Skip Navigation
Skip to contents

RCPHN : Research in Community and Public Health Nursing

OPEN ACCESS
SEARCH
Search

Articles

Page Path
HOME > J Korean Acad Community Health Nurs > Volume 26(3); 2015 > Article
Original Article
Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community
Suyeon Kim, Jina Choo
Journal of Korean Academy of Community Health Nursing 2015;26(3):292-302.
DOI: https://doi.org/10.12799/jkachn.2015.26.3.292
Published online: September 30, 2015

College of Nursing, Korea University, Seoul, Korea.

• Received: April 27, 2015   • Revised: September 16, 2015   • Accepted: September 23, 2015

© 2015 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

prev next
  • 1,185 Views
  • 8 Download
  • 8 Crossref
  • Purpose
    The purpose of this study was to examine the association between health behaviors and health-related quality of life (HRQOL) among vulnerable children in a community.
  • Methods
    Using data from 'The Obesity Prevention Framework for Vulnerable Children', a secondary analysis was conducted for 165 children (ages 8~12 years) and their parents who were recruited from 16 K-gu Community Child Centers in Seoul. Six types of health behaviors related to eating and activity were assessed. Each behavior was categorized into the non-recommended vs. recommended levels. The scores of the recommended levels of the six health behaviors were summed up for the composite score of health behaviors. HRQOL was measured by KIDSCREEN-52.
  • Results
    The groups with a non-recommended level of fast food intake and sedentary behavior had a significantly lower total score of KIDSCREEN-52 than those with a recommended level. Moreover, the lower composite score of health behaviors was significantly associated with the lower total score of KIDSCREEN-52.
  • Conclusion
    Among the vulnerable children, the six recommended health behaviors and their composite score were in significant positive associations with the HRQOL levels. Therefore, nursing strategies for enhancing the recommended levels of health behaviors are needed for vulnerable children.
Figure 1

Percentages of recommended vs. non-recommended health behaviors.

jkachn-26-292-g001.jpg
Figure 2

Distribution of the composite scores of health behaviors.

jkachn-26-292-g002.jpg
Figure 3

Levels of health-related quality of life as measured by KIDSCREEN-52.

jkachn-26-292-g003.jpg
Table 1

Sociodemographic Characteristics among Vulnerable Children and their Parents (N=165)

Variables Characteristics Categories N n (%) M±SD
Children's characteristics Age (year) 165 9.8±1.26
Girls 165 84 (50.9)
Family type Two parents family 165 107 (64.9)
One parent family 56 (33.9)
Grandparents family 2 (1.2)
Perceived economic status Very low 165 2 (1.2)
Low 13 (7.9)
Moderate 97 (58.8)
High 45 (27.3)
Very high 8 (4.8)
Academic achievement Very low 165 12 (7.3)
Low 20 (12.1)
Moderate 82 (49.7)
High 41 (24.8)
Very high 10 (6.1)
Having many friends Yes 165 132 (80.0)
No 33 (20.0)
Self-rated health Poor 165 6 (3.6)
Fair 12 (7.3)
Good 88 (53.3)
Very good 33 (20.0)
Excellent 26 (15.8)
Illness Yes 152 42 (27.6)
No 110 (72.4)
Parents' characteristics Mothers' age (year) 140 41.3±5.46
Mothers' education Elementary school 140 7 (5.0)
Middle school 12 (8.5)
High school 89 (63.6)
≥College 32 (22.9)
Fathers' age (year) 144 43.7±5.86
Fathers' education Elementary school 146 3 (2.1)
Middle school 19 (13.0)
High school 91 (62.3)
≥College 33 (22.6)
Marital status Married 148 85 (57.4)
Separated 14 (9.5)
Widowed 4 (2.7)
Divorced 45 (30.4)
Monthly household income (10,000 won) ≤100 152 35 (23.0)
101~200 82 (53.9)
201~300 21 (13.8)
301~400 12 (7.9)
401~500 2 (1.4)
≥501 0 (0.0)
Employed Yes 151 112 (74.2)
No 39 (25.8)
Coverage of health insurance Company health insurance 152 48 (31.6)
Local health insurance 59 (38.8)
Medical aid/none 45 (29.6)
Religion Yes 152 99 (65.1)
No 53 (34.9)
Table 2

Associations between Health Behaviors and HRQOL among Vulnerable Children (N=165)

