Abstract
Objectives
The usefulness of quality of life (QOL) as an outcome measure in medicine has inspired general population studies to establish normative values. The objectives of the study were to: (1) highlight the pattern of satisfaction with aspects of life circumstances among a nationwide sample of Kuwaiti subjects, using the 26-item WHOQOL Instrument (WHOQOL-Bref); (2) establish the QOL domain normative values; (3) highlight the relationship of QOL with socio-demographic variables and scores on scales for anxiety and depression; and (4) assess the relationship between domains of QOL.
Method
A one-in-three systematic random proportionate sample of consenting Kuwaiti nationals attending the large cooperative stores and municipal government offices in the six governorates, were requested to complete the questionnaires anonymously.
Results
There were 3,303 participants (44.8% m, 55.2% f, mean age 35.4, SD 11.9; range, 16–87). As a group, they were only moderately satisfied with their life circumstances. The domain scores for physical health (14.6 or 66.2%) and psychological health (14.2 or 63.9%) were at the middle of the range for the WHO 23-country report, while the social relations (15.0 or 68.8%) and environment (14.5 or 65.4%) domains were at the upper end of the WHO range. The general facet (GF) score (15.5 or 71.6%) was significantly higher than all domains. Diminished QOL was significantly associated with female gender, older age, social disadvantage, and high scores on anxiety/depression. Depression was the most important predictor of QOL, accounting for over 77% of total variance.
Conclusion
QOL was sensitive to distressing and unfulfilled life circumstances. Hence, coupled with the difficulty of conducting house-to-house surveys in such a conservative society, a cost effective way of tracking societal distress is by including a brief and responsive measure of QOL during national census exercises. Clinicians need to be aware of QOL issues because QOL is associated with clinical and social variables. The differences between GF (representing subjective well-being) and the domains, has implications for QOL theory.
Similar content being viewed by others
References
Abdalla IA (1996) Attitudes towards women in the Arabian Gulf region. Women Manage Rev 11(1):29–39
Aigner M, Forster-Streffleur S, Prause W, Freidl M, Weiss M, Bach M (2006) What does the WHOQOL-Bref measure? Measurement overlap between quality of life and depressive symptomatology in chronic somatoform disorder. Soc Psychiatry Psychiatr Epidemiol 41:81–86
Albrecht GL, Devlieger PJ (1998) The disability paradox: high quality of life against all odds. Soc Sci Med 48:977–988
Al-Fayez G, Ohaeri JU, Al-Zabin Z, Kamel N (2007) Prevalence of physical, psychological and sexual abuse among Kuwaiti adolescents: its impact on quality of life, self-esteem and mental health. Occasional Scientific Specialized series, No. 31. Kuwait Society for the Advancement of Arab Children, Safat
American Psychiatric Association (1994) Diagnostic and Statistical Manual. **IV-Revised edition, Washington, DC
Ampon RD, Williamson M, Correll PK, Marks GB (2005) Impact of asthma on self-reported health status and quality of life: a population based study of Australians aged 18–64. Thorax 60:735–739
Anderson KL, Burckhardt CS (1999) Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research. J Adv Nurs 29:298–306
Awadalla AW, Ohaeri JU, Salih AA, Tawfiq AM (2005) Subjective quality of life of community living Sudanese psychiatric patients: comparison with caregivers’ impression and control group. Qual Life Res 14:1855–1867
Bobak M, Pikhart H, Hertzman C, Rose R, Marmot M (1998) Socioeconomic factors, perceived control and self-reported health in Russia: a cross-sectional survey. Soc Sci Med 47:269–279
Cummins RA (1995) On the trail of the gold standard for subjective well-being. Soc Indic Res 35:179–200
Cummins RA (2005) Moving from the quality of life concept to a theory. J Intellect Disabl Res 49:699–706
Diener E, Diener M (1995) Cross-cultural correlates of life satisfaction and self-esteem. J Pers Soc Psychol 68:653–663
Diener E, Suh EM, Lucas RE, Smith HL (1999) Subjective well-being: three decades of progress. Psychol Bull 125:276–302
Diener E (2000) Subjective well-being: the science of happiness and a proposal for a national index. Am Psychol 55:34–43
Diener E, Lucas RE, Scollon CN (2006) Beyond the hedonic treadmill: revising the adaptation theory of well-being. Am Psychol 61:305–314
Eid S, Al-Zayed A (2005) Knowledge of symptoms and treatment of schizophrenia and depression among Kuwaiti population. Arab J Psychiatry 16:62–77
Gandek B, Ware JE (1998) Methods for validating and norming translations of health status questionnaires: The IQOLA project approach. J Clin Epidemiol 51:953–959
Helliwell JF, Putnam RD (2004) The social context of well-being. Phil Trans R Soc Lond B 359:3435–3446
