Factors affecting quality of life in low-income overweight and obese women: The mediating effects of health-promoting behaviors

Background: It is necessary to comprehensively consider the personal and environmental factors of women who experience overweight or obesity and low-income households (WOOL) to improve their quality of life (QoL). Aims: The aim of this study was to test a hypothetical path model to estimate the effects of self-efficacy, psychological distress, social support, and health-promoting behaviors (HPB) on QoL and verify the mediating effects of HPB among WOOL. Methods: A total of 151 women with a monthly household income less than 50% of the national median income at eight welfare centers in South Korea participated in this study. Data were collected from January to December 2019 and analyzed using SPSS 25.0 and Amos 23.0. Results: The fit indices of the model were adequate (χ² = 0.197, p =.657; normed χ² = 0.197, GFI = 0.999, CFI = 1.000, NFI = 0.999, TLI = 1.000, RMSEA = 0.000, and SRMR = 0.005). Self-efficacy had significant indirect and total effects on QoL (β = 0.064, p =.004, 95% CI [0.015, 0.139]; β = 0.064, p =.004, 95% CI [0.015, 0.139]). HPB completely mediated the path of self-efficacy to QoL. Social support had significant total, direct, indirect, and total effects on QoL (β = 0.326, p =.001, 95% CI [0.010, 0.025]; β = 0.047, p =.015, 95% CI [0.008, 0.120]; β = 0.373, p =.001, 95% CI [0.015, 0.369]). HPB partially mediated the path of social support to QoL. Psychological distress had significant direct effects on QoL (β = −0.307, p =.001, 95% CI [−0.022, −0.007]). Self-efficacy, psychological distress, social support, and HPB explained 42.3% of the total variance in QoL. Linking Evidence to Action: Integrated nursing interventions that consider self-efficacy, psychological distress, social stress, and HPB can be useful for improving the QoL of WOOL.