Functional limitation as a mediator of the relationship between multimorbidity on health-related quality of life in Australia: evidence from a national panel mediation analysis

Lee, John Tayu and Ishida, Marie and Haregu, Tilahun and Pati, Sanghamitra and Zhao, Yang and Palladino, Raffaele and Anindya, Kanya and Atun, Rifat and Oldenburg, Brian and Marthias, Tiara (2023) Functional limitation as a mediator of the relationship between multimorbidity on health-related quality of life in Australia: evidence from a national panel mediation analysis. Frontiers in Medicine, 10: 1151310. pp. 1-9. ISSN 2296858X

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Abstract

Objective: The inverse relationships between chronic disease multimorbidity and health-related quality of life (HRQoL) have been well-documented in the literature. However, the mechanism underlying this relationship remains largely unknown. This is the first study to look into the potential role of functional limitation as a mediator in the relationship between multimorbidity and HRQoL. Methods: This study utilized three recent waves of nationally representative longitudinal Household, Income, and Labor Dynamics in Australia (HILDA) surveys from 2009 to 2017 (n = 6,814). A panel mediation analysis was performed to assess the role of functional limitation as a mediator in the relationship between multimorbidity and HRQoL. The natural direct effect (NDE), indirect effect (NIE), marginal total effect (MTE), and percentage mediated were used to calculate the levels of the mediation effect. Results: This study found that functional limitation is a significant mediator in the relationship between multimorbidity and HRQoL. In the logistic regression analysis, the negative impact of multimorbidity on HRQoL was reduced after functional limitation was included in the regression model. In the panel mediation analysis, our results suggested that functional limitation mediated ~27.2 (p < 0.05) of the link between multimorbidity and the composite SF-36 score for HRQoL. Functional limitation also mediated the relationship between the number of chronic conditions and HRQoL for each of the eight SF-36 dimensions, with a proportion mediated ranging from 18.4 to 28.8 (p < 0.05). Conclusion: Functional status has a significant impact on HRQoL in multimorbid patients. Treatment should concentrate on interventions that improve patients' functioning and mitigate the negative effects of multimorbidity. Copyright © 2023 Lee, Ishida, Haregu, Pati, Zhao, Palladino, Anindya, Atun, Oldenburg and Marthias.

Item Type: Article
Additional Information: Cited by: 0; All Open Access, Gold Open Access
Uncontrolled Keywords: adult; anxiety disorder; arthritis; Article; asthma; Australia; chronic bronchitis; controlled study; depression; emotion; emphysema; female; functional status; health status; heart disease; household income; human; hypertension; insulin dependent diabetes mellitus; job market; logistic regression analysis; longitudinal study; major clinical study; male; malignant neoplasm; mediation analysis; mental disease; mental health; middle aged; multiple chronic conditions; non insulin dependent diabetes mellitus; osteoporosis; prevalence; quality of life; Short Form 36; social interaction; social status; socioeconomics; urban area
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Ngesti Gandini
Date Deposited: 16 Aug 2024 04:02
Last Modified: 16 Aug 2024 04:02
URI: https://ir.lib.ugm.ac.id/id/eprint/2794

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