Health-related quality of life of refugees: a systematic review of studies using the WHOQOL-Bref instrument in general and clinical refugee populations in the community setting.
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ABSTRACT: Purpose
To systematically review studies on HRQOL, measured by the WHOQOL-Bref instrument, of refugees in general and clinical populations who are settled in the community of the hosting country, and outline the differences in scores among the two population groups and across the four domains of WHOQOL-Bref (physical, psychological, social relationships and environment domain) as well as factors impacting those outcomes.Methods
Several databases were systematically searched by using a broad search strategy. Additionally, a hand search for grey literature was performed. Studies had to comply with the following inclusion criteria: (a) population of refugees; (b) living in the community of the country of destination; (c) assessing HRQOL through the WHOQOL-Bref instrument.Results
15 studies were identified and divided into two subgroups: (a) general population of refugees (b) clinical population of refugees, who were specifically selected for their mental status or because they had experienced relevant past traumas. Although we can outline common patterns among the two groups, in terms of domains scoring the highest and the lowest, heterogeneous values of HRQOL are observed across the studies included.Conclusions
Individuals who were included in the clinical refugee group have a lower quality of life in respect to the general population of refugees. However, among the two groups different patterns can be outlined considering each domain of HRQOL: higher scores for the Physical and lower for the Environment domain when considering the general population of refugees and higher scores for the Environment and lower for the Psychological domain when referring to the clinical one. These lower scores are probably due to having a higher rate of mental distress and being more exposed to somatization, stigmatization and barriers to access the healthcare system of the hosting country.
SUBMITTER: Gagliardi J
PROVIDER: S-EPMC8173726 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background Diabetes mellitus (DM) is rising at a rapid rate worldwide. As a chronic, incurable metabolic disease, diabetes affects a person’s life in all ways. Studies thus far have focused on the impact of diabetes on the physical and mental health of persons affected by the quality of life (QoL). This study aimed to explore the whole range of QoL deficits using the World Health Organization Quality of Life brief version (WHOQOL-BREF) in type-2 diabetic patients. Methods This cross-sectional study was carried out among individuals aged at or above 15 years with type 2 diabetes (T2DM). Patients with prior mental health illness and unwillingness to give consent were excluded. A pretested structured questionnaire including the 26-item WHOQOL-BREF questionnaire was used for face-to-face interviews. Appropriate ethical measures were ensured. All statistical analyses were carried out using the statistical software STATA (Version 16.1). Graphs were created using R (Version 4.0.0). Results A total of 500 T2 DM patients with a mean age of 55.8 ± 13.2 years (± SD) and a female proportion of 50.8% were included. Overall, 22.2% of participants rated their QoL as poor, and 25% were dissatisfied with their health (as assessed by questions 1 and 2 of the WHOQOL-BREF questionnaire). More than half (54% and 51.2%, respectively) had an average evaluation of their QoL and health. The QoL scores were below average, with mean scores (± SD) for the physical health, psychological, social relationship, and environmental domains of 37.2 ± 20.5, 44.2 ± 21.0, 39.6 ± 23.2, and 41.6 ± 19.5, respectively. Multiple regression analysis revealed that the patient’s level of education and monthly family income were significant positive modifiers and that complications (nephropathy, retinopathy, and peripheral artery disease) were significant negative determinants of the QoL score in different domains. Conclusion This study found the overall quality of life among T2DM patients below average. Health authorities and clinicians should take these findings into account and incorporate necessary measures to ameliorate negative modifiers of the quality of life of sufferers. Supplementary Information The online version contains supplementary material available at 10.1186/s12902-022-01072-w.
