|Year : 2020 | Volume
| Issue : 1 | Page : 19-25
Health related quality of life of adolescent school aged students in southwestern Saudi Arabia
Awad Saeed Alsamghan1, Abdullah Moraya Assiri2, Shehata Farag3, Safar Abadi Al-Saleem1, Mohamed Abadi Al-Saleem1
1 Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
2 Family Medicine Specialist, Ministry of Health, Aseer region, Saudi Arabia
3 Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia; High Institute of Public Health, Alexandria University, Egypt
|Date of Web Publication||13-Aug-2020|
MBBS, SBFM Awad Saeed Alsamghan
Department of Family and Community Medicine, King Khalid University, Abha
Source of Support: None, Conflict of Interest: None
Objectives: The present work aimed to measure the quality of life among adolescents in Abha City in southwestern Saudi Arabia. Methods: A descriptive cross-sectional study was performed targeting all male and female students enrolled in Abha secondary schools. The Arabic version of the World Health Organization Quality of Life Questionnaire (condensed edition) was used. Results: The study included 400 students. The reported average score of quality of life ranged from 60.6 for the physical health domain to 70.8 for the environmental domain. Factors that significantly affect the physical health domain were age, gender, nationality, mothers’ education, and monthly income. Regarding the psychological health domain, the significant determinants were age, gender, birth order, parental status, and income. As for the social relationship domain, the only significant factor was age. Regarding the environment domain, the significant determinants were birth order and income. Conclusion: The study augments evidence to boost relations between individual characters, lifestyle health behaviors, and quality of life among adolescents so that health managers, health instructors, and health advocates can create and execute relevant plans and services to specific groups to improve their quality of life.
Keywords: Adolescents, Quality of life, Abha
|How to cite this article:|
Alsamghan AS, Assiri AM, Farag S, Al-Saleem SA, Al-Saleem MA. Health related quality of life of adolescent school aged students in southwestern Saudi Arabia. King Khalid Univ J Health Scii 2020;5:19-25
|How to cite this URL:|
Alsamghan AS, Assiri AM, Farag S, Al-Saleem SA, Al-Saleem MA. Health related quality of life of adolescent school aged students in southwestern Saudi Arabia. King Khalid Univ J Health Scii [serial online] 2020 [cited 2020 Oct 21];5:19-25. Available from: https://www.kkujhs.org/text.asp?2020/5/1/19/291955
| Introduction|| |
Quality of life is often believed to be similar to, if not more vital than, quantity of life. It is a multifaceted component of well-being influenced by patients’ physical, mental, emotional, and social status, which is increasingly used to assess the health condition of the general public and patients as well as the influence of healthcare involvements.
Quality of life represents the sum of subjective sensations related to one’s state of well-being. It is an individual’s awareness of their place in life, in the framework of culture and system of standards in which they exist, and in relation to their aims, anticipations, morals, and interests. Quality of life acts as a marker in clinical trials for particular diseases and judges the physical and psychosocial influence of sicknesses on affected persons, permitting an improved experience for the patient and their adjustment to their unhealthy state..
The evaluation of quality of life is a mainly important effort with a considerable influence on patients’ physical, social, and mental areas that control their general well-being and status.
The aim of the current work was to measure the quality of life among adolescents in Abha City in southwestern Saudi Arabia.
| Methodology|| |
A descriptive cross-sectional study was conducted targeting all male and female students enrolled in Abha governmental secondary schools for the academic year 1436–1437 H. Abha City is the capital of Aseer Province, at the southwestern part of Saudi Arabia. In Abha, there are 25 governmental schools for girls with 4980 students and 18 governmental secondary schools for boys with 4359 students. Students with any psychiatric problems were excluded. Abha was divided into sectors, and within each sector, schools were stratified into boys’ and girls’ schools. Within each sector, the largest schools for boys and for girls were included in the survey. After the purpose was explained and data confidentiality confirmed, students in the three grades within the selected schools were invited to participate by filling out survey questionnaires.