Variables Eating behaviors Activity behaviors Composite scores of health behaviors
Fast food Sweetened beverage Fruits & vegetables Breakfast Sweated activity Sedentary behavior
β (SE) β (SE) β (SE) β (SE) β (SE) β (SE) β (SE)
Total -2.82 (1.31)* -2.26 (1.57) 1.25 (1.30) 2.16 (1.35) 3.45 (2.13) -4.35 (1.47)* 1.72 (0.49)*
 Physical well-being -0.48 (1.90) -2.13 (2.25) 2.10 (1.86) 1.28 (1.93) 14.28 (2.80)* -2.77 (2.16) 1.78 (0.71)*
 Psychological well-being -4.16 (2.07)* -3.98 (2.47) 2.51 (2.05) 4.76 (2.12)* 4.14 (3.38) -8.30 (2.29)* 3.16 (0.76)*
 Moods & emotions -2.19 (2.22) -2.04 (2.63) 1.48 (2.18) 3.21 (2.25) 1.53 (3.59) -0.61 (2.55) 1.29 (0.85)
 Social support & peers -2.03 (2.19) 0.17 (2.60) 2.70 (2.14) 2.83 (2.23) 5.17 (3.51) -7.78 (2.41)* 2.31 (0.82)*
 Parent relation & home life -5.87 (1.91)* -4.92 (2.31)* 4.85 (1.89)* 2.07 (1.99) 1.67 (3.20) -6.56 (2.19)* 2.95 (0.70)*
 Self-perception -5.93 (1.77)* -6.68 (2.10)* 0.67 (1.80) -0.66 (1.83) 5.02 (2.94) -2.45 (2.09) 1.88 (0.67)*
 Autonomy -3.17 (1.91) -0.99 (2.28) 0.47 (1.89) 1.91 (1.92) 2.26 (3.10) 5.96 (2.11)* 1.48 (0.72)*
 School environment -4.68 (2.28)* -3.00 (2.73) 0.75 (2.27) 5.54 (2.29)* 2.79 (3.73) -6.50 (2.58)* 2.52 (0.85)*
 Social acceptance (bullying) -1.78 (2.09) -0.35 (2.48) -1.52 (2.05) 1.42 (2.12) 1.17 (3.38) -0.49 (2.39) 0.41 (0.80)
 Financial resources 2.09 (2.07) 1.29 (2.45) -1.49 (2.03) -0.79 (2.08) -3.53 (3.34) -2.06 (2.37) -0.55 (0.78)

HRQOL=health-related quality of life; β=unstandardized coefficients; SE=standard error.

All HRQOL variables were adjusted for age, girls, perceived economic status, academic achievement, having many friends, mothers' education levels, monthly household income, parents' employed status, parents' coverage status of health insurance, and parent-reported children's illness.

*p<.05; Composite scores indicate the sum of recommended levels of six health behaviors[1617].

This article is based on a part of the first author's master's thesis from Korea University.

This study was supported by the Health Promotion Fund, Ministry of Health & Welfare, Republic of Korea(13-8).

