.92
	Hypertension	Yes (75)	48.18±18.62	-0.25	.802
	Hypertension	No (29)	47.17±17.37
	Diabetes	Yes (60)	50.41±18.81	-1.66	.100
	Diabetes	No (44)	44.46±16.95
	CAD	Yes (51)	51.75±20.25	-2.15	.034^§
	CAD	No (53)	44.18±15.29
	Others	Yes (75)	47.33±17.98	0.51	.611
	Others	No (29)	49.36±19.01

CAD=coronary artery disease; PTA=percutaneous transluminal angioplasty;

^† Scheffé test;

^‡ Multiple responses;

^§ Welch test.

Table 4.

Correlation of Subject's Characteristics, Social Support, Peripheral Arterial Disease related Knowledge and Health- related Quality of Life (N=104)

Characteristics	1	2	3	4	5	6	7	8	9
Characteristics	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
1. Age (year)	1
2. Rest pain	-.05(.644)	1
3. Walking pain	.02(.818)	.32(＜.001)	1
4. Rutherford's classification	-.10(.323)	.55(＜.001)	.62(＜.001)	1
5. Duration of diagnosis (year)	.11(.270)	-.20(.038)	-.05(.627)	-.16(.117)	1
6. Family support	.08(.943)	.07(.508)	-.19(.055)	-.24(.015)	.05(.638)	1
7. Medical staff support	.14(.155)	.10(.303)	-.05(.605)	-.05(.611)	.00(.974)	.60(＜.001)	1
8. Peripheral arterial disease related knowledge	.09(.375)	.04(.658)	-.02(.854)	-.03(.789)	.10(.334)	.31(＜.001)	.41(＜.001)	1
9. Health-related quality of life	.10(.299)	-.36(＜.001)	-.55(＜.001)	-.52(＜.001)	.23(.020)	.29(.003)	.21(.033)	.15(.140)	1

Table 5.

Factors Influencing Health-related Quality of Life (N=104)

Variables	B	SE	_β	t	p
Walking pain	-2.64	0.46	-.47	-5.74	.001
Duration of diagnosis	0.67	0.30	.17	2.08	.040
Medical staff support	0.50	0.19	.20	2.61	.011
Rest pain	-1.66	0.73	-.19	-0.28	.025
		Adj. R²=.384, F=17.02, p＜.001

SE=standard error.

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