Su Jung Choi; Keum Soon Kim

doi:10.4040/jkan.2013.43.1.81

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Original Article
Structural Equation Modeling On Health-related Quality of Life in Patients with Obstructive Sleep Apnea: Su Jung Choi, Keum Soon Kim; Journal of Korean Academy of Nursing 2013;43(1):81-90.
DOI: https://doi.org/10.4040/jkan.2013.43.1.81
Published online: February 28, 2013

¹Advanced Practice Nurse, Samsung Medical Center, Seoul, Korea.

²College of Nursing, Seoul National University, Seoul, Korea.

Address reprint requests to: Choi, Su Jung. Department of Nursing, Samsung Medical Center, #50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-10-9933-2851, Fax: +82-2-3410-2188, sujungchoi@hanmail.net

• Received: July 23, 2012 • Accepted: October 21, 2012

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Abstract
NOTES
REFERENCES

Abstract

Purpose
This study was done to test structural equation modeling of health-related quality of life (QOL) of men with obstructive sleep apnea in order to identify parameters affecting QOL and provide guidelines for interventions and strategies to improve QOL in these patients.
Methods
Model construction was based on 'The conceptual model of patient outcome in health-related QOL' by Wilson and Cleary, using the variables; age, physiological factors, social support, cognitive appraisal, symptoms and QOL. Participants were 201 adult male patients recruited at a tertiary university hospital in Seoul. Data were collected via questionnaires, polysomnography, and clinical records.
Results
Age and symptoms directly influenced QOL. Social support and cognitive appraisal about sleep did not have a direct influence on QOL, but indirectly affected it via symptoms. QOL was lower in patients who were younger and had more severe symptoms. Symptoms were more severe for patients with lower social support and more dysfunctional cognitive appraisal. When social support was lower, cognitive appraisal was more dysfunctional.
Conclusion
These results suggest it is necessary to not only manage symptoms, but also apply interventions to increase social support and cognitive appraisal about sleep in order to increase QOL in patients with obstructive sleep apnea.
Keywords: Obstructive sleep apnea; Quality of life; Age; Symptom; Social support

This manuscript is a condensed form of the first author's doctoral dissertation from Seoul National University.

REFERENCES

1. Akashiba T, Kawahara S, Akahoshi T, Omori C, Saito O, Majima T, et al. Relationship between quality of life and mood or depression in patients with severe obstructive sleep apnea syndrome. Chest. 2002;122(3):861–865. http://dx.doi.org/10.1378/chest.122.3.861.Article PubMed
2. American Academy of Sleep Medicine. The international classification of sleep disorders: Diagnostic and coding manual. 2005;2nd ed. Westchester, IL, Author.
3. Bae BR. Structural equation modeling with AMOS 19: Principles and practice. 2011;Seoul, CheongRam Publishing.
4. Balsevicius T, Uloza V, Sakalauskas R, Miliauskas S. Peculiarities of clinical profile of snoring and mild to moderate obstructive sleep apnea-hypopnea syndrome patients. Sleep Breath. 2012;16(3):835–843. http://dx.doi.org/10.1007/s11325-011-0584-z.Article PubMed PDF
5. Beck AT, Steer RA, Brown GK. Manual for the BDI-II, the psychological corporation. 1996;San Antonio, TX, Psychological Corporation.
6. Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A. Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab. 2005;90(8):4510–4515. http://dx.doi.org/10.1210/jc.2005-0035.Article PubMed
7. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40(5):373–383. http://dx.doi.org/10.1016/0021-9681(87)90171-8.Article PubMed
8. Collop N. The effect of obstructive sleep apnea on chronic medical disorders. Cleve Clin J Med. 2007;74(1):72–78. http://dx.doi.org/10.3949/ccjm.74.1.72.Article PubMed
9. Ferrans CE, Zerwic JJ, Wilbur JE, Larson JL. Conceptual model of health-related quality of life. J Nurs Scholarsh. 2005;37(4):336–342. http://dx.doi.org/10.1111/j.1547-5069.2005.00058.x.Article PubMed
10. Flemons WW, Reimer MA. Development of a disease-specific health-related quality of life questionnaire for sleep apnea. Am J Respir Crit Care Med. 1998;158(2):494–503.Article PubMed
11. Gélinas C, Fillion L. Factors related to persistent fatigue following completion of breast cancer treatment. Oncol Nurs Forum. 2004;31(2):269–278. http://dx.doi.org/10.1188/04.onf.269-278.Article PubMed
12. Jennum P, Kjellberg J. Health, social and economical consequences of sleep-disordered breathing: A controlled national study. Thorax. 2011;66(7):560–566. http://10.1136/thx.2010.143958.Article PubMed
13. Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep. 1991;14(6):540–545.Article PubMed
14. Kapur V, Strohl KP, Redline S, Iber C, O'Connor G, Nieto J. Underdiagnosis of sleep apnea syndrome in U.S. communities. Sleep Breath. 2002;6(2):49–54. http://dx.doi.org/10.1007/s11325-002-0049-5.Article PubMed PDF
15. Karademas EC. Self-efficacy, social support and well-being: The mediating role of optimism. Pers Individ Dif. 2006;40(6):1281–1290.
16. Kim J, In K, You S, Kang K, Shim J, Lee S, et al. Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med. 2004;170(10):1108–1113. http://dx.doi.org/10.1164/rccm.200404-519OC.Article PubMed
17. Korea Centers for Disease Control and Prevention. The fourth Korea national health and nutrition examination survey [KNHANES IV-2] data. 2010;01 01 Retrieved February 15, 2010. from http://knhanes.cdc.go.kr/.
18. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: An observational study. Lancet. 2005;365(9464):1046–1053. http://dx.doi.org/10.1016/s0140-6736(05)71141-7.Article PubMed
19. Morin CM. Insomnia: Psychological assessment and management. 1993;New York, Guilford Press.
20. Morin CM, Vallières A, Ivers H. Dysfunctional beliefs and attitudes about sleep (DBAS): Validation of a brief version (DBAS-16). Sleep. 2007;30(11):1547–1554.Article PubMed PMC
21. Pepin JL, Viot-Blanc V, Escourrou P, Racineux JL, Sapene M, Lévy P, et al. Prevalence of residual excessive sleepiness in CPAPtreated sleep apnoea patients: The French multicentre study. Eur Respir J. 2009;33(5):1062–1067. http://dx.doi.org/10.1183/09031936.00016808.Article PubMed
22. Pinto LR Jr, Pinto MC, Goulart LI, Truksinas E, Rossi MV, Morin CM, et al. Sleep perception in insomniacs, sleep-disordered breathing patients, and healthy volunteers--an important biologic parameter of sleep. Sleep Med. 2009;10(8):865–868. http://dx.doi.org/10.1016/j.sleep.2008.06.016.Article PubMed
23. Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W. The health-related quality of life in rheumatoidarthritis, ankylosing spondylitis, and psoriatic arthritis: A comparison with a selected sample of healthy people. Health Qual Life Outcomes. 2009;7:25. http://dx.doi.org/10.1186/1477-7525-7-25.PubMed PMC
24. Smith S, Sullivan K, Hopkins W, Douglas J. Frequency of insomnia report in patients with obstructive sleep apnoea hypopnea syndrome (OSAHS). Sleep Med. 2004;5(5):449–456. http://10.1016/j.sleep.2004.03.005.Article PubMed
25. Strine TW, Chapman DP, Balluz L, Mokdad AH. Health-related quality of life and health behaviors by social and emotional support. Their relevance to psychiatry and medicine. Soc Psychiatry Psychiatr Epidemiol. 2008;43(2):151–159. http://dx.doi.org/10.1007/s00127-007-0277-x.PubMed
26. Vozoris NT, Leung RS. Sedative medication use: Prevalence, risk factors, and associations with body mass index using population-level data. Sleep. 2011;34(7):869–874. http://dx.doi.org/10.5665/sleep.1116.Article PubMed PMC
27. Weaver EM, Woodson BT, Steward DL. Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients. Otolaryngol Head Neck Surg. 2005;132(2):255–262. http://dx.doi.org/10.1016/j.otohns.2004.11.001.Article PubMed PDF
28. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273(1):59–65.Article PubMed
29. Ye L, Liang ZA, Weaver TE. Predictors of health-related quality of life in patients with obstructive sleep apnoea. J Adv Nurs. 2008;63(1):54–63. http://dx.doi.org/10.1111/j.1365-2648.2008.04652.x.Article PubMed
30. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41. http://dx.doi.org/10.1207/s15327752jpa5201_2.Article

