Health-related quality of life for older patients with chronic low back pain: A structural equation modeling study

This study aimed to develop and validate a structural equation model for health-related quality of life in older patients with chronic low back pain.

We selected social support, symptoms, fear-avoidance beliefs, functional disability, health perception, and health-related quality of life as the main variables based on Wilson and Cleary's model of health-related quality of life. A total of 211 participants aged ≥65 years who had been diagnosed with low back pain for more than three months were considered in this study. Data were collected from two hospitals in D Metropolitan City and A City, one public health center, and two senior citizen centers. We utilized SPSS/WIN 24.0 and R package 'plspm' (R Version 3.1.3) for data analysis.

The overall fit of the proposed hypothesized model was .53, which met the acceptable threshold, confirming the adequacy of the model's fit. Social support, symptoms, fear-avoidance beliefs, functional disability, and health perception were statistically significant variables in the health-related quality of life, and the explanatory power of these variables was 75.1%. Out of the 15 hypotheses in the model, 13 hypotheses were supported.

The model showed 12 significant direct effects, one significant indirect effect, and 13 significant total effects (both direct and indirect). To enhance the health-related quality of life in older patients with chronic low back pain, alleviating fear-avoidance beliefs and functional disability is necessary and improving positive social resources such as social support and health perception is essential.