Influencing factors and mechanisms of health-related quality of life of elderly patients with chronic diseases in rural China: a cross-sectional study

Background The study aimed to understand the factors influencing health-related quality of life (HRQOL) and the intricate biological, psychological, and social processes that underlie it in elderly chronic disease patients in rural China. To do this, structural equation model(SEM) was utilized to construct a model based on the Wilson and Cleary model. Methods In this cross-sectional study, 1145 senior individuals with chronic illnesses from three cities in Anhui Province, China were chosen by a multi-stage random sampling procedure. Households were surveyed face-to-face using the following instruments: the five-level version of the European Five Dimensional Health Scale (EQ-5D-5L), Generalized Anxiety Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), Social Support Rating Scale (SSRS), Pittsburgh Sleep Quality Index (PSQI), Chinese Version of the elderly Kihon Checklist (KCL), and a self-designed questionnaire on vision conditions. Results This study identified 13 individual and environmental characteristics associated with HRQOL in rural elderly patients with chronic diseases, including gender, age, education, working status, main economic source, drinking, roughage, labor intensity, siesta, social support, marital status, and dwelling status, as well as the directional pathways of action of these factors affecting HRQOL, which included 26 indirect and 6 direct pathways. Conclusions This study adds to the body of knowledge on HRQOL and advances our comprehension of the potentially intricate biological and psychological processes that influence HRQOL in older individuals with chronic diseases by revealing the influencing factors and directed pathways of action on HRQOL. Providing timely and personalized therapies to address these causes and processes may eventually improve their HRQOL.