kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2017.17.3.199 kjhp-17-199 Original Article Factors Affecting Health-related Quality of Life in Middle-aged Male Patients with Benign Prostatic Hyperplasia KimDohyung 1 LeeSoo-Kyoung 2 Daegu Fatima Hospital, Daegu, Korea College of Nursing, Keimyung University, Daegu, Korea Corresponding author : Soo-Kyoung Lee, PhD College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea Tel: +82-53-580-3919, Fax: +82-53-580-3916 E-mail: soo1005@kmu.ac.kr 012017 19012017 173199 208 13032017 13172017 Copyright © 2017 The Korean Society of Health Promotion and Disease Prevention 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:

This study was conducted to provide a fundamental data and improve health-related quality of life (HRQoL) in increasing population of middle-aged male patients with benign prostatic hyperplasia (BPH) by investigating and analyzing the factors affecting the HRQoL.

 Methods:

The survey was performed with 124 middle-aged male BPH patients of Fatima hospital located in Daegu city. The data were collected by questionnaires and were analyzed by using SPSS WIN ver. 18.0 (IBM Corp., New York, NY, USA).

 Results:

Severity of BPH in participants was classified into moderate (54%), severe (31.5%), and mild (14.5%). The mean HRQoL score was 3.78 points. The scores in each section were 4.18 points for ‘disability of daily living activity’, 3.95 points for ‘discomfort due to BPH’, 3.69 points for ‘psychological state’, 3.65 points for ‘anxiety’ and 2.93 points for ‘sex life’. Perceived health state presented positive correlation with HRQoL and negative correlation with BPH symptoms. The BPH symptoms showed negative correlation with HRQoL. The level of BPH symptoms, perceived health status and prostate volume were revealed to influence the HRQoL in the order of the degree of influence. The factors’ determination value was 63.0%.

 Conclusions:

It was confirmed that the lower the patient's level of BPH symptoms is, the better the perceived health status is and that the smaller the prostate volume is, the higher the HRQoL is. Therefore, administration of medicine that relieves BPH symptoms and reduces a volume of the prostate should be encouraged and sustainable education, customized treatment and nursing care should be provided.

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Health-related quality of life of subjects (n=124)

Section M±SD Min Max
Discomfort 3.95±0.99 1.25 5.92
Disability 4.18±1.12 1.43 6.00
General psychological state 3.69±0.87 1.20 6.00
Concerns/worries 3.65±1.22 1.00 5.75
Sex life 2.93±0.94 1.00 4.75
Total 3.78±0.82 1.22 5.54

Abbreviations: M, mean; SD, standard deviation.

Health-related quality of life by general characteristics and lifestyle (n=124)