  • 1. The Organization for Economic Co-operation and Development. Doing better for families [Internet] Paris: The Organization for Economic Co-operation and Development; 2011;cited 2015 July 29. Available from: http://dx.doi.org/10.1787/9789264098732-en
  • 2. Statistics Korea. 2013 economic and financial data for Korea [Internet] Seoul: Statistics Korea; 2013;cited 2015 July 3. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/4/4/index.board?bmode=read&bSeq=&aSeq=310209&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=
  • 3. Kim HR, Lee SH, Choi JM, Oh YI. Report No.: 2011-07. Children's obesity and underweight among low income families in Korea: Status, implications and policy options. Sejong: Korea Institute for Health and Social Affairs; 2011. 07.
  • 4. Craig LC, McNeill G, Macdiarmid JI, Masson LF, Holmes BA. Dietary patterns of school-age children in Scotland: Association with socioeconomic indicators, physical activity and obesity. Br J Nutr. 2010;103(3):319–334. Article
  • 5. Drenowatz C, Eisenmann JC, Pfeiffer KA, Welk G, Heelan K, Gentile D, et al. Influence of socio-economic status on habitual physical activity and sedentary behavior in 8- to 11-year old children. BMC Public Health. 2010;10(1):214.ArticlePubMedPMCPDF
  • 6. United States Department of Agriculture. Dietary guidelines for Americans 2010 [Internet] Washington, DC: United States Department of Health and Human Services; 2010;cited 2014 April 14. Available from: http://www.cnpp.usda.gov/dgas2010-policydocument.htm
  • 7. Evans DR. Enhancing quality of life in the population at large. Soc Indic Res. 1994;33(1-3):47–88. ArticlePDF
  • 8. The KIDSCREEN Group Europe. The KIDSCREEN Questionnaires-quality of life questionnaires for children and adolescents. Lengerich: Pabst Science Publishers; 2006. p. 231.
  • 9. Mansour ME, Kotagal U, Rose B, Ho M, Brewer D, Roy-Chaudhury A, et al. Health-related quality of life in urban elementary schoolchildren. Pediatrics. 2003;111(6):1372–1381. ArticlePubMedPDF
  • 10. Chen G, Ratcliffe J, Olds T, Magarey A, Jones M, Leslie E. BMI, health behaviors, and quality of life in children and adolescents: A school-based study. Pediatrics. 2014;133(4):e868–e874. ArticlePubMedPDF
  • 11. Wu XY, Ohinmaa A, Veugelers PJ. Diet quality, physical activity, body weight and health-related quality of life among grade 5 students in Canada. Public Health Nutr. 2012;15(1):75–81. ArticlePubMed
  • 12. Dalton WT 3rd, Schetzina KE, Pfortmiller DT, Slawson DL, Frye WS. Health behaviors and health-related quality of life among middle school children in Southern Appalachia: data from the winning with wellness project. J Pediatr Psychol. 2011;36(6):677–686. ArticlePubMed
  • 13. Schlesinger S, Walter J, Hampe J, von Schonfels W, Hinz S, Kuchler T, et al. Lifestyle factors and health-related quality of life in colorectal cancer survivors. Cancer Causes Control. 2014;25(1):99–110. ArticlePubMedPDF
  • 14. Choo J, Kim HJ, Yang HM, Kim S. Report No.: General 13-8. An obesity prevention framework for vulnerable children based on a methodology of community-based participatory research: Using a strategy of training community lay health advisors. Seoul: Korea Health Promotion Foundation; 2013. 11.
  • 15. Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Duer W, et al. KIDSCREEN-52 quality-of-life measure for children and adolescents. Expert Rev Pharmacoecon Outcomes Res. 2005;5(3):353–364. ArticlePubMed
  • 16. Ministry of Health & Welfare. The Korean dietary guidelines for children [Internet] Sejong: Ministry of Health & Welfare; 2009;cited 2015 January 31. Available from: http://www.mw.go.kr/front_new/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=031603&CONT_SEQ=224044&page=1
  • 17. Kvaavik E, Andersen LF, Klepp KI. The stability of soft drinks intake from adolescence to adult age and the association between long-term consumption of soft drinks and lifestyle factors and body weight. Public Health Nutr. 2005;8(2):149–157. ArticlePubMed
  • 18. KIDSCREEN. Questionnaires [internet] Hamburg: Germany; 2011;cited 2014 December 23. Available from: http://www.kidscreen.org/
  • 19. Lee BJ, Kwak GJ, Gu IH, Kim MH, Kim SS, Kim JH, et al. Report No.: 11-1351000-000228-01. A nationwide survey: The status of Korean children and adolescents. Seoul National University Report. Sejong: Ministry of Health & Welfare; 2009. 01.
  • 20. Ministry of Education. Results of 2013 school health examination [Internet] Sejong: Ministry of Education; 2013;cited 2015 January 31. Available from: http://www.moe.go.kr/web/45859/ko/board/view.do?bbsId=294&boardSeq=52706
  • 21. Dave JM, Evans AE, Pfeiffer KA, Watkins KW, Saunders RP. Correlates of availability and accessibility of fruits and vegetables in homes of low-income hispanic families. Health Educ Res. 2010;25(1):97–108. ArticlePubMed
  • 22. Lee HY, Park YG, You SR, Jung SW, Ko JW. Report No.: 12-R09. Report of longitudinal analysis III: Socially disadvantaged children and adolescents. Sejong: National Youth Policy Institute; 2012. 12.
  • 23. Morales PF, Sanchez-Lopez M, Moya-Martinez P, Garcia-Prieto JC, Martinez-Andres M, Garcia NL, et al. Health-related quality of life, obesity, and fitness in schoolchildren: The cuenca study. Qual Life Res. 2013;22(7):1515–1523. ArticlePubMedPDF
  • 24. Young EM, Fors SW, Hayes DM. Associations between perceived parent behaviors and middle school student fruit and vegetable consumption. J Nutr Educ Behav. 2004;36(1):2–8. ArticlePubMed
  • 25. Chen X, Sekine M, Hamanishi S, Wang H, Gaina A, Yamagami T, et al. Lifestyles and health-related quality of life in Japanese school children: A cross-sectional study. Prev Med. 2005;40(6):668–678. ArticlePubMed
  • 26. June KJ, Kim JY, Park SM, Lee JY. Breakfast skipping and related factors in children in poverty. J Korean Acad Community Health Nurs. 2011;22(2):204–211. Article
  • 27. World Health Organization. Global health risks [Internet] Geneva: World Health Organization; 2009;cited 2015 January 31. Available from:http://www.who.int/healthinfo/global_burden_disease/global_health_risks/en/
  • 28. Mathers M, Canterford L, Olds T, Hesketh K, Ridley K, Wake M. Electronic media use and adolescent health and well-being: Cross-sectional community study. Acad Pediatr. 2009;9(5):307–314. ArticlePubMed
  • 29. Syväoja HJ, Kantomaa MT, Ahonen T, Hakonen H, Kankaanpää A, Tammelin TH. Physical activity, sedentary behavior, and academic performance in Finnish children. Med Sci Sports Exerc. 2013;45(11):2098–2104. ArticlePubMed
  • 30. Kwon YH, Kim CN. The relationship between computer game addiction and the impulsiveness, aggression, and emotional intelligence of elementary school students. J Korean Community Nurs. 2004;15(3):460–470.

