Health-related quality of life for older patients with chronic low back pain: A structural equation modeling study.

Purpose: This study aimed to develop and validate a structural equation model for health-related quality of life in older patients with chronic low back pain. Methods: We selected social support, symptoms, fear-avoidance beliefs, functional disability, health perception, and health-related quality of life as the main variables based on Wilson and Cleary's model of health-related quality of life. A total of 211 participants aged ≥65 years who had been diagnosed with low back pain for more than three months were considered in this study. Data were collected from two hospitals in D Metropolitan City and A City, one public health center, and two senior citizen centers. We utilized SPSS/WIN 24.0 and R package 'plspm' (R Version 3.1.3) for data analysis. Results: The overall fit of the proposed hypothesized model was .53, which met the acceptable threshold, confirming the adequacy of the model's fit. Social support, symptoms, fear-avoidance beliefs, functional disability, and health perception were statistically significant variables in the health-related quality of life, and the explanatory power of these variables was 75.1%. Out of the 15 hypotheses in the model, 13 hypotheses were supported. Conclusion: The model showed 12 significant direct effects, one significant indirect effect, and 13 significant total effects (both direct and indirect). To enhance the health-related quality of life in older patients with chronic low back pain, alleviating fear-avoidance beliefs and functional disability is necessary and improving positive social resources such as social support and health perception is essential.