Journal List > Korean J Women Health Nurs > v.25(3) > 1133348

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Chae and Kim: Health Behavior, Health Service Use, and Health Related Quality of Life of Adult Women in One-person and Multi-person Households
Original Article

Korean Journal of Women Health Nursing 2019; 25(3): 299-314.

Published online: 10 September 2019

DOI: https://doi.org/10.4069/kjwhn.2019.25.3.299

Health Behavior, Health Service Use, and Health Related Quality of Life of Adult Women in One-person and Multi-person Households

Hyun Ju Chae1, MiJong Kim2

1Assistant Professor, Department of Nursing, Joongbu University, Geumsan, Korea.

2Associate Professor, Department of Nursing, Hannam University, Daejeon, Korea.

Corresponding author: MiJong Kim. Associate Professor, Department of Nursing, Hannam University, 70 Hannamro, Daedeok-gu, Daejeon 34430, Korea. Tel: +82-42-629-8477, Fax: +82-42-629-8480, mijong@hnu.kr

Received 1 August 2019       Revised 1 September 2019       Accepted 2 September 2019

© 2019 Korean Society of Women Health Nursing

Korean Society of Women Health Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to identify health behavior, health service use, and health related quality of life of adult women in one-person and multi-person households.

Methods

It was used data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-2017). Subjects were 2,522 women with age of 19 to 64 years in 2017. Complex sampling design and data analysis were performed using SPSS 20.1.

Results

Women in one-person households had higher rates of alcohol drinking (χ2=13.77, p=.003), smoking (χ2=16.07, p=.001), unmet medical care (χ2=8.77, p=.004) and non-practice of cancer screening (χ2=13.77, p=.003) compared to women in multi-person households. Health-related quality of life was also lower for women in one-person households (t=−2.46, p=.015). Factors affecting health-related quality of life in one-person households were household income, job status, and unmet dental care, having 32.4% explanatory power. One-person household women with low incomes, no jobs, and unmet dental care showed low health-related quality of life. In comparison, factors affecting health-related quality of life of women in multi-person household women were age, education level, unmet medical care, and unmet dental care, having 10.4% explaining power. Women in multi-person households with age of 60–64, low education level, unmet medical care, and unmet dental care showed low health-related quality of life.

Conclusion

Health promotion strategies should be developed based on unique understanding of social, economic, and health of adult women in one-person and multi-person households.

Keywords: Family characteristics, Women, Health behavior, Health services, Health-related quality of life

Figures and Tables

Table 1

General Characteristics (N=2,552)

kjwhn-25-299-i001
Characteristics Categories One-person household (n†=187) Multi-person household (n†=2,335) χ2 (p)
% (SE) % (SE)
Age (year) 19–29 28.3 (5.2) 19.7 (1.1) 1,819.63 (<.001)
30–39 13.7 (2.8) 21.7 (1.3)
40–49 12.3 (2.7) 25.5 (1.1)
50–59 25.4 (3.8) 24.4 (0.9)
60–64 20.3 (3.1) 8.7 (0.6)
Living area Urban 87.1 (3.5) 87.2 (2.6) <0.01 (.994)
Rural 12.9 (3.5) 12.8 (2.6)
House type Non-apartment 72.3 (4.0) 36.9 (1.7) 79.57 (<.001)
Apartment 27.7 (4.0) 63.1 (1.7)
Marriage Living with spouse, bereavement 30.2 (4.4) 75.0 (1.2) 162.53 (<.001)
Separation, divorce 18.6 (3.1) 4.3 (0.5)
Unmarried 51.1 (5.2) 20.7 (1.1)
Education‡ ≤Elementary school 12.3 (2.7) 7.7 (0.6) 12.52 (.012)
Middle school 13.5 (2.6) 7.4 (0.7)
High school 29.9 (4.0) 35.7 (1.4)
≥University 44.3 (5.3) 49.2 (1.6)
House income‡ Low 24.2 (3.8) 7.8 (0.8) 78.43 (<.001)
Low middle 28.4 (3.6) 24.0 (1.3)
Upper middle 37.3 (4.4) 31.7 (1.2)
High 10.1 (2.6) 36.4 (1.7)
Occupation‡ Yes 72.1 (4.1) 59.5 (1.3) 9.51 (.006)
No 27.9 (4.1) 40.5 (1.3)
SE=standard error.
†Unweighted frequency, ‡Valid percent.
Table 2

