• Health Policy and Management
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• v.18 no.1
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• pp.108-126
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• 2008

Summary measures of population health or SMPH is an index which can describe morbidity as well as mortality. Summary measures of population health can be divided into health-adjusted life years which is a life expectancy measure and disability-adjusted life years which represents the gap between the ideal health status and the current health status. This study aims at estimating health-adjusted life expectancy(HALE) which is a measure of health-adjusted life years, by calculating life expectancy adjusted by health status using EQ-5D. The mortality data was obtained from the life table of 2005 which was published by the National Statistical Office and the health status by sex and age was obtained from the EQ-5D scores using the third National Health and Nutrition and Examination Survey in 2005. With these mortality and morbidity data, health-adjusted life expectancy was calculated using Sullivan's method. The study results showed that the health-adjusted life expectancy of males and females was 67.49 and 69.61, respectively, while the life expectancy of males and females was 75.14 and 81.89. In other words, Korean males and females lose 7.65 and 12.28, respectively, from the decrease of quality of life due to diseases and/or injuries. These results can further be interpreted that males lose 10.2% of their life expectancy and females 15.0%. This study suggests that it may be possible to monitor population's health-adjusted life expectancy by continuing to include health-related quality of life measures such as EQ-5D in national health surveys like the National Health and Nutrition and Examination Survey.

• Journal of Nutrition and Health
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• v.53 no.2
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• pp.129-140
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• 2020

Purpose: Although the importance of life satisfaction in patients with chronic diseases has been emphasized, limited studies have been performed on the health-related quality of life (HRQoL) among elderly patients with chronic diseases. This study examined the HRQoL among Korean patients with diabetes aged 65 years or older. Methods: This study used data from the Korea National Health and Nutrition Examination Survey 2008-2016. The analysis included data of 2,353 elderly patients with diabetes aged 65 years or older who were aware that they had type 2 diabetes. Each participant was categorized into one of three age groups (65-69 years, 70-74 years, and ≥ 75 years). The EuroQol-5 Dimensions (EQ-5D) scale was computed to estimate the HRQoL. Multivariate linear regression analysis was used to compare the demographic characteristics, lifestyle characteristics, nutrient intake, and EQ-5D scores between the age groups. Results: The intake levels of most nutrients were similar in the three age groups, but the total energy intake levels were significantly lower, and the sodium intake levels were significantly higher in the older age groups (p < 0.001). In addition, all items of the EQ-5D index, except for anxiety/depression, tended to decrease with age. In particular, the oldest age group (≥ 75 years) showed significantly lower levels on most items and the EQ-5D index than those in the other age groups (p < 0.001). Conclusion: Elderly patients with type 2 diabetes may have low levels of life satisfaction, which worsens with increasing age. Therefore, it is important to develop and manage personalized guidelines and medical systems so that elderly patients have a higher quality of life for the remainder of their lives. The results of this study are expected to be used as basic data for the systematic management of diabetes in elderly Korean patients.

• Journal of muscle and joint health
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• v.17 no.2
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• pp.203-211
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• 2010

Purpose: We aimed to test the validity of the EQ-5D (Euro-Quality of Life-5 Dimension), a brief and simple instrument, in measuring health related quality of life in the patients with osteoarthritis. Methods: 183 participants attending the education programs for osteoarthritis patients at the Health Centers located in Seoul and Gyunggi province area during the periods of June to December in 2009 were interviewed with the EQ-5D and KWOMAC (Korean version of Western Ontario and McMaster Scale). The data were analysed with Spearman correlation coefficents and t-test by using of SPSS/WIN 12.0 version. Results: There was a negative correlation between knee pain, stiffness and difficulty in usual activity of sub category items of KWOMAC and EQ-5Dindex, while there was no correlation between these categories and EQ-VAS. Moreover, as a result of comparing the score of physical function measured by KWOMAC according to the severity degree of the EQ-5Dindex, the group of advanced stage having moderate and severe symptoms reported significantly higher scores of physical function than those of groups having no health problems. Conclusion: The EQ-5D is an acceptable and valid instrument for measuring health-related quality of life in patients with osteoarthritis.

• Korean Journal of Adult Nursing
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• v.22 no.3
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• pp.291-302
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• 2010

Purpose: This study was a secondary data analysis aimed at identifying the predictors of health-related quality of life (HRQoL) of the home-dwelling disabled person by using EQ-5D which is a standardized instrument used as a measure of health outcome. Methods: Data were drawn from the 3rd Korea National Health and Nutritional Examination Survey conducted by the Ministry of Health and Welfare (MOHW). Subjects were 1,021 home-dwelling disabled persons over 19 years of age. Data were analyzed by using descriptive statistics, t-test, Pearson's correlation, one-way ANOVA, Scheff$\acute{e}$ test, and Stepwise multiple regression. Results: HRQoL (Health Related Quality of Life) is differentiated within age, genders, educational level, employment status, economic status, types and grades of disability, health problems associated with limited mobility, and the limited duration of time. HRQoL is correlated with age, number of cohabiters, educational level, grades of disability, activities of daily living (ADL), and instrumental ADL (IADL). HRQoL is significantly associated with ADL, health problems in connection with limited mobility, employment status, types of disability, marital status, grades of disability, and the limited duration of time. These factors explained 63.7% of variance in HRQoL. Conclusion: HRQoL among the disabled is related to their characteristics, ADL, and IADL. For this reason, it is necessary to develop health programs to promote those variables required to improve HRQoL.

• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.234-242
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• 2022

Objectives: This study assessed the validity and reliability of the Health-related Quality of Life Instrument with 8 Items (HINT-8) in patients with diabetes. HINT-8 is a newly-developed, generic health-related quality of life (HRQoL) instrument. Methods: Three HRQoL instruments-HINT-8, EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and Short Form Health Survey version 2.0 (SF-36v2)-were provided to 300 patients with diabetes visiting a tertiary hospital for follow-up visits in Korea. The HRQoL scores obtained using the HINT-8 were evaluated for subgroups with known differences based on demographics and diabetes-related characteristics (known-group validity). The mean scores of the instruments were compared between groups segmented by their responses to the HINT-8 (discriminatory ability). Correlation coefficients of the HINT-8 with other instruments were calculated (convergent and divergent validity). The Cohen kappa and intra-class correlation coefficient (ICC) were also evaluated (test-retest reliability). Results: The average HINT-8 indexes were lower among women, older, and less-educated subjects. Subjects who did not list any problems on the HINT-8 had significantly higher HRQoL scores than those who did. The correlation coefficients of the HINT-8 with the EQ-5D-5L index and EuroQoL visual analogue scale were 0.715 (p<0.001) and 0.517 (p<0.001), respectively. The correlation coefficients between the HINT-8 index and the scores of 8 domains of the SF-36v2 ranged from 0.478 (p<0.001) to 0.669 (p<0.001). The Cohen kappa values for the HINT-8 ranged from 0.268 to 0.601, and the ICC of the HINT-8 index was 0.800 (95% confidence interval [CI], 0.720 to 0.860). Conclusions: This study showed that the HINT-8 is a valid and reliable HRQoL instrument for patients with diabetes.

• Journal of Preventive Medicine and Public Health
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• v.56 no.5
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• pp.467-474
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• 2023

Objectives: Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population's health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia. Methods: A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group's validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL. Results: Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score. Conclusions: Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.

• Korean Journal of Health Education and Promotion
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• v.26 no.1
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• pp.1-13
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• 2009

Objectives: This study was conducted to estimate the health-related quality of life (HRQOL) using EuroQoL-5 Dimension (EQ-5D) and to identify its related factors among urban-dwelling adults. Methods: The data for this study were obtained from 1,134 subjects aged $20\sim91$, who participated in 'Survey on the health status and demand for health' in two cities of Korea (Dong-gu, Gwangju and Suncheon-si, Jeollanamdo). The HRQOL was measured using the EQ-5D instrument and EQ-5D index scores were calculated by two Korean valuation study model using time trade-off method. Results: The mean EQ-5D index scores for all subjects were $0.865{\pm}0.218$ (model A), and $0.921{\pm}0.170$ (model B). The EQ-5D index score was significantly different according to demographic and socioeconomic characteristics (gender, age, marital status, education, occupation, income, and health security system), self-rated health condition, health-related psychological assessments (enough sleep, fatigue rate, stress rate, and degree of satisfaction on the residence). The results of multiple linear regression showed that age, marital status, income, coverage of medical insurance, self-rated health condition, and fatigue rate were significantly related common statistical factors of HRQOL in two Korean valuation study model. Conclusion: Among the adults residing in urban environment, the HRQOL was significantly lower on the subjects with following conditions: higher age, being alone without a spouse as a result of death, divorce or separation, low income, medical aid program, poor self-rated health condition, and chronic fatigue. In order to improve the urban adults' quality of life, healthcare policy and health promotion program must be developed with considerations to factors related to the HRQOL.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.329-334
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• 2020

Purpose: The purpose of this study is to provide basic evidence on the need to approach osteoarthritis patients through a psychological factors-considering rehabilitation program by understanding how activity restrictions in osteoarthritis affect health-related quality of life and depression. Methods: This study assessed 3,761 osteoarthritis patients from the Korea National Health and Nutrition Examination Survey. The subjects were divided into two categories: with and without activity restriction. Results: The prevalence of osteoarthritis in women was higher than that of men (men: 19.7%; women: 80.3%), and high BMI increased the prevalence of osteoarthritis. The EQ-5D index of subjects with activity restriction was 0.84±0.18 (points), while in those without activity restriction was 0.93±0.12, and the diagnosis of depression was 15.8%, 8.2%. There was a statistically significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with activity restriction was 2.098 compared with no activity restriction. Conclusion: Activity restriction of osteoarthritis patients significantly decreases the health-related quality of life and increase the probability of depression. Therefore, early diagnosis of depression symptoms to prevent deterioration of symptoms in patients with osteoarthritis and to increase compliance with rehabilitation treatment, and to provide arbitration, including treatment that can alleviate depression.

• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.213-225
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• 2022

Objectives: The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS). Methods: We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations. Results: In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale. Conclusions: While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.

• Journal of muscle and joint health
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• v.21 no.3
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• pp.195-205
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• 2014

Purpose: This study was conducted to identify factors that influence health-related quality of life in older adults with osteoarthritis. Methods: This study used a cross-sectional design with secondary analysis of the Korean National Health and Nutrition Examination Survey 2011. A total of 362 participants aged 65 years and older who had osteoarthritis were selected. Health-related quality of life using EQ-5D, perceived health status, body mass index, numbers of chronic illness, smoking and alcohol use, exercise, activity limitation, joint pain and stiffness, depression, and perceived stress were measured. Descriptive statistics, $x^2$-test, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression were conducted with SPSS/WIN 21.0. Results: The mean score of EQ-5D was 0.77 in older adults with osteoarthritis. The results of multiple regression analysis showed that age, income, subjective health status, restriction of activity, knee joint stiffness, depressive mood, and perceived stress significantly predicted health-related quality of life in older adults with osteoarthritis, explaining 42% of the variance. Conclusion: Older adults with osteoarthritis have low health-related quality of life. In oder to improve health-related quality of life in older adults with osteoarthritis, it is important not only to enhance physical function but also to provide emotional support.