| S-EPMC9206302 | biostudies-literature
Project description:BackgroundMeasuring quality of life (QOL) in a population is important for the predictions of health and social care needs. In Pakistan, health related quality of life data exist but there are no quality of life data of general population. In this study, quality of life was assessed among the Pakistani general population and their associated factors by using the World Health Organization's quality of life instrument (WHOQOL-BREF).MethodologyA population-based cross-sectional study was carried out in all 52 Union Councils of District Abbottabad, Khaber Pkutunkhua province, Pakistan from March 2015 to August 2015. Multi-stage cluster sampling technique was employed in this study. Quality of life was measured by using the validated WHOQOL-BREF instrument, along with socioeconomic, demographic, and World Bank social capital questions in this population- based study. The data were collected through households, utilizing face to face interviews. The association between socio-demographic variables and quality of life domains were determined by using both univariate and multivariate analysis. Descriptive statistics were derived, and a multilevel linear regression using backward analysis allowing to obtain final model for each domain was achieved to recognize the variables that affect quality of life score.ResultsA total of 2063 participants were included in this study (51.2% male, 48.2% female). Mean age of participants was 37.9, SD = 13.2; ranging from 18 to 90. Mean score of quality of life domains (physical, psychological, social relationship and environmental domains) were 65.0 (SD = 15.2), 67.4 (SD = 15.0), 72.0 (SD = 16.5), 55.5 (SD = 15.0), respectively. Overall, socioeconomic status was established to be the strongest predictor of poorer quality of life for all domains as a change in SES from high to low results in reduction about (β = - 5.85, β = - 9.03, β = - 8.33, β = - 9.98, p < 0.001). Similarly, type of residency was negatively associated with physical, psychological and environmental domains while age and sex were negatively associated with physical, psychological and relationship domains in final model. Furthermore social capital (β = 0.09, β = 0.13, β =0.14, β =0.15, p < 0.001) had a positive effect on Pakistani quality of life. Overall, subjective quality of life was found to be low in our population and extremely varied by socio-demographic variables.ConclusionsIncreasing age, having average and lower socioeconomic status and living in the rural area were found to be the strong predictor of poorer quality of life in all domains, while total social capital score had a positive effect on Pakistani quality of life scores.
| S-EPMC6332637 | biostudies-literature
Project description:BACKGROUND:Health-related quality of life (HRQOL) is used as a measure of treatment outcomes, in addition to seizure control. Hence, the study was aimed to assess HRQOL and its determinants among adult patients with epilepsy (PWE). METHOD:A hospital-based cross-sectional study was conducted from April 20 to June 27/2019, through patient interviews and patient's chart review (medication and clinical information). Data were analyzed using SPSS version 20. The psychometric property was done using Cronbach's alpha test value of >0.7 as accepted internal consistency and Kaiser-Meyer-Olkin (KMO) measure of sample size adequacy value of ≥0.5 as acceptable construct validity, for Afaan Oromo version questionnaire. Multivariate linear logistic regression analysis was done to find predictors for the HRQOL score. RESULTS:Of 121 PWE included in the study, 24.4% had overall poor HRQOL with the overall mean ±SD score of 56.42±10.96. The predictors for low overall HRQOL score were: presence of co-morbidity (B = -5.620, SE = 1.531, p<0.0001, 95% C.I = -8.656 to -2.584), uncontrolled seizure for at least 2 years (B = -4.239, SE = 1.296, p = 0.001, 95% C.I = -6.809 to -1.670), divorced (B = -8.423, SE = 2.241, p<0.0001, 95%C.I = -12.867 to -3.978) relative to married, and no education (B = -8.715, SE = -8.15, SE = 2.604, p = 0.001, 95%C.I = -9.648 to -1.316) relative to who had level of education above tertiary. In addition, uncontrolled seizure (irrespective of time since seizure-free) (B = -10.083, SE = 2.104, p<0.0001, 95%C.I = -14.256 to -5.910), being widowed (B = -9.300, SE = 3.594, p = 0.011, 95%C.I = -16.429-2.170) relative to married and being illiterate/no education (B = -13.004, SE = 3.910, p = 0.001, 95%C.I = -20.760 to -5.248) relative to educational level of tertiary and above were found to be the strongest negative predictors of HRQOL of physical health. Moreover, uncontrolled seizure (irrespective of time since seizure-free) (B = -12.668, SE = 2.019, p<0.0001, 95%C.I = -16.671 to -8.664) and being divorced (B = -10.153, SE = 3.228, p = 0.002, 95%C.I = -16.556 