Association of regional-level perceived stress and depression with health related quality-of-life of Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
OBJECTIVES: We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults. METHODS: We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥ 10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index× 100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL. RESULTS: In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26). CONCLUSIONS: Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
Abstract
OBJECTIVES: We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults. METHODS: We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥ 10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index× 100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL. RESULTS: In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26). CONCLUSIONS: Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
참고문헌 (47)
- Ware JE Jr, "Overview of the SF-36 health survey and the international quality of life assessment(IQOLA)project", J Clin Epidemiol, 51, pp.903~912 (1998)
- Jung JG, "Changes in poor self-rated health status among elderly Koreans over 10 years : Community Health Survey 2008-2017", Geriatr Gerontol Int, 20, pp.1190~1195 (2020)
- Darker CD, "Determinants of self-rated health in an Irish deprived suburban population-a cross sectional face-to-face household survey", BMC Public Health, 16, pp.767~ (2016)
- Lin YH, "Health-related quality of life among adults 65 years and older in the United States, 2011-2012 : a multilevel small area estimation approach", Ann Epidemiol, 27, pp.52~58 (2017)
- Busija L, "Adult measures of general health and health-related quality of life: medical outcomes study short form 36-item (SF-36)and short form 12-item (SF-12) health surveys, Nottingham health profile (NHP), sickness impact profile (SIP), medical outcomes study short form 6D (SF-6D), health utilities index mark 3 (HUI3), quality of well-being scale (QWB), and assessment of quality of life (AQoL)", Arthritis Care Res (Hoboken), 63(Suppl 11), pp.S383~S412 (2011)
- Johnson JA, "Comparison of the EQ-5D and SF-12health surveys in a general population survey in Alberta, Canada", Med Care, 38, pp.115~121 (2000)
- Macintyre S, "Place effects on health: how can we conceptualise, operationalise and measure them?", Soc Sci Med, 55, pp.125~139 (2002)
- Kabir A, "Qualitative exploration of sociocultural determinants of health inequities of Dalit population in Dhaka City, Bangladesh", BMJ Open, 8, pp.e022906~ (2018)
- Merlo J, "A brief conceptual tutorial on multilevel analysis in social epidemiology : interpreting neighbourhood differences and the effect of neighbourhood characteristics on individual health", J Epidemiol Community Health, 59, pp.1022~1028 (2005)
- Yoon NH, "The effects of community environmental factors on obesity among Korean adults : a multilevel analysis", Epidemiol Health, 36, pp.e2014036~ (2014)
- Santos SM, "Demarcation of local neighborhoods to study relations between contextual factors and health", Int J Health Geogr, 9, pp.34~ (2010)
- Low CA, "Psychosocial factors in the development of heart disease in women : current research and future directions", Psychosom Med, 72, pp.842~854 (2010)
- Hiyoshi A, "Health inequalities in Japan : the role of material, psychosocial, social relational and behavioural factors", Soc Sci Med, 104, pp.201~209 (2014)
- Hemingway H, "Evidence based cardiology : psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies", BMJ, 318, pp.1460~1467 (1999)
- Macleod J, "Psychosocial factors and public health:a suitable case for treatment?", J Epidemiol Community Health, 57, pp.565~570 (2003)
- Kubzansky LD, "Positive psychological well-being and cardiovascular disease : JACC Health Promotion Series", J Am Coll Cardiol, 72, pp.1382~1396 (2018)
- Sievert LL, "Stress and midlife women’s health", Womens Midlife Health, 4, pp.4~ (2018)
- Okihiro M, "Promoting optimal native outcomes(PONO)by understanding women’s stress experiences", J Prim Prev, 38, pp.159~173 (2017)
- Thorsen SV, "Perceived stress and sickness absence : a prospective study of 17, 795 employees in Denmark", Int Arch Occup Environ Health, 92, pp.821~828 (2019)