A total of 400 pupils (200 males and 200 females) were recruited after completing the distributed questionnaire. The questionnaire was previously structured by the researchers after reviewing similar studies and was examined by experts for any modification. Data collected included students’ sociodemographic data such as age, sex, parents’ data, monthly income, and medical history.
The abbreviated version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) was used to measure participants’ quality of life. The Arabic version of the condensed, 26-question version of the WHOQOL-BREF was used in this study to evaluate participants’ quality of life. It contains 26 items covering 4 areas: physical, psychological, social, and environment. The mean score of items within each area was used to compute the area score. Mean scores were then multiplied by 4 to make area scores equivalent with the scores in the WH0Q0L-100.
After data were obtained, they were reviewed, coded, and entered into IBM SPSS version 22 (SPSS, Inc., Chicago, IL). All statistical analyses were done using two-tailed tests. A P value less than 0.05 was considered statistically significant. Scores of WHOQOL items were standardized to range from 0% to 100% to adjust for the number of items within each domain. Descriptive analysis based on frequency and percent distribution was done for all variables including demographic data and parents’ data. WHOQOL score % was assessed using means with SD. An independent-sample t-test and one-way ANOVA were then applied to demonstrate differences in WHOQOL domain scores between student’s personal data and their family data.
| Results|| |
The study participants were 400 students, 200 of which were males and 88.8% were aged 16–19 with a mean age of 17 ± 1.2 years. Of the students, 78.3% were in families with 5 to 10 members, and 55.3% has birth orders ranging from second to fifth. Meanwhile, 44% of the students’ fathers and 32.3% of their mothers were university graduates. Sixty students have a positive history of chronic health problems, 10.8% complained of chronic disease, and 4.3% had physical or sensory impairment. Among the participants, 87.5% have parents who are still living together, and 42.8% have monthly family incomes exceeding 10000 SR [Table 1].
|Table 1: Socio-demographic data of sampled secondary school students in Abha city, Southern Saudi Arabia|
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Regarding quality-of-life scores, the study revealed that the mean scores for the four domains were 60.6 ± 17.4 for physical health, 62.8 ± 19.1 for psychological health, 66.1 ± 23.7 for social relations, and 70.8 ± 18.9 for environment.
[Table 2] demonstrates that students’ average scores for their quality of life were significantly lower than those of younger students regarding their physical health (59.1% for students below 18 compared with 61.1% for those above 18; P=0.002). The same was found for psychological health (52.9% for the young age group compared with 63.7% for older students; P=0.007). The opposite was observed for social relationships (63.8% for the young age group compared with 57.2% for older students; P=0.003). Male students had significantly higher average scores for quality of life than female students for physical health (63.4% vs. 57.8%; P=0.001) and psychological health (64.7% vs. 60.8%; P=0.033). Regarding physical health, Saudi students had significantly higher average scores for quality of life than non-Saudi students (65.9% vs. 59.8%; P=0.001). First-born children had significantly higher mean quality-of-life scores for psychological health (66.5%, 64.1%, and 55.6%, respectively; P=0.002). Students who had chronic diseases had lower average quality-of-life scores than those who did not have chronic diseases, being significant for physical health (p<0.001), psychological health (p=0.01), and environment (p=0.001). However, mean quality-of-life scores did not differ significantly according to other personal characteristics.
|Table 2: Students' mean WHOQOL scores according to their personal characteristics|
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[Table 3] shows that average scores for the psychological health domain differed significantly according to parent status: 63.5% for children with parents living together compared with 58.3% for those with divorced parents (P=0.011). Average scores for physical health were significantly higher among students with university graduate mothers (63.1%) than those with illiterate mothers (58.7%) (P=0.024). Students with family incomes above 20,000 SR had the highest average quality-of-life scores for physical health (64.8% vs. 60.5%; P=0.039), psychological health (69.9% vs. 57.4%; P=0.002), and environment (78.1% vs. 63.9%; P=0.002). However, average scores for WHOQOL domains did not differ significantly according to other parents’ characteristics.