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Effects of Multidisciplinary Health Promotion Program Among Children in Community Childcare Center
      Yerin Kim, Gyeong Seob Shin, Jungwon Park, Minji Kang, Kumhee Son, Yoon Myung Kim, Kyung Hee Park, Hyunjung Lim
      Clinical Nutrition Research.2024; 13(1): 8.     CrossRef
    • Diet-Related Disparities and Childcare Food Environments for Vulnerable Children in South Korea: A Mixed-Methods Study
      Jiyoung Park, Seolhyang Baek, Gahui Hwang, Chongwon Park, Sein Hwang
      Nutrients.2023; 15(8): 1940.     CrossRef
    • Development of Forest-based Health Promotion Program forVulnerable School Children
      Kyung-Sook Bang, Sungjae Kim, Min Kyung Song, KyungIm Kang, Yeseul Jeong
      Perspectives in Nursing Science.2020; 17(1): 1.     CrossRef
    • Factors Affecting Health Behaviors in Late School-aged Children from Multicultural Families
      Sangmi Lee
      Child Health Nursing Research.2020; 26(1): 23.     CrossRef
    • A Systematic Review of Interventions with Low-Income School-Age Children and Adolescents
      Ji-hye Hwang, HyunJee Choi, Hyo Jin Jeong, Chorong Kim, YunJung Woo
      Perspectives in Nursing Science.2018; 15(2): 92.     CrossRef
    • The Differences in Obesity Rates According to Status of Co-Residence with Their Parents in Korean Adolescents: The Implication of the Gender of Single Parent Living with Adolescents
      Nahee Kim, Young Gyu Cho, Jae-Heon Kang, Hyun Ah Park, Kyoungwoo Kim, Yang-Im Hur, Duho Kwon
      Korean Journal of Health Promotion.2018; 18(4): 177.     CrossRef
    • Ecological factors associated with behavioral problems in vulnerable children
      Jina Choo, Hye‐Jin Kim, Melanie T. Turk, Eun‐Kyung Kim, Kyung‐Sook Yang
      Japan Journal of Nursing Science.2017; 14(3): 205.     CrossRef
    • Ecological predictors of health-related quality of life (HRQoL) among children from low-income families in South Korea
      Jiyoung Park, Suyon Baek
      Children and Youth Services Review.2017; 81: 238.     CrossRef

