Quality of life deterioration and associated factors in prenatal care pregnant women: assessment with the WHOQOL-BREF scale
Deterioro de la calidad de vida y factores asociados en gestantes en control prenatal: evaluación con la escala WHOQOL-BREF
Álvaro Monterrosa-Castro, Isabella Morales-Castellar, Alix Rodelo-Correa, Angélica Monterrosa-Blanco
Abstract
Introduction: Quality of life is a set of situations that contribute to people's well-being. In pregnant women, it is necessary to explore the emotional, social and physical aspects. Few studies in the Latin American population explore the quality of life of pregnant women. The objective was to establish the frequency of deterioration of the physical, psychological, social and environmental quality of life and to identify the associated factors in pregnant women residing in cities of the Colombian Caribbean who attended prenatal consultation.
Material and methods: A cross-sectional study was conducted on 509 pregnant women who performed daily activities and participated voluntarily and anonymously after signing informed consent. They filled out a form that explored sociodemographic and clinical characteristics and applied the WHOQOL-BREF scale, identifying the poor quality of life. Adjusted logistic regression was performed to estimate the association between quality of life (dependent variable) and biopsychosocial factors (independent variables).
Results: The age of the participants was 26.8 ± 6.2 years. In 250 (49.1%) physical or mental deterioration was identified, in 281 (55.2%) deterioration of the social relationship and in 270 (53.0%) of the environmental relationship. Diabetes OR:6.01[95%CI:1.20-18.42], depression OR:4.71[95%CI:1-20-18.42], living in a rural area OR:2.96[95%CI :1.78-4.91], anguish with pregnancy OR:2.87[95%CI:1.65-5.01], financial problems OR:2.61[95%CI:1.54-4.40 ] or couple OR:2.60[95%CI:1.03-6.69], were associated with impaired quality of life (p<0.01). Being cohabiting, compared to being alone, and being a student/employee versus a housewife, were associated with a lower possibility of deterioration in quality of life (p<0.01).
Conclusions: Deterioration of each quality of life domain was identified in half of the pregnant women and several biopsychosocial factors were significantly associated. Antenatal care protocols should provide guidelines for intervention on obstetric and non-obstetric factors that impair quality of life. It is necessary to highlight deficiencies in the exploration of the mental, social and environmental health of pregnant women.
Keywords
Resumen
Introducción: La calidad de vida es un conjunto de situaciones que contribuyen al bienestar de las personas. En las mujeres embarazadas es necesario explorar los aspectos emocionales, sociales y físicos. Son pocos los estudios en población latinoamericana que exploran la calidad de vida de las gestantes. El objetivo fue establecer la frecuencia de deterioro de la calidad de vida física, psicológica, social y ambiental e identificar los factores asociados en gestantes residentes en ciudades del Caribe colombiano que acudieron a consulta prenatal.
Material y métodos: Se realizó un estudio transversal en 509 gestantes que realizaban actividades cotidianas y participaban de forma voluntaria y anónima previa firma del consentimiento informado. Llenaron un formulario que exploró características sociodemográficas y clínicas y aplicaron la escala WHOQOL-BREF, identificando la mala calidad de vida. Se realizó una regresión logística ajustada para estimar la asociación entre calidad de vida (variable dependiente) y factores biopsicosociales (variables independientes).
Resultados: La edad de los participantes fue de 26,8 ± 6,2 años. En 250 (49,1%) se identificó deterioro físico o mental, en 281 (55,2%) deterioro de la relación social y en 270 (53,0%) de la relación ambiental. Diabetes OR:6.01[IC95%:1.20-18.42], depresión OR:4.71[IC95%:1-20-18.42], vivir en zona rural OR:2.96[IC95% :1.78-4.91], angustia con embarazo OR:2,87[IC95%:1,65-5,01], problemas financieros OR:2,61[IC95%:1,54-4,40] o pareja OR:2,60[IC95%:1,03-6,69], se asociaron con deterioro de la calidad de vida (p<0,01). Ser conviviente, comparado con estar solo, y ser estudiante/empleado versus ama de casa, se asoció con una menor posibilidad de deterioro en la calidad de vida (p<0,01).
Conclusiones: Se identificó deterioro de cada dominio de la calidad de vida en la mitad de las gestantes y varios factores biopsicosociales se asociaron significativamente. Los protocolos de atención prenatal deben proporcionar pautas para la intervención sobre los factores obstétricos y no obstétricos que deterioran la calidad de vida. Es necesario resaltar las deficiencias en la exploración de la salud mental, social y ambiental de las gestantes.
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References
1. World Health Organization (WHO). Quality of Life Assessment Group. What quality of life? World Health Forum. 1996;17(4):354-356.
2. World Health Organization (WHO) Division of Mental Health. WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment: field trial version. Geneve: 1996
3. Calou CGP, de Oliveira MF, Carvalho FHC, Soares PRAL, Bezerra RA, de Lima SKM, et al. Maternal predictors related to quality of life in pregnant women in the Northeast of Brazil. Health Qual Life Outcomes. 2018;16(1):109. doi: 10.1186/s12955-018-0917-8.
4. Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, et al. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth. 2018;18(1):455. doi: 10.1186/s12884-018-2087-4.
5. Lau Y. The effect of maternal stress and health-related quality of life on birth outcomes among Macao Chinese pregnant women. J Perinat Neonatal Nurs. 2013;27(1):14-24. doi: 10.1097/JPN.0b013e31824473b9.