Health Behavior, Health Service Use and Health Related Quality of Life (EQ-5D index) (N=2,552)

kjwhn-25-299-i002
Variables Categories One-person household (n†=187) Multi-person household (n†=2,335) χ2 or t p
% (SE) or M (SE) % (SE) or M (SE)
Health behavior
Drinking‡ No 38.5 (4.0) 49.2 (1.1) 6.96 .014
Yes 61.5 (4.0) 50.8 (1.1)
Smoking‡ No 86.8 (2.9) 94.6 (0.6) 16.07 .001
Yes 13.2 (2.9) 5.4 (0.6)
Exercise‡ No 51.8 (4.9) 52.4 (1.3) 0.02 .914
Yes 48.2 (4.9) 47.6 (1.3)
Health service use
Unmet medical needs‡ Yes 17.8 (3.1) 10.2 (0.8) 8.77 .004
No 82.2 (3.1) 89.8 (0.8)
Influenza vaccination‡ Yes 27.8 (3.9) 33.1 (1.2) 1.84 .208
No 72.2 (3.9) 66.9 (1.2)
Medical check-up‡ Yes 65.7 (3.4) 66.6 (1.4) 0.06 .795
No 34.3 (3.4) 33.4 (1.4)
Cancer screening‡ Yes 47.4 (5.0) 62.5 (1.2) 13.77 .003
No 52.6 (5.0) 37.5 (1.2)
Unmet dental needs‡ Yes 34.2 (4.4) 26.8 (1.2) 4.20 .103
No 65.8 (4.4) 73.2 (1.2)
Dental check-up‡ Yes 33.6 (3.9) 41.5 (1.3) 3.86 .056
No 66.4 (3.9) 58.5 (1.3)
EQ-5D index 0.95 (0.01) 0.97 (<0.01) −2.46 .015
EQ-5D=Euro Quality of Life-5 Dimensions; M=mean; SE=standard error.
†Unweighted frequency, ‡Valid percent.
Table 3

Health Related Quality of Life (EQ-5D Index) according to General Characteristics (N=2,552)

kjwhn-25-299-i003
Characteristics Categories One-person household (n†=187) Multi-person household (n†=2,335)
M (SE) F (p) M (SE) F (p)
Age (year) 19–29 0.97 (0.01) 4.27 (.003) 0.98 (<0.01) 13.12 (<.001)
30–39 0.97 (0.01) 0.98 (<0.01)
40–49 0.98 (0.01) 0.98 (<0.01)
50–59 0.94 (0.02) 0.96 (<0.01)
60–64 0.91 (0.02) 0.93 (0.01)
Living area Urban 0.95 (0.01) 0.01 (.935) 0.97 (<0.01) 3.94 (.048)
Rural 0.95 (0.02) 0.96 (0.01)
House type Non-apartment 0.95 (0.01) 0.01 (.926) 0.96 (<0.01) 19.54 (<.001)
Apartment 0.95 (0.02) 0.97 (<0.01)
Marriage Living with spouse, bereavement 0.95 (0.01) 4.21 (.016) 0.97 (<0.01) 7.34 (.001)
Separation, divorce 0.90 (0.03) 0.95 (0.01)
Unmarried 0.97 (0.01) 0.98 (<0.01)
Education ≤Elementary school 0.86 (0.04) 4.48 (.004) 0.92 (0.01) 18.01 (<.001)
Middle school 0.93 (0.02) 0.96 (0.01)
High school 0.97 (0.01) 0.97 (<0.01)
≥University 0.97 (0.01) 0.98 (<0.01)
House income Low 0.88 (0.02) 19.01 (<.001) 0.94 (0.01) 7.86 (<.001)
Low middle 0.97 (0.01) 0.97 (<0.01)
Upper middle 0.97 (0.01) 0.97 (<0.01)
High 1.00 (<0.01) 0.97 (<0.01)
Occupation Yes 0.97 (0.01) 9.54 (.002) 0.97 (<0.01) 1.89 (.170)
No 0.90 (0.02) 0.97 (<0.01)
EQ-5D=Euro Quality of Life-5 Dimensions; M=mean; SE=standard error.
†Unweighted frequency.
Table 4