to -3.751) compared to married were strong predictors for low HRQOL score of psychological health. Absence of Poly-pharmacy (B = 9.050, SE = 3.027, P = 0.003, 95%C.I = 3.047 to 15.054), being single (B = -9.551, SE = 2.095, p<0.0001, 95%C.I = -14.419 to -4.683), and divorced (B = -11.022, SE = 3.351, P = 0.001, 95%C.I = -17.668 to -4.376) relative to married were found to be strong predictors for HRQOL score of social health. Moreover, low HRQOL score of environmental health was predicted by rural residence (B = -5.795, SE = 2.101, p = 0.007, 95%C.I = -9.962 to -1.628), co-morbidity (B+ -4.230, SE = 2.125, p = 0.049, 95%C.I = -8.444 to -0.015) & uncontrolled seizure irrespective of time since seizure-free (B = -6.907, SE = 1.945, p = 0.001, 95%C.I = -10.765 to -3.049) and uncontrolled seizure of at least 2 years (B = -4.520, SE = 1.798, p = 0.014, 95%C.I = -8.088 to -0.953). CONCLUSIONS:The majority of the study participants had a good overall HRQOL. In general, a low level of HRQOL score was significantly associated with the marital status of single/widowed/divorced, low level of education, low level of monthly income, co-morbidity, uncontrolled seizure, and poly-pharmacy; irrespective of HRQOL domains. Therefore, it is required to improve HRQOL, by avoiding modifiable factors for PWE to achieve the optimum HRQOL.
| S-EPMC6974038 | biostudies-literature
Project description:The objective of this study is to obtain population norms and to assess test-retest reliability of EQ-5D-5L and WHOQOL-BREF for the Indonesian population.A representative sample of 1056 people aged 17-75 years was recruited from the Indonesian general population. We used a multistage stratified quota sampling method with respect to residence, gender, age, education level, religion and ethnicity. Respondents completed EQ-5D-5L and WHOQOL-BREF with help from an interviewer. Norms data for both instruments were reported. For the test-retest evaluations, a sub-sample of 206 respondents completed both instruments twice.The total sample and test-retest sub-sample were representative of the Indonesian general population. The EQ-5D-5L shows almost perfect agreement between the two tests (Gwet's AC: 0.85-0.99 and percentage agreement: 90-99%) regarding the five dimensions. However, the agreement of EQ-VAS and index scores can be considered as poor (ICC: 0.45 and 0.37 respectively). For the WHOQOL-BREF, ICCs of the four domains were between 0.70 and 0.79, which indicates moderate to good agreement. For EQ-5D-5L, it was shown that female and older respondents had lower EQ-index scores, whilst rural, younger and higher-educated respondents had higher EQ-VAS scores. For WHOQOL-BREF: male, younger, higher-educated, high-income respondents had the highest scores in most of the domains, overall quality of life, and health satisfaction.This study provides representative estimates of self-reported health status and quality of life for the general Indonesian population as assessed by the EQ-5D-5L and WHOQOL-BREF instruments. The descriptive system of the EQ-5D-5L and the WHOQOL-BREF have high test-retest reliability while the EQ-VAS and the index score of EQ-5D-5L show poor agreement between the two tests. Our results can be useful to researchers and clinicians who can compare their findings with respect to these concepts with those of the Indonesian general population.
| S-EPMC5947896 | biostudies-literature
Project description:PurposeThis study aimed at mapping the World Health Organization Quality of Life Brief (WHOQOL-BREF) and the EQ-5D-5L in the general Thai population and to determine the impact on the incremental cost-utility ratio (ICUR) through five hypothetical scenarios.MethodsA total of 1,200 Thai participants were randomly allocated into the 'estimation' and 'validation' groups. A curve estimation with nine regression models was performed to identify the best-fit regression model of significant WHOQOL-BREF dimension scores for the EQ-5D-5L index score predictions in the estimation group. The identified model was then used for the calculation of the predicted EQ-5D-5L index scores in the validation group. The percentage change from the hypothetical base-case scenario with predefined parameters was used to determine the impact on the ICUR.ResultsAn inverse model was the best-fit regression model to predict the EQ-5D-5L index scores. The absolute difference between the predicted and observed index scores was 0.064, and the percentage of the sample that was mispredicted by ≥ 0.05 and ≥ 0.1 was 43.8% and 16.8%, respectively. Moreover, the percentage change in ICUR ranged between 0.13 and 1.84% from the hypothetical base-case scenario.ConclusionsAn inverse relationship between the studied scores was identified. The minimal impact on the ICUR suggests that the Health Utility Index of the mapped equation can be applied to economic analyses.
