Health-related Quality of Life in Multimorbid Adults: A Random Forest Cross-sectional Analysis of the Korean National Health and Nutrition Examination Survey.

Purpose: This study aimed to identify predictors of health-related quality of life (HRQoL) among adults with multimorbidity using Andersen's behavioral model and to develop a predictive model with a random forest(RF) algorithm. Methods: We conducted a secondary cross-sectional analysis of the 2019-2...

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Publicado en:Journal of Korean Academy of Psychiatric & Mental Health Nursing (JKPMHN) Vol. 34; no. 3; pp. 349 - 360
Autores principales: You, Moonchang, Kim, Geun-Myun
Formato: research tables/charts Journal Article
Publicado: Korean Academy of Psychiatric & Mental Health Nursing Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
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      pub: Korean Academy of Psychiatric & Mental Health Nursing
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        10.12934/jkpmhn.2025.34.3.349
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        atl: Health-related Quality of Life in Multimorbid Adults: A Random Forest Cross-sectional Analysis of the Korean National Health and Nutrition Examination Survey.
      aug:
        au:
          You, Moonchang
          Kim, Geun-Myun
        affil: Graduate Student, Department of Nursing, Gangneung-Wonju National University, Wonju, Korea
      sug:
        subj:
          Quality of Life In Adulthood
          Health Status
          Comorbidity In Adulthood
          Theory Construction
          Health Behavior
          Prediction Models
          Random Forest
          Machine Learning Algorithms
          Risk Assessment
          South Korea
          Human
          Secondary Analysis
          Cross Sectional Studies
          Questionnaires
          Descriptive Statistics
          Decision Trees
          Confidence Intervals
          Middle Age
          Aged
          Male
          Female
          Educational Status
          Marital Status
          Economic Status
          Insurance, Health
          Employment Status
          Body Image
          Counseling
          Health Resource Utilization
          Exercise Intensity
          Age Factors
          Adult
          Conceptual Framework
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: This study aimed to identify predictors of health-related quality of life (HRQoL) among adults with multimorbidity using Andersen's behavioral model and to develop a predictive model with a random forest(RF) algorithm. Methods: We conducted a secondary cross-sectional analysis of the 2019-2020 Korea National Health and Nutrition Examination Survey (KNHANES) including 858 adults with two or more chronic conditions. Predictors were grouped as predisposing, enabling, need, and health-behavior factors. HRQoL was measured with the EuroQol five-dimension index (EQ5D) value based on the Korean tariff. Model performance was evaluated using mean absolute error, root mean squared error, and the coefficient of determination. Variable importance and Shapley additive explanations (SHAP) were used for interpretation. Results: The mean HRQoL was 0.90 (standard deviation 0.14). The model achieved a mean absolute error of 0.08 and a coefficient of determination of 0.15. The strongest predictors were subjective health status, days of walking per week, age, monthly income, and private medical insurance; Shapley analyses confirmed their direction and relative influence. Conclusion: Andersen's model provided a coherent framework to interpret determinants of HRQoL in multimorbidity. The findings support routine assessment of subjective health, promotion of walking, and resource linkage for older adults and individuals with limited socioeconomic resources. Interpretable machine learning may aid early risk stratification and tailored nursing interventions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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