Prediction model of quality of life using the decision tree model in older adult single-person households: a secondary data analysis

BACKGROUND: Attention is drawn to the subjective health status and quality of life of older adult single-person households, whose number is gradually increasing as factors including low fertility, increased life expectancy, aging, and household miniaturization interact. OBJECTIVE: The study was to identify predictors that affect the quality of life of single-person households aged 65 years or older and living in South Korea. METHODS: A secondary data analysis design was used. Data included physical, mental, social, and demographic characteristics, subjective health status, and quality of life parameters of 1,029 older adult single-person households surveyed by the Korea Health Panel in 2019. For analysis, the predictive model was evaluated using split-sample validation and the ROC curve. The area under the curve after the decision tree analysis was calculated. Final nodes predicting the quality of life of older adult single-person households were derived. RESULTS: Significant predictors were identified in this order: subjective health status, chronic disease, income, and age. Subjective health status was the most important factor influencing quality of life (△ p < 0.001, x(2) = 151.774). The first combination that perceived high quality of life of older adult single-person households was the case of high subjective health status and no chronic disease, followed by the case of high subjective health status, presence of chronic disease, and high income. CONCLUSION: This study confirmed that subjective health status and chronic disease are essential factors for quality of life among the four related indicators of quality of life presented by the OECD. In nursing practice, nurses need to pay attention the factors influencing quality of life of older adult single-person households. Especially, nursing practice for older adult single-person households needs to be focused on improving subjective health status and on relieving chronic disease.