Pathways Through Which Experience in Treatment Decision-Making Affects Health-Related Quality of Life in People with Chronic Conditions

Abstract

Patient engagement in treatment decision-making is essential to improve the health-related quality of life (HRQoL) of patients affected by chronic diseases. However, research on how decision-making patterns influence HRQoL is limited. This study investigated the paths linking patient experience in decision-making to HRQoL through healthcare accessibility and physical activity among a representative sample of adults with chronic diseases. Using a cross-sectional design, the data of 4,071 individuals with chronic diseases from the 2015 Korea National Health and Nutrition Examination Survey were analyzed. We used R to account for the complex survey design and weights and conducted structural equation modeling. The EuroQoL 5 Dimensions were used to assess HRQoL. About half of the participants reported that providers always offered sufficient encounter time (48.8%), used lay terms (60.4%), provided opportunities for questions (57.8%), and reflected patient opinions on treatment plans (57.8%). Healthcare accessibility completely mediated the association between patient experience in decision-making and HRQoL, whereas decision-making experiences directly affected HRQoL, not via physical activity. Clinicians should provide solid and tailored advice that entails benefits and detriments to achieve evidence-based decision-making. Programs to enhance access to after-hour healthcare should be considered to improve patients’ HRQoL.

Acknowledgments

This work was supported by the grants from Korea University Nursing Research Institute.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10810730.2023.2222706

Data availability statement

The data that support the findings of this study are available at https://knhanes.kdca.go.kr/knhanes/sub03/sub03_02_05.do, reference (Korea Disease Control and Prevention Agency, 2022).

Author Contributions

All authors contributed to the conception and design of this study. KK conceived the original idea, made substantial contributions to the analysis and wrote the draft. JP made substantial contributions to the acquisition and interpretation of the data and drafted the manuscript. JL made substantial contributions to the analysis and interpretation of data and wrote the draft. All authors have read and approved the submitted version of the manuscript.

Statement of Ethical Approval

This study was exempted from review by the institutional review board.

Additional information

Funding

The work was supported by the Korea University Nursing Research Institute.