| S-EPMC9928993 | biostudies-literature
Project description:BACKGROUND:The WHOQOL-BREF is a frequently used instrument for the assessment of health-related quality of life. Unlike other generic instruments used for the assessment of this construct, little is known about its properties in individuals with headache disorders. The present study examines the reliability and factorial validity of the WHOQOL-BREF in individuals with chronic headache residing in Austria. METHODS:Data from a representative population-based survey on 963 individuals with chronic headache surveyed between 2013 and 2015 was used. The factorial validity was examined by means of confirmatory factor analysis. Differential item functioning related to sex was analyzed using multiple indicators multiple causes models. RESULTS:Information on 239 men and 724 women with chronic headache was available. The four-factor, 24-item baseline model showed a moderate fit (RMSEA = 0.066; CFI = 0.868; TLI = 0.852; SRMR = 0.053), which improved significantly after the addition of six error covariances (RMSEA = 0.052; CFI = 0.920; TLI = 0.908; SRMR = 0.046). Sex-related differential item functioning was observed in two items of the environment factor, two items of the psychological health factor and two items of the physical health factor. CONCLUSIONS:After some modifications to the measurement model, the WHOQOL-BREF shows a satisfactory fit among individuals with chronic headache in Austria. Because of these modifications and the questionnaire's susceptibility for differential item functioning, a latent variable framework should be employed for the analysis. Future studies need to confirm these results for other language regions and should also examine different subtypes of headache.
| S-EPMC7333387 | biostudies-literature
Project description:The World Health Organization has developed a brief generic questionnaire to assess quality of life, the WHOQOL-BREF. It has been studied in diverse groups, but not specifically in older people. The purpose of this study was to analyze the psychometric properties of the French version of the WHOQOL-BREF questionnaire in healthy older people and to compare the mean profiles of participants with the mean profile obtained in the international validation study of the WHOQOL-BREF. Of the total sample of 262 Swiss French speaking older participants, 122 completed a retest after 2 weeks. The WHOQOL-BREF items demonstrated high test-retest reliability and validity. The WHOQOL-BREF items were differentially related to physical and mental health measures (SF-12 components, morbidity, and depression), thereby demonstrating convergent and discriminant validity. Compared to the international validation sample of the WHOQOL-BREF, participants of the present study reported higher QOL on 22 of the 26 items. A comparison of item profiles between male and female participants revealed gender differences for two items only (social support and negative feelings). We conclude that the psychometric properties of the WHOQOL-BREF items in older adults are good. To consider the 24 specific facets that are assessed by the WHOQOL-BREF appropriately, we recommend using item profiles on the individual and the sample level.
| S-EPMC5546259 | biostudies-other
Project description:BACKGROUND:Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal. METHODS:The Nepali version of World Health Organization Quality of Life Instruments -(WHOQOL-BREF) questionnaire was administered using face to face interviews among end stage renal disease (ESRD) patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using the Chi-square test. The group differences in quality of life (QOL) were examined using the Mann-Whitney U test and Kruskal-Wallis tests. RESULTS:Of the 161 participants, 92 (57.1%) were renal transplant recipients and 69 (42.9%) patients were on maintenance haemodialysis. Hypertension (70.9%) was the most common co-morbidity among ESRD patients. Haemodialysis patients scored significantly lower than the transplant recipients in all four domains as well as in overall perception of quality of life and general health. Ethnicity (p?=?0.020), socio-economic status (p?<?0.001), educational status (p?<?0.001) and employment status (p?=?0.009) were significantly associated with the overall QOL in ESRD patients. Across patient groups, educational status (p?=?0.012) was positively associated with QOL in dialysis patients, while urban residence (p?=?0.023), higher socio-economic status (p?<?0.001), higher educational status (p?=?0.004) and diabetes status (p?=?0.010) were significantly associated with better QOL in transplant recipients. CONCLUSION:The overall QOL of the renal transplant recipients was higher than that of the patients on maintenance haemodialysis; this was true in all four domains of the WHOQOL-BREF. ESRD patients with low HRQOL could benefit from targeted risk modification intervention.