Health Related Quality of Life (EQ-5D Index) according to Health Behavior and Health Service Use (N=2,552)

kjwhn-25-299-i004
Variables Categories One-person household (n†=187) Multi-person household (n†=2,335)
M (SE) F (p) M (SE) F (p)
Health behavior
Drinking No 0.92 (0.02) 6.76 (.010) 0.97 (<0.01) 3.57 (.060)
Yes 0.97 (0.01) 0.97 (<0.01)
Smoking No 0.95 (0.01) 2.04 (.154) 0.97 (<0.01) 0.05 (.831)
Yes 0.97 (0.01) 0.97 (<0.01)
Exercise No 0.94 (0.01) 1.83 (.177) 0.97 (<0.01) 2.44 (.119)
Yes 0.96 (0.01) 0.97 (<0.01)
Health service use
Unmet medical needs Yes 0.91 (0.03) 2.04 (.154) 0.93 (0.01) 32.33 (<.001)
No 0.96 (0.01) 0.97 (<0.01)
Influenza vaccination Yes 0.93 (0.02) 4.22 (.041) 0.96 (<0.01) 8.92 (.003)
No 0.96 (0.01) 0.97 (<0.01)
Medical check-up Yes 0.95 (0.01) 0.05 (.826) 0.97 (<0.01) 0.01 (.736)
No 0.95 (0.01) 0.97 (<0.01)
Cancer screening Yes 0.94 (0.01) 2.92 (.088) 0.97 (<0.01) 0.47 (.492)
No 0.96 (0.01) 0.97 (<0.01)
Unmet dental needs Yes 0.91 (0.02) 11.41 (.001) 0.95 (<0.01) 29.38 (<.001)
No 0.97 (0.01) 0.97 (<0.01)
Dental check-up Yes 0.96 (0.01) 1.89 (.171) 0.97 (<0.01) 0.09 (.762)
No 0.94 (0.01) 0.97 (<0.01)
EQ-5D=Euro Quality of Life-5 Dimensions; M=mean; SE=standard error.
†Unweighted frequency.
Table 5

Factors Associated with Health Related Quality of Life (EQ-5D Index) in One-person Household Women (N=187)

kjwhn-25-299-i005
Variables Categories B (SE) 95% CI t p
Lower Upper
Intercept 1.04 (0.04) 0.97 1.11 30.07 <.001
Age (year) 19–29 −0.06 (0.04) −0.13 0.01 −1.59 .113
30–39 −0.06 (0.04) −0.13 0.02 −1.53 .128
40–49 −0.05 (0.03) −0.11 0.01 −1.55 .122
50–59 −0.02 (0.03) −0.08 0.04 −0.68 .495
60–64 Reference
Marriage Living with spouse, bereavement −0.02 (0.02) −0.06 0.01 −1.28 .201
Separation, divorce −0.05 (0.03) −0.10 0.01 −1.60 .110
Unmarried Reference
Education ≤Elementary school −0.08 (0.04) −0.17 0.00 −1.89 .060
Middle school −0.02 (0.02) −0.06 0.01 −1.29 .197
High school 0.02 (0.01) −0.00 0.05 1.70 .090
≥Universities Reference
House income Low −0.07 (0.02) −0.11 −0.03 −3.60 <.001
Low middle −0.01 (0.02) −0.04 0.02 −0.64 .521
Upper middle −0.04 (0.02) −0.07 −0.01 −2.71 .007
High Reference
Occupation Yes 0.05 (0.02) 0.01 0.08 2.66 .008
No Reference
Drinking No −0.02 (0.01) −0.05 0.01 −1.43 .153
Yes Reference
Influenza vaccination Yes −0.02 (0.02) −0.05 0.01 −1.33 .183
No Reference
Unmet dental needs Yes −0.05 (0.01) −0.07 −0.02 −3.89 <.001
No Reference
R2=.32, F=4.48, p<.001
EQ-5D=Euro Quality of Life-5 Dimensions; B=unstandardized coefficients; SE=standard error; CI=confidence interval.
Table 6

