Health-related Quality Of Life Of Guangdong Urban Dwellers And Associated Factors

Objectives:With SF-36scale of health-related quality of life as measuring tool, the study was carried out for health-related quality of life and the main influencing factors among urban dwellers in Guangdong, and put forward measures and countermeasures to improve and promote health-related quality of life.Methods:1SubjectsAccording to the regional economic development and population index, Stratified sampling was carried on in2760urban dwellers in Guangdong from3to12, in2012. Urban dwellers were over the age of14from Guangzhou, Shenzhen, Chaozhou, Shantou and Maoming five cities and towns.2Methods(1) Operational definitionUrban dwellers refer to the residents living in cities and towns, with urban household registration effectively, lawful citizens with non-agricultural production living in urban areas in this study.World Health Organization considers quality of life to be "the individual’s perception of his or her position about life, within the cultural context and value system he or she lives in, and in relation to his or her goals, expectations, parameters, and social relations. It is a broad-ranging concept affected in a complex way by the person’s physical health, psychological state, level of independence, social relationships, and their relationship to salient features of their environment."(2) InstrumentQuestionnaire of quality of life for urban dwellers was designed, which included SF-36scale and main influencing factors such as demography, life way and events. SF-36scale is an international popular scale about health-related quality of life, which is widely used by measurement about quality of life, evaluation of clinical trial effect, assessment of civil health policy and similar fields. It was proved to be well in reliability and validity.(3) Quality controlThis research was supported by the National Natural Science Foundation of China (NSFC)(NO:81172775) and the Youth Foundation of Social Science Humanity of Education of China (NO:10YJCZH192).The sampling design and the statistical analysis were both performed according to the design of this subject to make sure the whole study was scientific and reasonable. Based on the literature review, we designed questionnaire, and the questionnaire was preliminary investigated and repeated inspection, modification combining the experts’suggests so that there are strong operability. In order to ensure the unified standard, investigators were unified training. Investigators explained to subjects how to fill in the scale before the test. Then subjects should asses themselves based on their understanding to each item independently without others’influence. Investigators should not give suggesting guide. For vision, investigators assisted to read all questions and options. After the investigation, all questionnaire were taken back and checked, then subjects added any items on the spot.Database was established by Epidata3.02, and double input was conducted to make the lowest deviation. We selected the received questionnaires, rejected questionnaires which quality of writing was not high (for instance all questions were with the same answer) or two questionnaires shared totally the same answer.(4) Data management and statistical analysis According to the uniform rules for number, Database was established by Epidata3.02, and eliminated the missing value more than20%of the data. Correct data was processed by SPSS15.0statistical software. The absence item of SF-36scale was to use its average instead of the dimension.Statistical methods include descriptive statistics, liability and validity analysis, two independent samples t test, single factor analysis of variance (one-way ANOVA), Logistic regression analysis, Pearson correlation analysis and canonical correlation analysis.Result:1.2760questionnaires were distributed, and2582was taken back. The response rate is93.55%. Participants concerned content of the questionnaire, and they would like to finish it.2. Reliability and validity of SF-36scale(1) Reliability①Internal consistency reliability. Cronbach’s a coefficient of SF-36scale is0.925. Cronbach’s a coefficient of physiological and psychological subscale were0.901,0.849respectively. Cronbach’s a coefficient of every dimension is not less than0.70without of Social Functioning and Vitality.②Split-half reliability. The spot trial results indicated a Spearman-Brown split-half reliability of0.784.(2) Validity①Construct validity. Correlation coefficient between each dimension and its affiliated items were bigger than that between the dimension and other items. Correlation coefficient between each subscale and its affiliated dimensions were higher than that between the dimension and other subscale.②Factor analysis. Kaiser-Meyer-Olkin index is0.930, suggesting that the data is suitable for factor analysis. According to the design of SF-36scale, extract9factors by principal axis factor analysis, whose cumulating contribution rate reach54.88%. After equamax rotation, result shows that every item has a high load value in one factor. The nine factors extracted match the theoretic conception, and every item of a dimension gathers together in the same factor.3. The average scores of urban dwellers in GuangdongThe average scores in eight dimensions of SF-36scale physical function dimension scored the highest (88.92±16.62), and general health dimension scored lowest (65.91±19.17). Its total score, PCS and MCS were (75.00±13.54),(77.91±14.68),(72.20±14.90) respectively.4. The single factor analysis on influential factors of quality of life in urban dwellersThe difference of SF-36total scores was statistical significance among different gender (t=2.358,P=0.018), age (F=33.656,P=0.000), marital status (F=13.322, P=0.000), level of education (F=13.170, P=0.000), inauguration situation (F=47.081, P=0.000), household registration (F=7.084, P=0.000), work time (F=8.839, P=0.000), monthly income (F=3.135, P=0.014), living situation (F=8.993, P=0.000), living place (F=3.876,P=0.004), eating habits (F=13.937,P=0.000), nutritional status(F=109.670, P=0.000), sleeping time (F=20.341, P=0.000), physical exercise (F=21.808, P=0.000), sedentary or desk for a long time (F=7.563,P=0.000), disease (t=11.542,P=0.000). The difference of SF-36total scores was no statistical significance among different smoking (t=-0.134,P=0.893), drinking (F=0.053, P=0.948) and staying up late (F=1.273,P=0.278).5. Logistic regressions Factors of quality of life in Guangdong urban dwellersMultiple Factors logistic regressions analysis showed gender, age, inauguration situation, work time, nutritional status, sleeping time, physical exercise, disease and negative events related to quality of life of urban dwellers (P<0.05).6. Relationship between quality of life and sub-health state in urban dwellers.Bivariate correlation analysis showed the PCS and MCS of quality of life was positively related with dimensions of sub-health (P<0.001). Canonical correlation analysis revealed that social adaptability, vitality, psychosocial symptom, positive emotion, MCS were reflected mainly SHMS V1.0and quality of life, respectively. Canonical structure analysis also showed sub-health state of Guangdong urban dwellers was positively related with quality of life, and the more serious sub-health state was, the worse quality of life.7. Suggestions(1) Give a three-tier intervention plan for urban dwellers. First, health education could reduce the dangerous factors that affected health, and develop a healthy life habit. Second, we could chose musical therapy, mental therapeutic and convalesce for medium or mild quality of life to prevent from disease. Third, improve the basic health service and dynamic monitoring and tracking.(2) Monitor, analysis, evaluate and forecast urban dwellers’ quality of life, so that to give relevant suggestions and system health management.(3) Manage department should pay close attention to quality of life state of urban dwellers. Attache great importance to the social and economic development, improve the social security system.Conclusions:1. SF-36scale shows good reliability and validity in test for Guangdong urban dwellers, it is suitable for quality of life evaluation among Guangdong urban dwellers.2. The total score of SF-36scale is100. The average scores in quality of life of SF-36scale among Guangdong urban dwellers, and physical function dimension scored the highest, and general health dimension scored lowest.3. The single factor analysis showed that influenced urban dwellers’ quality of life included elderly, divorce, widowed, daily working hours, solitary, elderly poor nutritional status, drink, no breakfast, sleep too little time or often stay up late, few or no physical training, sedentary or desk for a long time.4. Multiple Factors logistic regressions showed that influenced urban dwellers’ quality of life included gender, age, inauguration situation, work time, nutritional status, sleeping time, physical exercise, disease and negative events.5. Bivariate correlation analysis and canonical structure analysis showed sub-health state of Guangdong urban dwellers was positively related with quality of life, and the more serious sub-health state was, the worse quality of life.6. According to main factors influencing quality of life, the related countermeasure and the suggestion was put forward.