| S-EPMC7552453 | biostudies-literature
Project description:ObjectivesThe abbreviated World Health Organisation Quality of Life tool (WHOQOL-BREF) is a short-form quality of life (QoL) assessment commonly used worldwide in both healthy and ill populations. Normative data for the Australian general population are limited. The objective of this study was to present normative data for the WHOQOL-BREF based on a general population sample. A secondary aim was to explore sociodemographic factors related to QoL.DesignPopulation-based cross-sectional study.Participants929 men and 830 women aged 24-94 years participating in the Geelong Osteoporosis Study.Outcome measuresThe 26-item WHOQOL-BREF.ResultsMeans and SD for each domain are presented by age group and sex. Percentile scores were also generated. Mean scores for WHOQOL-BREF domains were 74.52 (SD=16.22) for physical health, 72.07 (SD=15.35) for psychological, 72.87 (SD=18.78) for social relationships and 79.68 (SD=12.55) for environment. We identified significant associations between sociodemographic factors and WHOQOL-BREF domains. Notably, being married or in a relationship was associated with increased odds for high QoL across all four WHOQOL-BREF domains: physical health (women OR 2.46, 95% CI 1.36 to 4.44, p=0.003), psychological (men OR 2.07, 95% CI: 1.20 to 3.55, p=0.009; women OR 2.15, 95% CI 1.21 to 3.81, p=0.009), social relationships (men OR 2.28, 95% CI 1.29 to 4.04, p=0.005; women OR 2.77, 95% CI 1.42 to 5.41, p=0.003) and environment (women OR 2.07, 95% CI 1.13 to 3.80, p=0.019).ConclusionsThis study provides population norms for the WHOQOL-BREF based on a representative sample of Australian adults. Our results will be useful to researchers and clinicians who can use these data as a reference point for interpreting WHOQOL-BREF scores.
| S-EPMC10729265 | biostudies-literature
Project description:BackgroundThe assessment of health-related quality of life (HRQoL) in people living with HIV (PLHIV) has become crucial to evidence-based practice. The goals of this study are to analyze the psychometric properties and evidence of the validity of the Spanish version of WHOQOL-HIV-BREF in a sample of PLHIV in Spain and to examine the more impaired HRQoL facets and dimensions and identify the PLHIV who show the most vulnerable profile.MethodsA total of 1462 PLHIV participated in an observational cross-sectional ex-post-facto study. Data were collected at 33 Spanish sites through an online survey. In addition to measuring HRQoL, the study used other tools to measure treatment adherence (CEAT-VIH 2.0 version), psychological well-being (GHQ-12) and HIV-related stigma (HSSS). Cronbach's alpha, first- and second-order confirmatory factor analysis (CFA), the Pearson coefficient and one-way ANOVA were used to evaluate reliability, construct validity and concurrent and known-group validity, respectively. Differences according to the socio-demographic and epidemiological profiles of participants were analyzed.ResultsFirst- and second-order CFAs confirmed a six-domain first-order structure of the Spanish version of WHOQOL-HIV-BREF and one second-order factor related to overall HRQoL with an acceptable fit to the data, although some minor changes would improve it. The six-domain structure showed an acceptable internal consistency (Cronbach's alpha ranged from .61 to .81). Significant moderate to large correlations between domains and overall HRQoL, adherence, psychological well-being and negative self-image were found. Significant differences were found according to participants' self-reported CD4+ cell count in several HRQoL facets and domains. Being female, heterosexual, having low socio-economic and educational statuses, having acquired HIV through an unsafe injection and living more years with HIV were related to poorer HRQoL. PLHIV older than 50 presented lower scores in 19 HRQoL facets.ConclusionsThis study demonstrates that the Spanish version of the WHOQOL-HIV-BREF is a valid instrument. It also presents the most recent data about HRQoL in PLHIV in Spain with the largest sample to date.
| S-EPMC6700970 | biostudies-literature