Hennessy CH, Moriarty DG, Zack MM, Scherr PA, Brackbilln R (1994) Measuring health-related quality of life for public health surveillance. Public Health Rep 109:665–672
Jelsma J, Mkoka S, Amosun SL (2008) Health-related quality of life (HRQoL) domains most valued by urban IsiXhosa-speaking people. Qual Life Res 17:347–355
Katschnig H (2006) How useful is the concept of quality of life in psychiatry? In: Katschnig H, Freeman H, Sartorius N (eds) Quality of life in mental disorders. Wiley, West Sussex, pp 3–17
Kebede D, Alem A, Shibre T, Negash A, Devassa N, Beyero T (2004) Health related quality of life survey in Butajira, rural Ethiopia: normative data and evaluation of reliability and validity. Ethiopia Med J 42:289–297
Kenny C (2005) Does development make you happy? Subjective well being in developing countries. Soc Indic Res 73(2):199–219
Lucas RE, Diener E, Suh E (1996) Discriminant validity of well-being measures. J Pers Soc Psychol 71:616–628
Myers DG (2000) The funds, friends and faith of happy people. Am Psychol 55:56–67
Myers DG, Diener E (1996) The pursuit of happiness. Sci Am 274:54–56
Nedjat S, Montazeri A, Holakouie K, Mohammad K, Majdzadeh R (2008) Psychometric properties of the Iranian interview-administered version of the World Health Organization’s quality of life questionnaire (WHOQOL-Bref): a population-based study. BMC Health Serv Res 8:61
Noerholm V, Groenvold M, Watt T, Bjorner JB, Rasmussen NA, Bech P (2004) Quality of life in the Danish general population-normative data and validity of WHOQOL-Bref using Rasch and item response theory models. Qual Life Res 13:531–540
Ohaeri JU, Awadalla AW, Ghoulum A, El-Abassi AM, Jacob A (2007) Confirmatory factor analytical study of the WHOQOL-Bref: experience with Sudanese general population and psychiatric samples. BMC Med Res Methodol 7:37
Olusina AK, Ohaeri JU (2003) Subjective quality of life of recently discharged Nigerian psychiatric patients. Soc Psychiatry Psychiatr Epidemiol 38:707–714
Paulik E, Belec B, Molnar R, Muller A, Belicza E, Kullmann L, Nagymajtenyi L (2007) Applicability of the abbreviated version of the World Health Organization’s quality of life questionnaire in Hungary. Orv Hetil 148:155–160
Saarni SI, Suvisaari J, Sintonen H, Pikkola S, Koskinen S, Aromaa A, Lonnqvist J (2007) Impact of psychiatric disorders on health-related quality of life: general population survey. Br J Psychiatry 190:326–332
Sabbah AI, Drougby N, Sabbah S, Retel-Rude N, Mercier M (2003) Quality of life in rural and urban populations in Lebanon using SF-36 health survey. Health Qual Life Outcomes 1:30
Seitz DP (2005) Screening mnemonic for generalized anxiety disorder. Can Fam Physician 51:1340–1342
Skevington SM, Lofty M, O’Connell KA (2004) The World Health Organization’s WHOQOL-Bref quality of life assessment: psychometric properties and results of the international field trial: a report from the WHOQOL group. Qual Life Res 13:299–310
Spitzer R, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD. JAMA 282:1737–1744
Stewart K (2005) Dimensions of well being in EU Regions: do GDP and unemployment tell us all we need to know? Soc Indic Res 73:221–246
United Nations Economic Social Commission for Western Asia (1992) Second Amman declaration on population and development in the Arab world. Popul Bull ESCWA 40:37–67
Warner R (1999) The emics and etics of quality of life assessment. Soc Psychiatry Psychiatr Epidemiol 34:117–121
HO W (1998) WHOQOL user manual. World Health Organization, Program on Mental Health, Geneva
Wilson IB, Cleary PD (1995) Linking clinical variables with health-related quality of life. JAMA 273:59–65
Zahran HS, Kobau R, Moriarty DG, Zack MM, Holt J, Donehoo R (2005) Health-related quality of life surveillance-United States, 1993–2002. MMWR Surveill Summ 54:1–35
Zissi A, Barry MM, Cochrane R (1998) A mediational model of quality of life for individuals with severe mental health problems. Psychol Med 28:1221–1230
Acknowledgments
The project was carried out with a grant from the Kuwait Foundation for the Advancement of Sciences (KFAS). Joy Wilson coded all the data. Charles Osuagwu played an invaluable role in locating literature. The staff of Al-Bayan for Translation was responsible for administering the questionnaires in the community. Dr. Yusuf Al-Failakiya coordinated the work in the community. We thank the staff and heads of administration at the various locations in the community where the study took place.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ohaeri, J.U., Awadalla, A.W. & Gado, O.M. Subjective quality of life in a nationwide sample of Kuwaiti subjects using the short version of the WHO quality of life instrument. Soc Psychiat Epidemiol 44, 693–701 (2009). https://doi.org/10.1007/s00127-008-0477-z
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-008-0477-z