|Table 3: Students' mean WHOQOL scores according to their family characteristics|
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| Discussion|| |
The present study of adolescents in Abha City reported an average quality-of-life score ranging from 60.6 for physical health to 70.8 for environment. Factors significantly affecting physical health were age, gender, nationality, mothers’ education, and monthly income. For psychological health, the significant determinants were age, gender, birth order, parental status, and income. As for social relationships, the only significant determinant was age. Regarding the environment domain, the significant factors were birth order and income.
Health-related quality of life is the efficient consequence of a medical situation and/or its treatment upon a person. It is thus personal and multidimensional, incorporating physical and occupational functions, psychological status, social interface, and somatic impression. It is therefore particularly appropriate to portray individual health in a general representative sample that may also comprise specific condition groups. Research has shown that many components are associated with health-related quality of life.,.
Adolescence is a unique growing phase in the evolution from infanthood to adulthood. Adolescents are exposed to risk-taking behaviors and obstacles to get into proper health facilities. Identifying quality of life–related issues can create pertinent knowledge for public health policy to promote the health and safety of adolescents.
In this rapidly transforming world, globalization and progressive technology constantly permeate in adolescents’ lives by providing them with high anticipations and social patterns from the world culture. In previous years, some studies inspected the predictors of healthy lifestyle behaviors and psychosocial welfare among adolescents. Regarding the physical health and mental status of adolescents in relation to their quality of life, a cross-cultural study found that adolescents within four countries (Hungary, Poland, Turkey, and the United States) with sound and hopeful self-belief and self-efficacy practiced physical activities more regularly. However, health condition and physical actions are highly proven as elements in adolescents’ and adults’ felt quality of life. Another cross-cultural research on adolescents’ quality of life reported that physically functional adolescents have greater self-reported quality-of-life total scores whereas boys were more physically active. Lastly, socioeconomic condition can also influence quality of life among adolescents; a study found that adolescents with higher socioeconomic status had improved health conditions, leading to an improved quality of life.
While most studies on quality of life among adolescents have concentrated on susceptible social groups with particular diseases, such as coeliac disease, diabetes, and thalassemia,, a few studies with a population-based design have examined personal, physical, and psychosocial issues that influence adolescents’ quality of life in Saudi Arabia.
The findings in this study show the relationship between demographic features and adolescents’ lifestyle behaviors, which are the causative factors of quality of life. These findings are comparable to those of the study done in Hong Kong and Guangzhou, which reported sociodemographic factors as predisposing factors. Nevertheless, the health issues of adolescents in these regions and worldwide may not be similar, and it is crucial to recognize the influencing factors of harmful and risk-taking activities in each nation to deliver cultural-distinctive early intervention and suitable supervision in this complicated, transforming world which would influence the quality of life of adolescents in Saudi Arabia,
| Conclusions|| |
This cross-sectional study confirmed that personal features are considered as predictors of adolescents’ quality of life in the Abha region. The study findings add new evidence to support the associations between personal characteristics, lifestyle health behaviors, and quality of life among adolescents so that health managers, health instructors, and health advocates can create and execute relevant plans and services to specific groups to improve their quality of life. Thus, the results of this regional adolescent health study should be distributed nationally so that researchers could implement more culturally relevant and tailored health promotion interventions to enhance the quality of life for this population.
Conflict of Interest: None
Sources of funding: None
| References|| |
Theodorou M, Kaitelidou D, Galanis P, Middleton N, Theodorou P, Stafylas P, Siskou O, Maniadakis N. Quality of life measurement in patients with hypertension in Cyprus. Hellenic J Cardiol 2011; 52 (5): 407-15.