Variable N (%) Health-related quality of life
Discomfort Disability General Pyschological state Concerns/worries Sex life Overall state
M±SD P M±SD P M±SD P M±SD P M±SD P M±SD P
Age,Y     0.331   0.091   0.664   0.276   0.018   0.328
40.49a 15(12.1) 4.14±0.80   4.34±0.77   3.72±O.72   3.57±1.1O   3.40±O.68 C<a 3.92±0.67  
50-59b 55(44.4) 3.81±1.17   3.93±1.22   3.61±0.87   3.48±1.26   3.40±0.89   3.66±0.89  
60-64c 54(43.5 4.04±0.83   4.38±1.07   3.76±0.91   3.85±1.19   2.69±0.99   3.87±0.77  
Education level     0.109   0.207   0.002   0.351   0.001   0.019
              d,e<g       d<f   d<F
<<Elementary Schoold 19(15.3) 3.71±1.06   3.93±1.38   3.57±0.91   3.79±1.52   2.38±0.99   3.58±0.77  
Middle and high schoolc 74(59.7) 3.89±0.99   4.12±1.10   3.53±0.83   3.52±1.12   2.90±0.89   3.58±0.91  
>>College± 31(25.0) 4.76±0.90   4.47±0.97   4.16±0.78   3.87±1.24   3.35±0.86   4.13±0.70  
Religion     0.287   0.063   0.293   0.591   0.181   0.262
Have 73(58.9) 4.03±0.88   4.33±1.09   3.76±0.84   3.70+1.13   2.84±0.92   3.85±0.74  
Don't have 51(41.1) 3.84±1.13   3.95±1.14   3.59±0.90   3.58±1.35   3.07±0.95   3.68±0.92  
Spouse     0.261   0.145   0.259   0.360   0.757   0.183
Have 107(86.3) 3.99±0.96   4.24±1.08   3.730.87   3.59±1.22   2.94±0.94   3.82±0.79  
Don't Have 17(13.7) 3.70±1.13   3.81±1.33   3.47±0.88   3.40±1.21   2.87±0.94.   3.54±0.97  
Occupation     0.035   0.003   <0.001   0.034   <0.001   <0.001
Yes 92(74.2) 4.06±0.95   4.35±1.05   3.90±0.81   3.79±1.22   3.14±0.85   3.94±0.75  
No 32 (25.8} 3.64±1.05   3.68±1.19   3.09±0.74   326:1‘14   2.34:0.94   3.32±0.84  
Smoking     0.864   0327   0.348   0.621   0.411   0.439
Yes 20(16.1) 3.92±1.06   3.95±1.20   3.53±0.77   3.53±1.26   2.78±0.98   3.65±0.87  
No 104(33.9) 3.96±0.97   4.22+1.11   3.73±0.89   3.67±1.22   2.96±0.93   3.81±0.81  
Drinking     0.110   0.550   0.124   0.390   0.036   0.104
Yes 63(50.8) 4.09±0.90   4.24±1.08   3.81±0.78   3.74±1.25   3.11±0.94   3.90±0.75  
No 61(49.7) 3.81±1.06   4.11±1.17   3.57±0.94   3.55±1.19   2.34±0.94   3.66±0.87  
Coffee intake     0.956   0.487   0.847   0687   0.322   0.664
Yes 89(71.8) 3.95±1.06   4.21±1.23   3.70±0.92   3.68±1.22   2.99+0.93   3.80±0.89  
No 35(28.2) 3.96±0.78   4.08±0.81   3.67±0.74   3.58±1.22   2.80±0.96   3.74±0.62  
Exercise     0.016   0.098   0.043   0.045   0.328   0.016
Yes 69(55.6) 4.14±1.04   4.33±1.14   3.83±0.91   3.84±1.1.17   3.01±0.89   ‘1 044.“ Q:  
No 55(44.4) 3.71±0.86   3.99±1.08   3.52±0.78   3.40±1.25   2.84±1.00   3.58±0.73  
Sleeping per day     0.168   0.294   0.380   0.091   0.535   0157
<7 hours 60(48.4) 3.83±0.88   4.07±1.05   3.62±0.82   3.46±1.20   2.88±0.91   3.67±0.73  
>>7 hours 64(51.6) 4.07±1.07   4.25±1.18   3.76±0.92   3.83±1.22   2.98±0.97   3.88±0.88  

Abbreviations: M, mean; SD, standard deviation. Values are presented as number (%) 0r mean±standard deviation unless otherwise indicated.

Age group: 40—49.

Age group: 50—59.

Age group: 60—64.

Educational level group: Selementary school.

Educational level group: middle and high school.

Educational level group: >>college.

Health-related quality of life by disease-related characteristics and triage of BPH symptoms (n=124)

