Original Research Article
Year: 2018 | Month: July | Volume: 8 | Issue: 7 | Pages: 245-258
Structural Equation Modeling of Health Related Quality of Life of Lymphatic Filariasis Patients
K. T. Harichandrakumar1, M. Kumaran2
1Department of Medical Biometrics & Informatics (Biostatistics), Jawaharlal Institute of Post Graduate Medical Education & Research (JIPMER), Dhanwantiri Nagar, Pondicherry - 605 006, India.
2Former Course Director, Department of Statistical Sciences, Kannur University, Mangattuparamba Campus, Kannur, Kerala
Corresponding Author: K. T. Harichandrakumar
ABSTRACT
Health Related quality of Life (HRQoL) assess the perceived well being of the individuals in their physical, mental and social well being of their daily life. The items in the HRQoL measures are interrelated and the relationship between them is complex in nature and the domains, which are the constructs of the HRQoL cannot be observed or measured directly. One of the major challenges in the modeling of HRQoL is related to the complexity and collinearities of the relationships among the variables, which cannot be unraveled by standard statistical analysis. Structural Equation Modeling (SEM) is a powerful statistical tool, which combines factor analysis and mathematical modeling to test hypotheses consisting of interacting variables and pathways with reference to substantive theory. The HRQoL of patients with filarial lymphoedema was assessed by using SF-36 and the Structural Equations Model was used to model the HRQoL data. Structural Equation Models consist of two interrelated components, a measurement model and a structural model. The measurement model, which specifies how the latent constructs are indicated by their observed variables, describes these observed variables measurement properties and is analogous to confirmatory factor analysis (CFA). The structural equation model specifies causal relationships among the latent variables, describes their direct and indirect effects, and allocates explained and unexplained variance of the dependent constructs. The present study developed a SEM of HRQoL with 16 indicator/measured variables of SF-36, 4 first order latents, 2 second order latents and one third order latent. This model was developed from the HRQoL data of filarial lymphoedema patients and it is novel in HRQoL among lymphoedema patient in our population. This model is highly useful to understand the inter relationship of the variables related to different health domains in HRQoL and it will help in the planning and implementing a comprehensive morbidity management program to improve the HRQoL in lymphatic filariasis patients.
Key words: Health Related Quality of Life (HRQoL), Lymphatic Filariasis, Structural Equations Model.