This study aimed to understand and explore perception of healthy adults and chronically ill adults on health and health-related quality of life (HRQoL).
Data were collected by open questions using a focus group discussion for healthy adults (N＝6) and in-depth interviews for chronically ill adults (N＝6). Previously developed 34 HRQoL items also were offered and participants were asked to select the five most important HRQoL items among them.
Findings were elicited along the following themes: health, HRQoL, health maintenance strategies, and elements affecting health. The definition on “being healthy” by healthy participants had a variety of standards and required several conditions to be fulfilled. Whereas chronically ill adults have more flexible perception about the coexistence of health and disease. Health dimensions were thought to affect each other, and physical and mental health dimension were selected as the most important items. As for the five most important HRQoL items, both group participants selected mental health dimension than physical or social health dimensions. Health maintenance strategies were similar in both groups except more healthcare service use in chronically ill adults.
This study shows the difference of perception on health and HRQoL between health group and disease group in Korea. It can be used for developing the HRQoL assessment tool reflecting the perception of Korean people.
Guideline for conducting a focus group discussion and in-depth interviews
| Opening | • Explaining the procedure and the purpose of focus group discussion/in-depth interview |
|---|---|
| • Self-introduction | |
| Introductory questions | • Thinking or feeling on health |
| • One's own past and current health condition | |
| Key questions | • Definition of health |
| • Definition of health-related quality of life and its dimensions and items | |
| • Assessing one's own health-related quality of life using EQ-5D | |
| • Important items of health-related quality of life | |
| Closure | • Thanks for participating |
Characteristics of healthy group and disease group
| Healthy group | Disease group | |||
|---|---|---|---|---|
| Age (Mean, SD) | 40.33 (6.28) | 58.50 (6.89) | ||
| Female (n, %) | 3 (50) | 4 (33.3) | ||
| Education period |
All 16 | F 1: 9, F 4: 12, F 2, F 3: 6 | ||
| Self-rated health |
M 1 | Very good | M 1 | Fair |
| M 2 | Good | M 2 | Fair | |
| M 3 | Good | F 1 | Good | |
| F 1 | Good | F 2 | Very good | |
| F 2 | Good | F 3 | Fair | |
| F 3 | Good | F 4 | Good | |
| EQ-5D–3L profile |
M 1 | 11111 | M 1 | 11111 |
| M 2 | 11112 | M 2 | 21211 | |
| M 3 | 11111 | F 1 | 21122 | |
| F 1 | 11111 | F 2 | 11121 | |
| F 2 | 11122 | F 3 | 11222 | |
| F 3 | 11112 | F 4 | 21121 | |
| EQ-5D index (Mean, SD) | 0.95 (0.06) | 0.85 (0.09) | ||
| Morbidity | None | M 1 | Diabetes mellitus | |
| M 2 | Parkinson's disease | |||
| F 1 | Diabetes mellitus, Hypercholesterolemia | |||
| F 2 | Hypercholesterolemia | |||
| F 3 | Hypertension | |||
| F 4 | Diabetes mellitus, Anemia |
Abbreviations: SD, standard deviation; M, male; F, female.
Male participants did not answer the question about education period.
Participants responded on a 5-point Likert scale: excellent, very good, good, fair, and poor.
EQ-5D–3L descriptive system comprises 5 dimension: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems and extreme problems.
Selecting items of health-related quality of life
| Health dimension | Healthy group | Disease group | ||
|---|---|---|---|---|
| Items | Items | |||
| n | % | n | % | |
| Physical | 14.5 | 50.3 | 15.7 | 58.8 |
| Mental | 11.2 | 38.7 | 8.8 | 33.1 |
| Social | 3.2 | 11.0 | 2.2 | 8.1 |
| Total | 28.8 | 100.0 | 26.7 | 100.0 |
Ranking orders of items of health-related quality of life
| Rank 1 | Rank 2 | Rank 3 | Rank 4 | Rank 5 | |
|---|---|---|---|---|---|
| Healthy group | |||||
| M1 | Belief, Faith | Positive feelings about life | Value for life and world | Easygoingness | Confidence |
| M2 | Relationships with | Leisure activity | Concentration | Tranquilness, calmness | Climbing stairs |
| co-workers | |||||
| M3 | Vitality | Relationships with family | Satisfaction with oneself | Easygoingness | Happiness, joy |
| and life | |||||
| F1 | Belief, faith | Coping with stress | Relationships with family | Working | Symptoms that limit usual activities |
| F2 | Walking | Vision | Happiness, joy | Relationships with family | Thinking |
| F3 | Happiness, joy | Coping with stress | Keeping balance | Sexual activity | Relationships with family |
| Diseas | se group |
||||
| M1 | Easygoingness | Positive thinking | Walking | Working | Consideration |
| M2 | Relationships with family | Appearance management | Thinking | Belief, faith | Thinking about suicide |
| F1 | Relationships with family | Stamina | Memory | Sexual activity | Environmental pollution |
| F2 | Walking | Taste sense | Easygoingness | Worthlessness | Relationships with |
| co-workers | |||||
| F4 | Toileting | Sleep | Standing up from chair/ | Recovery from fatigue | Difficulty with decision |
| bed | making | ||||
Abbreviations: M, male; F, female.
Female 3 participant did not complete ranking orders.