Factors Associated with Health Related Quality of Life (EQ-5D Index) in Multi-person Household Women (N=2,335)

kjwhn-25-299-i006
Variable Categories B (SE) 95% CI t p
Lower Upper
Intercept 1.04 (0.04) 0.97 1.11 30.07 <.001
Age (year) 19–29 0.02 (0.01) 0.00 0.04 2.23 .026
30–39 0.02 (0.01) 0.00 0.03 2.43 .016
40–49 0.02 (0.01) 0.01 0.04 2.66 .008
50–59 0.01 (0.01) −0.00 0.03 1.58 .115
60–64 Reference
Living area Urban 0.00 (0.01) −0.01 0.01 0.45 .653
Rural Reference
House type Non-apartment 0.01 (0.00) −0.01 0.00 −1.37 .173
Apartment Reference
Marriage Living with spouse, bereavement 0.00 (0.01) −0.01 0.01 −0.30 .531
Separation, divorce −0.01 (0.01) −0.03 0.01 −0.72 .475
Unmarried Reference
Education ≤Elementary school −0.03 (0.01) −0.05 −0.02 −3.60 <.001
Middle school −0.01 (0.01) −0.02 0.01 −0.87 .383
High school 0.00 (0.00) −0.01 0.00 −0.90 .368
≥Universities Reference
House income Low −0.01 (0.01) −0.03 0.00 −1.66 .098
Low middle 0.00 (0.00) −0.01 0.01 0.79 .428
Upper middle 0.01 (0.00) 0.00 0.01 1.72 .086
High Reference
Unmet medical needs Yes −0.03 (0.01) −0.04 −0.02 −4.51 <.001
No Reference
Influenza vaccination Yes −0.01 (0.00) −0.01 0.00 −1.73 .084
No Reference
Unmet dental needs Yes −0.02 (0.00) −0.02 −0.01 −4.52 <.001
No Reference
R2=.10, F=8.71, p<.001
EQ-5D=Euro Quality of Life-5 Dimensions; B=unstandardized coefficients; SE=standard error; CI=confidence interval.

Notes

Conflict of Interest The authors declared no conflict of interest.

Author Contributions

  • Conceptualization: Kim MJ, Chae HJ.

  • Formal analysis: Kim MJ, Chae HJ.

  • Writing - original draft: Kim MJ, Chae HJ.

  • Writing - review & editing: Kim MJ, Chae HJ.

Summary Statement

  • • What is already known about this topic?

  • One-person household women have more risky health behaviors and have more limitations in using health services than multi-person household women.

  • • What this paper adds?

  • One-person household women have lower health related quality of life than multi-person household women. Factors influencing health related quality of life are different between one-person household women and multi-person household women.

  • • Implications for practice, education and/or policy

  • Intervention programs and policies should be provided to improve health related quality of life of one-person household women. Factors influencing health related quality of life of one-person household women should be considered and included in these programs and policies.

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ORCID iDs

Hyun Ju Chae
https://orcid.org/http://orcid.org/0000-0002-6946-4060

MiJong Kim
https://orcid.org/0000-0002-4365-2338

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