Factors Affecting Quality of life in the Elderly with Chronic Musculoskeletal Pain

근골격계 만성통증 노인의 삶의 질 영향요인

  • Jeong, Hyesun (Pusan National University Hospital, Busan Center for Infectious Disease Control and Prevention) ;
  • Lee, Yoonju (College of Nursing, Pusan National University)
  • 정혜선 (부산대학교병원 부산시 감염병관리지원단) ;
  • 이윤주 (부산대학교 간호대학)
  • Received : 2018.03.09
  • Accepted : 2018.06.23
  • Published : 2018.08.31


Purpose: This study aimed to identify factors affecting the quality of life of the elderly people with chronic musculoskeletal pain. Methods: The data were collected from 307 older adults aged 65 years or older with chronic musculoskeletal pain, who visited senior welfare centers in two cities. We used self-rated questionnaires including NRS for pain, WHOQOL-BREF for quality of life, Pain Response Inventory for coping responses to pain, and MSPSS for social support. Stepwise multiple regression analysis were performed using SPSS/WIN 23.0 to identify factors affecting the study subjects' quality of life. Results: The regression model explained 43% of quality of life, which was statistically significant (F=34.11, p<.001). Educational level of high school (${\beta}=.13$, p=.006), pain (${\beta}=-.13$, p=.013), restriction of function (${\beta}=-.13$, p=.028), accommodative pain coping (${\beta}=.24$, p<.001), family support (${\beta}=.18$, p<.001), colleague's support (${\beta}=.25$, p<.001), and perceived health status (${\beta}=.25$, p<.001) were identified as influential factors on subjects' quality of life. Conclusion: Developing integrative interventions is necessary to improve accommodative pain coping skills and to engage family and colleague in support for positive perception of older adults' health status and management of symptoms.


  1. Bae, S. C., Lee, H. S., Yun, H. R., Kim, T. H., Yoo, D. H., & Kim, S. Y. (2001). Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis and Cartilage, 9(8), 746-750.
  2. Bellamy, N., Buchnan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology, 15(12), 1833-1840.
  3. Blyth, F. M., & Noguchi, N. (2017). Chronic musculoskeletal pain and its impact on older people. Best Practice & Research Clinical Rheumatology, 31(2), 160-168.
  4. Brown, G. K., & Nicassio, P. M. (1987). Development of a questionnaire for the assessment of active and passive coping strategies in chronic pain patients. Pain, 31(1), 53-64.
  5. Choi, W. M., Yoon, H. H, & Lee, J. H. (2016). Mediation effects of self-efficacy on the relationship between perceived health status and self-esteem in the elderly from a health sports program. Korean Journal of Physical Education, 55(5), 165-175.
  6. Ferrans, C. E., Zerwic, J. J., Wilbur, J. E., & Larson, J. L. (2005). Conceptual model of health-related quality of life. Journal of Nursing Scholarship, 37(4), 336-342.
  7. Gong, G., & Mao, J. (2016). Health-related quality of life among Chinese patients with rheumatoid arthritis: The predictive roles of fatigue, functional disability, self-efficacy, and social support. Nursing Research, 65(1), 55-67.
  8. Im, M. Y. (1998). Determinants of health promoting behavior of college students in Korea. Unpublished doctoral dissertation, Yonsei University, Seoul.
  9. Jakobsson, U., & Hallberg, I. R. (2002). Pain and quality of life among older people with rheumatoid arthritis and/or osteoarthritis: A literature review. Journal of Clinical Nursing, 11-(4), 430-443.
  10. Jia, H., Zack, M. M., Gottesman, I. I., & Thompson, W. W. (2018). Associations of smoking, physical inactivity, heavy drinking, and obesity with quality-adjusted life expectancy among US adults with depression. Value in Health, 21(3), 364-371.
  11. Jungchoi, K. H., Park, J. Y., Kim, N. S., & Park, H. Y. (2015). Status of chronic pain prevalence in the Korean adults. Public Health Weekly Report, 8(31), 728-734.
  12. Karttunen, N. M., Turunen, J., Ahonen, R., & Hartikainen, S. (2014). More attention to pain management in community-dwelling older persons with chronic musculoskeletal pain. Age and Ageing, 43(6), 845-850.
  13. Kim, M. J., & Bae, S. H. (2014). Factors influencing health-related quality of life in older adults with osteoarthritis: Based on the 2010-2011 Korea National Health and Nutrition Examination Survey. Journal of Muscle and Joint Health, 21(3), 195-205.
  14. Lawton, M. P., Moss, M., Fulcomer, M., & Kleban, M. H. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37(1), 91-99.
  15. Lee, S. S. (2012). Influencing factors on quality of life in elderly hemodialysis patient. Unpublished master's thesis, Inje University, Busan.
  16. Ma, L., Li, Y., Wang, J., Zhu, H., Yang, W., Cao, R., et al. (2015). Quality of life is related to social support in elderly osteoporosis patients in a Chinese population. PLoS ONE, 10(6), 127849-127859.
  17. Min, S. K., Kim, K. I., Suh, S. Y., & Kim, D. (2000). Development of Korean version of World Health Organization Quality of Life Scale (WHOQOL). Journal of Neuropsychiatry Association, 39(1), 78-88.
  18. Nam, J., & Sung, K. (2017). Effects of peer mentoring program on the health conservation in elderly women with osteoarthritis. Journal of Korean Academy of Community Health Nursing, 28(3), 227-239.
  19. Oh, J. H., & Yi, M. S. (2014). Structural equation modeling on quality of life in older adults with osteoarthritis. Journal of Korean Academy of Nursing, 44(1), 75-85.
  20. Riddle, D. L., Jensen, M. P., Ang, D., Slover, J., Perera, R., & Dumenci, L. (2018). Do pain coping and pain beliefs associate with outcome measures before knee arthroplasty in patients who catastrophize about pain? A cross-sectional analysis from a randomized clinical trial. Clinical Orthopaedics and Related Research, 476(4), 778-786.
  21. Schrubbe, L. A., Ravyts, S. G., Benas, B. C., Campbell, L. C., Cene, C. W., Coffman, C. J., et al. (2016). Pain coping skills training for African Americans with osteoarthritis (STAART): Study protocol of a randomized controlled trial. BMC Musculoskeletal Disorder, 17(1), 359-371.
  22. Shin, J. S., & Lee, Y. B. (1999). The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare, 37, 241-269.
  23. Sousa, K. H., & Kwok, O. M. (2006). Putting Wilson and Cleary to the test: Analysis of a HRQOL conceptual model using structural equation modeling. Quality of Life Research, 15(4), 725-737.
  24. Swift, C. M., Reed, K., & Hocking, C. (2014). A new perspective on family involvement in chronic pain management programmes. Musculoskeletal Care, 12(1), 47-55.
  25. Veehof, M. M., Oskam, M. J., Schreurs, K. M., & Bohlmeijer, E. T. (2011). Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. Pain, 152(3), 533-542.
  26. Walker, L. S., Baber, K. F., Garber, J., & Smith, C. A. (2008). A typology of pain coping in pediatric patients with chronic abdominal pain. Pain, 137(2), 266-275.
  27. Walker, L. S., Smith, C. A., Garber, J., & Van Slyke, D. A. (1997). Development and validation of the pain response inventory for children. Psychological Assessment, 9(4), 392-405.
  28. WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551-558.
  29. Yu, H. H. (2001). The effect of locus of control, pain coping strategy and depression on pain assessment. Unpublished master's thesis, Catholic University, Bucheon.
  30. Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41.