Title : Assessing the Quality of Life of People with Chronic Diseases in a Selected Community of Ambala

 Assessing the Quality of Life of People with Chronic Diseases in a Selected Community of Ambala (Haryana)

 

Abstract

Chronic diseases may not kill but they consume a lot of health care resources and threaten the quality of life of the sufferers. The present study was undertaken to assess the Quality of life of people with chronic diseases. Sample comprised of 160 subjects with chronic diseases in a selected community of Ambala, Haryana and was selected using purposive sampling technique. Subject data sheet and WHOQOL-BREF Questionnaire were used to collect data. Study findings show that 51.25 percent people with chronic diseases had fair quality of life, 46.87 percent had poor quality of life and 1.87 percent had good quality of life. Based on these findings, it has been concluded that as more than half of the subjects had fair quality of life, nurses must plan some strategies in order to improve the quality of life of people with chronic diseases.

 

In recent decades chronic diseases have emerged as the major cluster of health concerns worldwide. Chronic conditions are slow in progression, long in duration and void of spontaneous resolution and it often limits the functional productivity and quality of life of those living with them. These diseases may or may not contribute significantly to mortality but can severely impact the quality of life of individuals who live with them. India is currently facing an uncertain future in relation to the potential burden that chronic diseases such as diabetes mellitus and Hypertension may impose upon the country. Many factors affect the prevalence of disease throughout the country, and identification of those factors is necessary to address these challenges as well as promote health and quality of life.

A quality of life (QOL) assessment is of great importance for patients with chronic diseases, because problems caused by specific diseases impact specific area of their lives. Nurses are involved in all stages of care and spend more time with patients than any other health care providers. Thus, this study was an initiative to assess the quality of life of people with chronic diseases such as diabetes mellitus and Hypertension as by assessing the quality of life of people, various strategies can be planned by nurses (if required) to improve quality of life of their patients.

 

Objectives 

The study comprised of following objectives:

1.      1.  To assess the quality of life of people with chronic diseases.

2.      2.  To find the association of level of quality of life of people having chronic disease with selected de-mographic and clinical variables.

 

Literature Review

cross-sectional study on diabetes-dependent quality of life among 285 older patients with diabetes mellitus was carried out in Slovenia. Results of the study show negative impact of diabetes on QOL among 96.1 percent patients whereas 3.9 percent patients re-ported no impact of diabetes on their QOL.

Another study was conducted to assess the quality of life of patients with type 2 diabetes mellitus in Oman. Data was collected from 200 diabetic subjects using diabetes quality of life questionnaire (DQOL). Results of the study demonstrated that patients with diabetes had moderate quality of life which appears to be related to demographics, medical history, and management regimens.

A systematic review and meta-analysis of 20 obser-vational studies regarding health-related quality of life of hypertensive clients identified lower quality of life in patients with hypertension. The meta-analy-sis identified lower scores in hypertensive patients for physical [-2.43; 95% confidence interval (CI) -4.77 to -0.08] and mental (-1.68; 95% CI -2.14 to -1.23) components. Quality of life was lower in the eight domains of the SF-36: physical and functional func-tioning, role physical and emotional, bodily pain, gen-eral health, vitality and mental health. Quality of life of individuals with hypertension was slightly worse than that of normotensive individuals.

Methodology

Research approach adopted in the present study was quantitative non-experimental research approach, while research design was descriptive type. The study setting was Singhpura village of Ambala, Haryana; the sample consisted of 160 people with chronic diseases living of Singhpura village, Ambala, Haryana. The sampling technique used was purposive sampling technique. Sample selection criteria: People with chronic diseases having diabetes mellitus, hypertension or both, above the age of 20 years, who could understand Hindi, present at the time of data collection and willing to participate in the study were included.

Data collection tools & techniques

1. Subject data sheet consisted of age, sex, education status, religion, marital status oc-cupation, dietary habits, types of family, monthly income, average sleep, daily activi-ties, disease, duration of disease, medicine and presence of acute illness.

2. World Health Organisation Quality of Life-WHOQOL - BREF questionnaire to assess the quality of life of people with chronic diseases. It is a standardised tool consisting various domains such as general, physical, psycho-logical, social and environment health do-main. The reliability of tool was 0.70 as as-sessed by Cronbach’s alpha method. Pilot study was done earlier on 16 subjects to as-sess the feasibility of the study.

Results and Discussion

The collected data was analysed and inter-preted in accordance with objectives using inferential and descriptive statistics (Table 1).

