Application and Validation of the PRECEDE Model for Measuring the Quality of Life of the People with Physical Disabilities

Abstract

Background: This study aimed to diagnose the quality of life of people with disabilities through social, epidemiological, behavioural, educational, and ecological factors based on the Predisposing, Reinforcing, and Enabling Causes in Educational Diagnosis and Evaluation (PRECEDE) diagnostic model. Methods: Using the systematic stratified cluster sampling method, 605 people with disabilities from five districts (Seoul, Gyeonggi, Chungcheong, Jeolla, and Gyeongsang) who were registered at the welfare centres in 2019 were recruited. In addition, the study participants were limited to grades 1 to 4 with disabilities, and those with physical disabilities who did not have intellectual disabilities. The final model’s goodness of fit was found to be good (χ2 = 554.257 (p < 0.001), Tucker Lewis Index (TLI) = 0.921, comparative fit index (CFI) = 0.939, root mean square error of approximation (RMSEA) = 0.059). Results: The finding demonstrated that physical self-efficacy and social support, excluding the health promotion behavioural intention, were found to have a statistically significant effect. The behavioural factor was found to have a statistically significant effect on the epidemiological and the social factor. The former was also found to have a statistically significant effect on the latter. The results for each group according to gender were the same as for the integrated group in the case of men. In the case of women, it was found that there was a direct effect on the promotion behavior and health status, the promotion behavior and the quality of life, and all other pathways were found to be statistically insignificant. Conclusions: This research demonstrated that it is important to increase the sense of efficacy and social support for enhancing the quality of life of the physically disabled. Moreover, their health promotion behaviour had a positive effect on their health status and quality of life. This evidence could be used as data for establishing an efficient system for improving their quality of life.