6. Schwarz EB, Smith R, Steinauer J, Reeves MF, Caughey AB. Measuring the effects of unintended pregnancy on women's quality of life. Contraception. 2008;78(3):204-10. doi: 10.1016/j.contraception.2008.04.120.
7. Estebsari F, Kandi ZRK, Bahabadi FJ, Filabadi ZR, Estebsari K, Mostafaei D. Health-related quality of life and related factors among pregnant women. J Educ Health Promot. 2020;9:299. doi: 10.4103/jehp.jehp_307_20.
8. Alzboon G, Vural G. Factors Influencing the Quality of Life of Healthy Pregnant Women in North Jordan. Medicina (Kaunas). 2019;55(6):278. doi: 10.3390/medicina55060278.
9. Iwanowicz-Palus G, Zarajczyk M, Bień A. The relationship between health-related quality of life, acceptance of illness and characteristics of pregnant women with hyperglycemia. Health Qual Life Outcomes. 2020;18(1):325. doi: 10.1186/s12955-020-01582-y.
10. Oviedo-Caro MA, Bueno-Antequera J, Munguía-Izquierdo D. Explanatory factors and levels of health-related quality of life among healthy pregnant women at midpregnancy: A cross-sectional study of The PregnActive Project. J Adv Nurs. 2018;74(12):2766-76. doi: 10.1111/jan.13787.
11. Da Costa D, Dritsa M, Verreault N, Balaa C, Kudzman J, Khalifé S. Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy. Arch Womens Ment Health. 2010;13(3):249-57. doi: 10.1007/s00737-009-0104-3.
12. Cardona JA, Ospina LC, Eljadue AP. Discriminant, convergent/divergent validity, reliability and internal consistency of the WHOQOL-BREF and MOSSF-36 in healthy adults from Colombian municipality. Rev Fac. Nac Salud Pública. 2015;33(1):50-7.
13. Dağlar G, Dilek B, Özkan S.A. Factors affecting the quality of life among pregnant women during third trimester of pregnancy. Cukurova Med J 2019;44(3):772-81. doi: 10.17826/cumj.482553.
14. Piccinini CRP, de Castro Almeida V, da Silva Ezequiel O, de Matos Fajardo EF, Lucchetti ALG, Lucchetti G. Religiosity/Spirituality and Mental
Health and Quality of Life of Early Pregnant Women. J Relig Health. 2021;60(3):1908-23. doi: 10.1007/s10943-020-01124-2.
15. Gariepy A, Lundsberg LS, Vilardo N, Stanwood N, Yonkers K, Schwarz EB. Pregnancy context and women's health-related quality of life. Contraception. 2017;95(5):491-9. doi: 10.1016/j.contraception.2017.02.001.
16. Mourady D, Richa S, Karam R, Papazian T, Hajj Moussa F, El Osta N, et al. Associations between quality of life, physical activity, worry, depression and insomnia: A cross-sectional designed study in healthy pregnant women. PLoS One. 2017;12(5):e0178181. doi: 10.1371/journal.pone.0178181.
17. Abbaszadeh F, Kafaei Atrian M, Masoudi Alavi N, Bagheri A, Sadat Z, Karimian Z. Relationship between quality of life and depression in pregnant women. Nurs Midwifery Stud. 2013;2(2):193-7. doi: 10.5812/nms.8518.
18. Davoud A, Abazari M. The Relationship between Quality of Life and Physical Activity, Worry, Depression, and Insomnia in Pregnant Women. Iran J Psychiatry. 2020;15(2):159-68.
19. Kazemi F, Nahidi F, Kariman N. Exploring factors behind pregnant women's quality of life in Iran: a qualitative study. Electron Physician. 2017;9(12):5991-6001. doi: 10.19082/5991.
20. Abujilban S, Abuidhail J, Mrayan L, Hatamleh R. Characteristics of pregnant Jordanian women dissatisfied with life: A comparison between satisfied and dissatisfied women's demographics. Health Care Women Int. 2017;38(6):556-70. doi: 10.1080/07399332.2017.1289535.
21. Naseem K, Khurshid S, Khan SF, Moeen A, Farooq MU, Sheikh S, et al. Health related quality of life in pregnant women: a comparison between urban and rural populations. J Pak Med Assoc. 2011;61(3):308-12.
22. Arute JE, Eniojukan JF, Odili VO. Quality of Life in Pregnant Women Attending Anti-Natal Clinics in Rural and Urban Areas of Delta State. Value Health. 2014;17(7):A518. doi: 10.1016/j.jval.2014.08.1612.
23. Dalfrà MG, Nicolucci A, Bisson T, Bonsembiante B, Lapolla A; QLISG (Quality of Life Italian Study Group). Quality of life in pregnancy and post-partum: a study in diabetic patients. Qual Life Res. 2012;21(2):291-8. doi: 10.1007/s11136-011-9940-5.
24. Balíková M, Bužgová R. Quality of Women’s Life with Nausea and Vomiting during Pregnancy. Ošetř Porod Asist. 2014;5(1):29-35.
25. Ali A. Relationship between Unwanted Pregnancy and Health-Related Quality of Life in Pregnant Women. J Coll Physicians Surg Pak. 2016;26(6):507-12.
Submitted date:
11/13/2022
Reviewed date:
01/05/2023
Accepted date:
01/16/2023
Publication date:
01/16/2023