Melchiors AC, Correr CJ, Pontarolo R, Santos Fde O, Souza R. Quality of life in hypertensive patients and concurrent validity of Minichal-Brazil. Arq Bras Cardiol 2010; 94(3): 337-344.
Carvalho MAN, Silva IBS, Ramos SBP, Coelho LF, Goncalves ID, Figueiredo Neto JA. Quality of life of hypertensive patients and comparison of two instruments of HRQOL measure. Arquivos brasileiros de cardiologia 2012; 98(5): 442-451.
Schutta MH. Diabetes and hypertension: epidemiology of the relationship and pathophysiology of factors associated with these comorbid conditions. Journal of the cardiometabolic syndrome 2007; 2(2): 124-130.
PowerM, Harper A, Bullinger M. The world health organization whoqol-100: test of the universality of quality of life in 15 defferent cultural groups world wide. Health Psychology 2003; 18(5): 495-505.
Houben-van Herten M, Bai G, Hafkamp E, Landgraf, JM, Raat H. Determinants of health-related quality of life in school-aged children: A general population study in the Netherlands. PLoS One 2015; 10 (5):
Waters E, Davis E, Nicolas C, Wake M, Lo SK. The impact of childhood conditions and concurrent morbidities on child health and well-being. Child: care, health and development 2008; 34(4): 418-429.
Organization WH. Adolescent health research priorities: report of a technical consultation, 13th and 14th October 2015, Geneva, Switzerland; World Health Organization: 2015.
Gielen, UP, Roopnarine JL. Childhood and Adolescence: Cross-Cultural Perspectives and Applications: Cross-Cultural Perspectives and Applications. ABC-CLIO: 2016.
Rew L, Arheart KL, Thompson S, Johnson K. Predictors of adolescents’ health-promoting behaviors guided by primary socialization theory. Journal for Specialists in Pediatric Nursing 2013; 18(4): 277-288.
Luszczynska A, Gibbons FX, Piko BF, Tekozel M. Self-regulatory cognitions, social comparison, and perceived peers’ behaviors as predictors of nutrition and physical activity: A comparison among adolescents in Hungary, Poland, Turkey, and USA. Psychology & Health 2004; 19(5): 577-593.
Lacy KE, Allender SE, Kremer PJ, de Silva- Sanigorski AM, Millar LM, Moodie ML, Mathews LB, Malakellis M, Swinburn BA. Screen time and physical activity behaviours are associated with health-related quality of life in Australian adolescents. Quality of life Research 2012; 21(6): 1085-1099.
Iversen AC, Holsen I. Inequality in health, psychosocial resources and health behavior in early adolescence: the influence of different indicators of socioeconomic position. Child Indicators Research 2008; 1(3): 291-302.
Al Nofaie ND, Ahmadi JR, Saadah OI. Health related quality of life among Saudi children and adolescents with celiac disease. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association 2020.
Hussain AA, Naser KM, Ali DKA. Quality of Life among Adolescents with Type I Diabetes Mellitus at AL-Najaf Center for Diabetes and Endocrine. kufa Journal for Nursing sciences 2018; 8(1): 1-10.
Mikael NA, Al-Allawi NA. Factors affecting quality of life in children and adolescents with thalassemia in Iraqi Kurdistan. Saudi medical journal 2018; 39(8): 799.
Ismail DK, El-Tagui MH, Hussein ZA, Eid MA, Aly SM. Evaluation of health-related quality of life and muscular strength in children with beta thalassemia major. Egyptian Journal of Medical Human Genetics 2018; 19(4): 353-357.
Bowker JC, Ostrov JM, Raja R. Relational and overt aggression in urban India: Associations with peer relations and best friends’ aggression. International Journal of Behavioral Development 2012; 36(2): 107-116.
Organization WH. Improving the quality of paediatric care: an operational guide for facility-based audit and review of paediatric mortality. 2018.
[Table 1], [Table 2], [Table 3]