O.O. Akinyemi1, E.T. Owoaje1, 2, O.A. Popoola1 and O.S. Ilesanmi1
- Department of Community Medicine, University College Hospital, Ibadan..
- Department of Preventive Medicine and Primary Care, College of Medicine, University of Ibadan.
Background: Quality of life (QoL) is an important measure in the assessment of population well being and health status. However despite locally validated measuring tools, little is known about the quality of life and associated factors in Nigerian adults.
Objective: This study therefore aimed to assess QoL and contributory factors among adults residing in a sub urban Nigerian community.
Methods: A descriptive cross-sectional study of 527 adults, in Oru community was conducted. An interviewer-administered questionnaire adapted from the WHO quality of life (WHOQOLBREF) questionnaire was used to obtain information from respondents. Associations were explored with the chi square test; multivariate analysis was done with logistic regression at 5% level of significance.
Results: Respondents mean age was 33.3 ±8.1 years. In all, 46.5 % were currently married or cohabiting. Christianity was the dominant religion, 72.7%. In all, 81.6% had good QoL. Predictors of good QoL were respondents less than 25 years [OR: 3.5 (1.264- 9.508)], having educational level that is secondary and above [OR: 4.2 (1.810-9.762)]. Being Unemployed [OR: 1.9 (1.099- 3.351)], living in flats and other bigger apartments [OR: 1.8 (1.121- 3.04)], currently ill [OR: 3.7 (2.096- 6.509)], and lack of involvement in religious activities [OR: 3.1 (1.166- 8.045)] were also shown to be predictors of good QoL.
Conclusion: The majority of those evaluated had good QoL. Further surveys involving larger samples sizes are required to explore the QoL in distinct sub-populations and in currently ill patients to strengthen the results of this study.
Keywords: quality of life, Nigeria, health, well-being.
Dr. O. O. Akinyemi
Department of Community Medicine,
University College Hospital,
E mail: firstname.lastname@example.org
Quality of life (QoL) is a term understood differently by workers in many professions for whom it is relevant. According to Costanza et al, “quality of life is the extent to which objective human needs are fulfilled in relation to personal or group perceptions of subjective wellbeing”. 1 QoL cannot be measured by a single variable and has substantial overlap with concepts such as social functioning, disability, social support and well-being.3 Although the subjective nature of the quality of life assessment is regarded as problematic, it is still widely used, mainly to keep research costs low.2
QoL as a measure is important for: planning clinical care of patients; outcome measurement in clinical trials and health services management; health needs assessment of populations in descriptive studies; and for resource allocation and health economics.3 Of all these uses the most important are in health services research and as an outcome measure in clinical trials.4 Health related Quality of Life is used to assess impact of chronic illnesses like cancers and asthma on health status of individuals with such conditions.5-7 However, this definition misses the positive dimensions of well being as well as complexity of what is meant by the terms “perceived”, “subjective” or “evaluation”8-9
Little is known about the factors predictive of quality of life in Nigeria. This study therefore aimed to describe quality of life and factors associated with this in an adult population resident in a sub-urban community in South West Nigeria.
MATERIALS AND METHOD
This study, which was part of a larger one, was a descriptive cross-sectional study of 527 consenting adults, males and females aged 18 years and above who have resided in Oru community for at least one year prior to study. Oru-Ijebu is a semi-urban town located in Ijebu North Local Government Area (LGA) of Ogun State. According to the 2006 national population census, it has a population of 27,000. Sampling was done using a cluster sampling method after four enumeration areas had been randomly selected from the 60 in the town. Each enumeration area has 15-30 houses and about 350-450 people. A survey of adults in the 4 enumeration areas yielded an adequate number of respondents.
The WHO quality of life (WHOQOL-BREF) questionnaire was used to measure physical health, psychological (mental) health, social relationship and relationship with features in their environment as a function of quality of life. This quality of life assessment tool has been validated in Nigeria.6-7, 10-12 The WHOQOL-BREF has 26 items scored on a Likert scale of 1 to 5. Scores were scaled in a positive direction (i.e. higher scores denote higher quality of life). The scoring of negatively phrased questions (3, 4 and 26) were reversed (1=5, 2=4, 3=3, 4=2, 5=1) thus transforming them to positively phrased questions.8 The higher the score on the WHOQOL-BREF, the better the quality of life.10 Scores less than 78, which corresponds to an average response of 3 or below on each item were categorised as poor QoL while scores equal to and above 78 were categorised as good QoL.
The research instrument was translated to Yoruba, the predominant local language (in the community) for ease of communication and to ensure proper understanding. It was then back-translated to English to ensure the original meaning was retained. The research instrument was pre-tested in Ago-Iwoye (a semi-urban community in Ijebu-North Local Government) which is similar to the study site in terms of geographical location, culture, beliefs and lifestyle of the people. Twenty questionnaires were pretested and appropriate amendments were then made after the pre-test. Data was entered and analyzed using SPSS version 17. Relevant frequencies, percentages, means and appropriate diagrams were generated. Chi square test was used to assess associations between categorical variables. Predictors of good QoL was determined with logistic regression analysis. Significance was set at 5%.
Ethical approval for this study was sought from the joint UI/UCH Ethical Review Committee and permission to conduct the study obtained from the Medical Officer of Health, Ijebu-North Local Government. Informed consent was obtained from participants before administering questionnaires. Respondents were informed that participation was voluntary and that they would not suffer any consequences if they chose not to participate or to withdraw from the study at any point.