- Cohen S, "A stage model of stress and disease", Perspect Psychol Sci, 11, pp.456~463 (2016)
- Levenson RW, "Stress and illness : a role for specific emotions", Psychosom Med, 81, pp.720~730 (2019)
- Meira TM, "Perceived stress and quality of life among graduate dental faculty", J Dent Educ, 84, pp.1099~1107 (2020)
- Ertl MM, "Perceived stress, resilience, and healthrelated quality of life among Parkinson’s disease caregivers in Mexico", Health Soc Care Community, 27, pp.1303~1310 (2019)
- Seib C, "Stress, lifestyle, and quality of life in midlife and older Australian women : results from the Stress and the Health of Women Study", Womens Health Issues, 24, pp.e43~e52 (2014)
- Ostergaard SD, "The heterogeneity of the depressive syndrome : when numbers get serious", Acta Psychiatr Scand, 124, pp.495~496 (2011)
- Sivertsen H, "Depression and quality of life in older persons : a review", Dement Geriatr Cogn Disord, 40, pp.311~339 (2015)
- Tang AL, "Relationships between depressive symptoms, other psychological symptoms, and quality of life", Psychiatry Res, 289, pp.113049~ (2020)
- Kershaw KN, "Associations of chronic individual-level and neighbourhood-level stressors with incident coronary heart disease : the Multi-Ethnic Study of Atherosclerosis", J Epidemiol Community Health, 69, pp.136~141 (2015)
- Meier HC, "Cellular response to chronic psychosocial stress : ten-year longitudinal changes in telomere length in the Multi-Ethnic Study of Atherosclerosis", Psychoneuroendocrinology, 107, pp.70~81 (2019)
- Short H, "The relationship of neighbourhood-level material and social deprivation with health-related quality of life", Qual Life Res, 27, pp.3265~3274 (2018)
- Rocha V, "Neighbourhood socioeconomic deprivation and health-related quality of life : a multilevel analysis", PLoS One, 12, pp.e0188736~ (2017)
- Fone D, "Effect of neighbourhood deprivation and social cohesion on mental health inequality : a multilevel population-based longitudinal study", Psychol Med, 44, pp.2449~2460 (2014)
- Wu XY, "Sociodemographic and neighbourhood determinants of health-related quality of life among grade-five students in Canada", Qual Life Res, 19, pp.969~976 (2010)
- Yang Wha Kang, "Korea Community Health Survey Data Profiles", Osong Public Health and Research Perspectives, 6(3), pp.211~217 (2015), 질병관리청
- Lee YK, "South Korean time trade-off values for EQ-5D health states : modeling with observed values for 101 health states", Value Health, 12, pp.1187~1193 (2009)
- Kroenke K, "The PHQ-9 : validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
- Manea L, "Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire(PHQ9) : a meta-analysis", CMAJ, 184, pp.E191~E196 (2012)
- WHO Expert Consultation, "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363, pp.157~163 (2004)
- Hassanzadeh J, "Association between social capital, healthrelated quality of life, and mental health : a structural-equation modeling approach", Croat Med J, 57, pp.58~65 (2016)
- Feizi A, "Association of perceived stress with stressful life events, lifestyle and sociodemographic factors : a large-scale community-based study using logistic quantile regression", Comput Math Methods Med, 2012, pp.151865~ (2012)
- Cohen S, "Ten surprising facts about stressful life events and disease risk", Annu Rev Psychol, 70, pp.577~597 (2019)
- Ferraro KF, "Psychological distress and mortality:are women more vulnerable?", J Health Soc Behav, 47, pp.227~241 (2006)
- Matud MP, "Gender differences in psychological distress in Spain", Int J Soc Psychiatry, 61, pp.560~568 (2015)
- Cheon Y, "Factors associated with psychological stress and distress among Korean adults : the results from Korea National Health and Nutrition Examination Survey", Sci Rep, 10, pp.15134~ (2020)
- Darviri C, "Determinants of self-rated health in a representative sample of a rural population : a cross-sectional study in Greece", Int J Environ Res Public Health, 9, pp.943~954 (2012)
- Kim HJ, "The relationship between sleep duration and perceived stress : findings from the 2017Community Health Survey in Korea", Int J Environ Res Public Health, 16, pp.3208~ (2019)
- Choi DW, "Association between sleep duration and perceived stress : salaried worker in circumstances of high workload", Int J Environ Res Public Health, 15, pp.796~ (2018)