The data presented in Table 2 indi-cates that 51.25 percent of the subjects were having fair quality of life, 46.87 percent of the subjects were having poor quality of life and 1.87 percent of the subjects were having good quality of life.

The data in Table 3 indicates that mean, median and range of overall quality of life of people with chronic diseases was 76.9, ±9.1, 76 and 54 – 108 respectively.

Table 4 shows that domain wise also most of the subjects were having fair quality of life.

 

Association of quality of life of people having chronic diseases with selected demographic and clinical variables such as age, sex, education, re-ligion, marital status, occupation, dietary habits, type of family, family income, average sleep, daily activities, disease, duration of diseases, medicine, presence of acute illness depicts no association be-tween them as assessed by Chi-square test at p≤ 0.05 level of significance.

 

Table-1 Frequency and percentage distribution of people having chronic diseases based on demographic and clinical variables (n=160)

Table-2 Frequency and percentage distribution of people having chronic diseases based on overall quality of life (n=160)

 

Table-3 Mean median SD and range of overall quality of life of people of with chronic diseases (n=160)

 

 

 

Table-4 Frequency and percentage distribution of level of quality life of …

 

Discussion

In present study, findings related to quality of life of patients with chronic diseases revealed that more than half of the subjects (51.25%) were having fair quality of life. These findings were similar to the systematic review conducted by Kiadaliri et al (2013) in-cluding 46 identified studies examining HR QOL among the Iranian patients with diabetes. The findings of the review showed that generally people with diabetes had worse HR QOL than their healthy counterparts.

46.87 percent people with chronic diseases had poor quality of life. These findings were in line with the study done by Al-Maskari et al (2011) to measure quality of life of type 2 diabetes patients in Oman, which suggested that moderate diabetic quality of life was reported by patients.

In present study, it was found out that there is no association found between levels of quality of life with selected demographic and clinical variables such as age, sex, education, cigarettes smoked, activity etc. These findings are in contrast to the study done by Khalifeh et al (2015) to assess the impact on health-related quality of life of hypertension in the adults in Lebanon. The finding of the study shows that quality of life significantly decreases with older age, female, lower education, and cigarettes smoked daily; regular sport activity significantly increased quality of life. Possible explanation for this mismatch in the results could be different setting with limited sample size.

Implications 

Nursing Administration

The nurse administrators are in a key position to prepare policies and procedure to provide quality care. Efforts should be made by the administration to assess the quality of life of an individual including various aspects of health such as physical, psychological, social, environmental etc.

Nursing Practice

Nurses should assess the quality of life of patients with chronic diseases admitted in the hospital or residing in the community area, on regular basis and take necessary steps to improve the quality of life of their patients.

Nursing Education

Nursing students must be taught to assess the quality of life of life of people having chronic diseases in their curriculum. During in-service education programmes, nurses should be encouraged to assess their patients having chronic disease for quality of life.

Recommendations

1. The study can be replicated on a large sample in other settings to validate the finding and make generalisation.

2. Some interventions-based studies can be done to improve the quality of life of people with chronic diseases.

3. A correlation survey can be conducted to assess the quality of life for chronic ill patients in rural and urban areas.

4. A study can be done to compare quality of life be-tween normal population and chronic ill patients.

 

Conclusion

Based on the study findings, it has been concluded that as more than half of the subjects had fair quality of life, nurses must plan some strategies in order to improve the quality of life of people with chronic diseases.

 

References

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Turk E, Rupel VP, Tapajner A, Leyshon S, Isola A. An audit of diabetes dependent quality of life in older patients with dia-betes mellitus type 2 in Slovenia. Value in Health Regional Issues 2013; 2: 248-53

Al-Maskari MY, Al-Shookri AO, Al-Adawi SH, Lin KG. Assess-ment of quality of life in patients with type 2 diabetes melli-tus in Oman. Saudi Med J 2011; 32(12): 1285-90

Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD. Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens 2011; 29 (2):179-88

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Khalifeh M, Salameh P, Hajje AA, Awada S, Rachidi S, Bawab W. Hypertension in the Lebanese adults: Impact on health related quality of life. Journal of epidemiology and Global Health 2015; 5(4): 327-36

 

Authors: Tarika Sharma, Manpreet Sharma

(Both the authors are Assistant Professor, at MM College of Nursing, MMU, Ambala, Haryana)

Source: TNAI-Journal