    • PubReader PubReader
    • Cite
      CITE
      export Copy
      Close
    • XML DownloadXML Download
    Figure
    • 0
    • 1
    • 2
    We recommend
    Related articles
    Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community
    Image Image Image
    Figure 1 Percentages of recommended vs. non-recommended health behaviors.
    Figure 2 Distribution of the composite scores of health behaviors.
    Figure 3 Levels of health-related quality of life as measured by KIDSCREEN-52.
    Health Behaviors and Health-related Quality of Life among Vulnerable Children in a Community
    Variables Characteristics Categories N n (%) M±SD
    Children's characteristics Age (year) 165 9.8±1.26
    Girls 165 84 (50.9)
    Family type Two parents family 165 107 (64.9)
    One parent family 56 (33.9)
    Grandparents family 2 (1.2)
    Perceived economic status Very low 165 2 (1.2)
    Low 13 (7.9)
    Moderate 97 (58.8)
    High 45 (27.3)
    Very high 8 (4.8)
    Academic achievement Very low 165 12 (7.3)
    Low 20 (12.1)
    Moderate 82 (49.7)
    High 41 (24.8)
    Very high 10 (6.1)
    Having many friends Yes 165 132 (80.0)
    No 33 (20.0)
    Self-rated health Poor 165 6 (3.6)
    Fair 12 (7.3)
    Good 88 (53.3)
    Very good 33 (20.0)
    Excellent 26 (15.8)
    Illness Yes 152 42 (27.6)
    No 110 (72.4)
    Parents' characteristics Mothers' age (year) 140 41.3±5.46
    Mothers' education Elementary school 140 7 (5.0)
    Middle school 12 (8.5)
    High school 89 (63.6)
    ≥College 32 (22.9)
    Fathers' age (year) 144 43.7±5.86
    Fathers' education Elementary school 146 3 (2.1)
    Middle school 19 (13.0)
    High school 91 (62.3)
    ≥College 33 (22.6)
    Marital status Married 148 85 (57.4)
    Separated 14 (9.5)
    Widowed 4 (2.7)
    Divorced 45 (30.4)
    Monthly household income (10,000 won) ≤100 152 35 (23.0)
    101~200 82 (53.9)
    201~300 21 (13.8)
    301~400 12 (7.9)
    401~500 2 (1.4)
    ≥501 0 (0.0)
    Employed Yes 151 112 (74.2)
    No 39 (25.8)
    Coverage of health insurance Company health insurance 152 48 (31.6)
    Local health insurance 59 (38.8)
    Medical aid/none 45 (29.6)
    Religion Yes 152 99 (65.1)
    No 53 (34.9)
    Variables Eating behaviors Activity behaviors Composite scores of health behaviors
    Fast food Sweetened beverage Fruits & vegetables Breakfast Sweated activity Sedentary behavior
    β (SE) β (SE) β (SE) β (SE) β (SE) β (SE) β (SE)
    Total -2.82 (1.31)* -2.26 (1.57) 1.25 (1.30) 2.16 (1.35) 3.45 (2.13) -4.35 (1.47)* 1.72 (0.49)*
     Physical well-being -0.48 (1.90) -2.13 (2.25) 2.10 (1.86) 1.28 (1.93) 14.28 (2.80)* -2.77 (2.16) 1.78 (0.71)*
     Psychological well-being -4.16 (2.07)* -3.98 (2.47) 2.51 (2.05) 4.76 (2.12)* 4.14 (3.38) -8.30 (2.29)* 3.16 (0.76)*
     Moods & emotions -2.19 (2.22) -2.04 (2.63) 1.48 (2.18) 3.21 (2.25) 1.53 (3.59) -0.61 (2.55) 1.29 (0.85)
     Social support & peers -2.03 (2.19) 0.17 (2.60) 2.70 (2.14) 2.83 (2.23) 5.17 (3.51) -7.78 (2.41)* 2.31 (0.82)*
     Parent relation & home life -5.87 (1.91)* -4.92 (2.31)* 4.85 (1.89)* 2.07 (1.99) 1.67 (3.20) -6.56 (2.19)* 2.95 (0.70)*
     Self-perception -5.93 (1.77)* -6.68 (2.10)* 0.67 (1.80) -0.66 (1.83) 5.02 (2.94) -2.45 (2.09) 1.88 (0.67)*
     Autonomy -3.17 (1.91) -0.99 (2.28) 0.47 (1.89) 1.91 (1.92) 2.26 (3.10) 5.96 (2.11)* 1.48 (0.72)*
     School environment -4.68 (2.28)* -3.00 (2.73) 0.75 (2.27) 5.54 (2.29)* 2.79 (3.73) -6.50 (2.58)* 2.52 (0.85)*
     Social acceptance (bullying) -1.78 (2.09) -0.35 (2.48) -1.52 (2.05) 1.42 (2.12) 1.17 (3.38) -0.49 (2.39) 0.41 (0.80)
     Financial resources 2.09 (2.07) 1.29 (2.45) -1.49 (2.03) -0.79 (2.08) -3.53 (3.34) -2.06 (2.37) -0.55 (0.78)
    Table 1 Sociodemographic Characteristics among Vulnerable Children and their Parents (N=165)

    Table 2 Associations between Health Behaviors and HRQOL among Vulnerable Children (N=165)

    HRQOL=health-related quality of life; β=unstandardized coefficients; SE=standard error.

    All HRQOL variables were adjusted for age, girls, perceived economic status, academic achievement, having many friends, mothers' education levels, monthly household income, parents' employed status, parents' coverage status of health insurance, and parent-reported children's illness.

    *p<.05; Composite scores indicate the sum of recommended levels of six health behaviors[1617].


    RCPHN : Research in Community and Public Health Nursing
    TOP