Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria.
Lagos State University Teaching Hospital, Lagos, Nigeria.
Qual Life Res. 2024 Jan;33(1):157-168. doi: 10.1007/s11136-023-03506-x. Epub 2023 Sep 6.
Tuberculosis (TB) has far-reaching effects on the social, mental, and emotional well-being of patients and consequently, their health-related quality of life (HRQOL). Few studies in Nigeria have examined changes in quality of life over the course of treatment. changes in (PTB) and factors associated with HRQOL.
A prospective cohort study was conducted with patients recruited from health facilities in Lagos State. The World Health Organization Quality of Life Instrument, Short-Form (WHOQOL-BREF) was used to assess HRQOL. A semi-structured questionnaire was also administered to elicit information on socio-demographic characteristics and the medical and social history of the respondents. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 23. A repeated measures analysis of variance (ANOVA) test with polynomial contrasts was used to assess how domain scores varied over time. Multivariable analysis was conducted using generalized estimating equations (GEE) to assess change in HRQOL and its predictors.
Two hundred and ten patients, predominantly male [108 (63.3%)] were recruited. The mean age was 36.7 ± 12.3 years. The HRQOL was impaired in all four domains at baseline. However, HRQOL scores increased over the treatment period with the largest improvement being in the 'environment' domain, where mean scores increased from 45.27 ± 14.59 to 61.28 ± 15.86. The proportion of respondents that expressed satisfaction with their health increased from 13.5% at baseline to 55.7% at the end of treatment. Low socio-economic status, delay in presentation, and an HIV-positive status were found to be significantly associated with reduced HRQOL at baseline (p < 0.05). In the multivariable longitudinal analysis, patients who were employed had higher HRQOL scores while persistent symptoms and a delay in presentation (≥ 4 weeks) were negatively associated with change in HRQOL scores over the course of treatment.
The HRQOL of respondents progressively improved over the six-month treatment period. However, change in HRQOL was influenced by a delay in presentation and persistence of symptoms. The study also highlights the need for increased recognition of patient-reported outcomes as an adjunct outcome measure.
结核病（TB）对患者的社会、心理和情感健康有着深远的影响，进而影响他们的健康相关生活质量（HRQOL）。在尼日利亚，很少有研究探讨治疗过程中生活质量的变化。本研究旨在评估涂阴和涂阳肺结核（PTB）患者治疗期间的生活质量变化及其相关因素。
这是一项前瞻性队列研究，研究对象来自拉各斯州的医疗机构。采用世界卫生组织生活质量量表简表（WHOQOL-BREF）评估 HRQOL。还使用半结构式问卷收集受访者的社会人口统计学特征、医疗和社会史信息。使用社会科学统计软件包（SPSS）版本 23 进行数据分析。采用重复测量方差分析（ANOVA）检验和多项式对比来评估各领域评分随时间的变化。使用广义估计方程（GEE）进行多变量分析，以评估 HRQOL 及其预测因素的变化。
共招募了 210 名患者，其中男性居多（108 名，占 63.3%），平均年龄为 36.7±12.3 岁。基线时所有四个领域的 HRQOL 均受损。然而，治疗期间 HRQOL 评分逐渐提高，其中“环境”领域的改善最大，平均得分从 45.27±14.59 增加到 61.28±15.86。对健康表示满意的受访者比例从基线时的 13.5%增加到治疗结束时的 55.7%。低社会经济地位、延迟就诊和 HIV 阳性状态与基线时 HRQOL 降低显著相关（p<0.05）。多变量纵向分析显示，就业患者的 HRQOL 评分较高，而持续症状和延迟就诊（≥4 周）与治疗过程中 HRQOL 评分的变化呈负相关。
在六个月的治疗期间，受访者的 HRQOL 逐渐改善。然而，HRQOL 的变化受到延迟就诊和症状持续存在的影响。该研究还强调需要增加对患者报告结局的认识，将其作为辅助结局测量指标。
