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Health-Promoting Behavior and Quality of Life among Community-Dwelling, Middle-Aged Women: A Comparative Study between Overweight and Normal-Weight Groups

지역사회 거주 중년 여성 집단에서 건강증진 행위와 삶의 질: 과체중 집단과 정상체중 집단 간 비교

  • Received : 2018.08.22
  • Accepted : 2018.10.04
  • Published : 2018.12.30

Abstract

Background: Strategically improving health-related quality of life (HRQOL) should be discussed among overweight middle-aged women who are vulnerable to low HRQOL. We examined firstly if overweight middle-aged women would have significantly lower levels of HRQOL and health-promoting behaviors than normal-weight middle-aged women, and to examine secondly if health-promoting behaviors would be significantly associated with generic and obesity-specific HRQOLs within the overweight middle-aged women. Methods: We conducted a cross-sectional, comparative study. Participants were 119 women aged 30-49 years who were recruited from a community in Seoul, South Korea; 63 women for the overweight group who were recruited from a baseline sample of the Community-Based Heart and Weight Management Trial, while 56 for the normal-weight group who were recruited separetely. Health Promoting Lifestyle Profile II (HPLP II), World Health Organization Quality of Life-brief version (WHOQOL-BREF) of a generic HRQOL measure, and Impact of Weight on Quality of Life-Lite (IWQOL-Lite) of an obesity-specific HRQOL measure were used. Results: Compared to the normal-weight group, the overweight group showed significantly lower scores of total WHOQOL-BREF as well as some HPLP II subscales including stress management (P=0.029). Among the HPLP II subscales, stress management was significantly and positively associated with total WHOQOL-BREF (${\beta}=1.58$, P=0.003) and self-esteem IWQOL-Lite (${\beta}=11.58$, P=0.034) among the overweight group. Conclusions: Among middle-aged overweight women, low levels of health-promoting behavior for stress management were shown, which should be strategically increased for improving their generic and obesity-specific HRQOLs.

연구배경: 중년기 여성은 젊은 여성에 비하여 과체중과 비만의 유병률이 높으며, 특히 여성이 남성에 비하여 비만과 관련된 건강관련 삶의 질이 나쁘다고 알려져 있다. 이에 건강관련 삶의 질에 취약한 과체중 중년 여성의 건강관련 삶의 질을 전략적으로 개선하는 것이 중요하겠다. 건강증진 행위는 건강관련 삶의 질과 밀접한 연관성이 있을 수 있다. 이에 본 연구는 과체중 중년 여성이 정상체중의 중년 여성에 비하여 건강증진 행위와 건강관련 삶의 질이 낮은지를 조사하고, 과체중 중년 여성에서 건강증진 행위가 일반적(generic) 혹은 비만특이적(obesity-specific) 건강관련 삶의 질과 유의한 연관성이 있는지 밝히고자 한다. 방법: 본 연구는 횡단적 비교 연구이다. 서울시 성북구에 거주하는 30-49세 중년 여성 119명을 대상으로 하였으며, 과체중군은 63명이고 정상체중군은 56명이었다. 건강증진 행위는 Health Promoting Lifestyle Profile II (HPLP II) 도구를 사용하여 측정하였다. 일반적 건강관련 삶의 질은 World Health Organization Quality of Life-brief version(WHOQOL-BREF)을 사용하였으며, 비만특이적 건강관련 삶의 질은 Impact of Weight on Quality of Life-Lite(IWQOL-Lite)를 사용하였다. 과체중군과 정상체중군 간의 건강증진 행위와 건강관련 삶의 질 차이를 분석하기 위하여 일반선형모델을 수행하였고, 과체중군 안에서 건강증진 행위와 건강관련 삶의 질과의 연관성은 다중회귀분석을 시행하였다. 결과: 과체중군은 정상체중군에 비하여 건강증진 행위의 스트레스 관리(P=0.029)를 포함하여 영양(P=0.004)과 신체활동(P=0.006)의 하부영역에서 유의하게 낮은 점수를 보였다. 또한 과체중군은 정상체중군에 비하여 일반적 건강관련 삶의 질 총점(P<0.001)과 비만특이적 건강관련 삶의 질 총점이 유의하게 낮았다(P<0.001). 더욱이, 과체중군에서 건강증진 행위 하부영역 중 스트레스 관리 점수가 높을수록 일반적 건강관련 삶의 질 총점이 높고(${\beta}=1.58$, P=0.003), 비만특이적 삶의 질 영역 중 자아존중감 점수가 유의하게 높았다(${\beta}=11.58$, P=0.034). 결론: 중년기 과체중 여성이 정상체중 여성과 비교하여 특히 건강증진 행위 중 스트레스 관리의 수준이 낮은 것으로 나타났다. 이에, 지역사회 중년기 과체중 여성의 일반적 혹은 비만과 관련된 건강관련 삶의 질 개선을 위해서는 스트레스 관리의 전략적 접근이 무엇보다 중요하겠다.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea (NRF)

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