Figure 1

Conceptual framework based on Wilson & Cleary's conceptual model.

Figure 2

Path diagram for the modified model.

Table 1

Descriptive Statistics of Observed Variables (N=201)

Table 2

Model Fitness of Hypothetical Model and Modified Model

χ²=Chi square; df=degree of freedom; GFI=Goodness fit index; TLI=Tucker-lewis index; CFI=Comparative fit index; RMSEA=Root-mean square error of approximation; AIC=Akaike information criterion.

Table 3

Effects of Exogenous Variables in the Modified Model

β=Standardized regression weight; C.R.=Critical ratio; SMC=Squared multiple correlation (R²).

^*p<.05; ^**p<.01.

Figure & Data

REFERENCES

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Correlation between Sleep Disorders and Sleepy Drivers
Ki-Bong Kim, Hyun-Ho Sung, Sang-Nam Park, Bok-Jo Kim, Chang-Eun Park
Korean Journal of Clinical Laboratory Science.2015; 47(4): 216. CrossRef

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Structural Equation Modeling On Health-related Quality of Life in Patients with Obstructive Sleep Apnea

J Korean Acad Nurs. 2013;43(1):81-90. Published online February 28, 2013

DOI: https://doi.org/10.4040/jkan.2013.43.1.81

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Structural Equation Modeling On Health-related Quality of Life in Patients with Obstructive Sleep Apnea

Figure 1 Conceptual framework based on Wilson & Cleary's conceptual model.

Figure 2 Path diagram for the modified model.

Figure 1

Figure 2

Structural Equation Modeling On Health-related Quality of Life in Patients with Obstructive Sleep Apnea

Table 1

Descriptive Statistics of Observed Variables (N=201)

Table 2

Model Fitness of Hypothetical Model and Modified Model

χ²=Chi square; df=degree of freedom; GFI=Goodness fit index; TLI=Tucker-lewis index; CFI=Comparative fit index; RMSEA=Root-mean square error of approximation; AIC=Akaike information criterion.

Table 3

Effects of Exogenous Variables in the Modified Model

β=Standardized regression weight; C.R.=Critical ratio; SMC=Squared multiple correlation (R²).

^*p<.05; ^**p<.01.

Table 1 Descriptive Statistics of Observed Variables (N=201)

Table 2 Model Fitness of Hypothetical Model and Modified Model

χ²=Chi square; df=degree of freedom; GFI=Goodness fit index; TLI=Tucker-lewis index; CFI=Comparative fit index; RMSEA=Root-mean square error of approximation; AIC=Akaike information criterion.

Table 3 Effects of Exogenous Variables in the Modified Model

β=Standardized regression weight; C.R.=Critical ratio; SMC=Squared multiple correlation (R²).

^*p<.05; ^**p<.01.