Variable N(%) Health-related quality of life
Discomfort Disability General psychological Concerns/worries Sex life Overall state
M±SD p M±SD p M±SD p M±SD p M±SD p M±SD p
Perceived Health     0.001   0.019   <0.001   0.091   0.002   <0.001
status     c<a,b   c<b   c<a,b           c<a,b
Satisfieda 15(12.1) 4.43±0.97   4.34±1.02   4.11±0.89   3.98±1.40   3.33±0.96   4.16±0.73  
Moderateb 74 (59.7) 4.09±0.96   4.36±1.05   3.87±0.78   3.75±1.21   3.06±0.90   3.93±0.76  
Dissatisfiedc 35(28.2) 3.46±0.88   3.73±1.22   3.13±0.78   3.29±1.10   2.49±0.87   3.30±0.77  
Dysuria duration of symptoms. Y     0.223   0.327   0.108   0.515   0.031 f<d   0.269
1-2d 39(31.5) 4.18±0.80   4.18±0.91   3.71±0.65   3.79±1.15   3.22±0.92   3.91±0.62  
2-3e 29(23.4) 3.80±0.95   4.18±1.00   3.96±0.92   3.72±1.28   2.97±0.74   3.86±0.79  
>3† 56(45.2) 3.87±1.11   4.04±1.30   3.51±0.95   3.51±1.24   2.71±0.99   3.65±0.94  
Prostate operation     0.395   0.865   0.261   0.965   0.002   0.748
Have 9(7.3) 4.22±1.08   4.24±0.96   3.38+0.61   3.67±0.93   2.00±0.71   3.70±0.67  
Don't have 115(92.7) 3.93±0.98   4.17±1.14   3.72±0.88   3.65±1.24   3.01±0.92   3.79±0.83  
Family history     0.253   0.373   0.222   0.546   0.865   0.272
Have 10(8.1) 4.30±0.89   3.87±1.16   3.37±0.61   3.43±1.40   3.00±1.29   3.51±0.79  
Don't have 14(91.9) 3.98+0.99   4.20±1.12   3.72±0.89   3.67±1.21   2.93±0.91   3.81±0.82  
Prostate volume, mL     0.021   0.404   0.214   0.243   0.989   0.096
Normal(<25) 31(25.0) 4.30±0.89   4.32±0.96   3.86±0.71   3.87±1.14   2.94±0.99   3.99±0.67  
Abnormal (>25) 93 (75.0) 3.83±0.99   4.13±1.17   3.64±0.91   3.58±1.24   2.93±0.93   3.71±0.85  
Maximum flow rate, mL/sec     0.277   0.292   0.111   0.905   0.041   0.153
Normal (>15) 45(36.3) 4.08±0.92   4.32±1.04   3.86±0.75   3.67±1.14   3.16±0.91   3.92±0.69  
Abnormal(<15) 79 (63.7) 3.88±1.02   4.10±1.17   3.60±0.92   3.64±1.27   2.80±0.93   3.70±0.88  
Amount of re-siduao of mL     0.386   0.494   0.251   0.174   0.586   0.257
Normal (<50) 101(81.5) 3.99:1 A01   421±1.14   3.74±088   372±1.20   296±0.93   382±0.82  
Abnormal (>50) 23(18.5) 3.79±0.87   4.03±1.06   3.50±0.81   3.34±1.25   2.84±0.99   3.61±0.77  
Triage of BPH     <0.001   <0.001   <0.001   <0.001   0.031   <0.001
Symptoms     h<j<g   i<h<g   i<h<g   i<h<g   i<g   i<h<g
Mildg 18(14.5) 5.13±0.62   5.10±0.68   4.36±0.79   4.67±0.71   3.93±0.61   4.68±0.48  
Moderateh 67(54.0) 4.15±0.72   4.45±0.92   3.77±0.79   3.93±1.00   2.95±0.95   3.95±0.63  
Severei 39(31.5) 3.07±0.74   3.27±1.01   3.25±0.82   2.21±1.14   2.69±0.97   3.08±0.65  

Abbreviations: BPH, benign prostatic hyperplasia; M, mean; SD, standard deviation. Values are presented as number (%) or mean±standard deviation unless otherwise indicated.

Categories of perceived health status: satisfied.

Categories of perceived health status: moderate.

Categories of perceived health status: dissatisfied.

Categories of dysuria duration of symptoms: 1—2 years.

Categories of dysuria duration of symptoms: 2—3 years.

Categories of dysuria duration of symptoms: >3 years.

Categories of triage: mild.

Categories of triage: moderate. iCategories of triage:severe

Factors affecting health-related quality of life

Variable B SE β F P
Symptoms of BPH -0.07 0.01 -0.71 165.15 <0.001
Perceived health statusa 0.22 0.06 0.20 94.40 0.001
Prostate volume -0.01 0.00 -0.16 69.45 0.005
R2=0.64, adjusted R2=0.63

Abbreviations: BPH, benign prostatic hyperplasia; SE, standard error. Calculated by multiple linear regression analysis adjusted for education level, occupation, exercise.

Dummy variables: perceived health status: satisfied=1, moderate=0, dissatisfied=0.