Determinants of Quality of Life by Domain Among Patients with Diabetes Mellitus at the Komfo Anokye Teaching Hospital in Ghana

Abstract

Background The impact of diabetes mellitus (DM) on the individual beyond acute and chronic complications and financial burden is the deterioration of the person's quality of life (QOL). This study assessed domain-specific predictors of QOL among patients with DM at a tertiary hospital in Ghana. Methods We conducted a cross-sectional study of patients with DM attending the clinic, using face-to-face interviews with the World Health Organisation Quality of Life-BREF (WHOQOL-BREF) scale for assessinng patients' QOL and reviewed medical records. A multivariable logistic regression analysis was used to identify independent factors associated with poor QOL. Results The study included 360 patients with a mean age of 62.5 ± 11.6 years and an overall QOL score of 71.00. Urban residence (aOR 0.24; 95% CI 0.06-0.87, p=0.030) was protective against poor overall QOL. However, poor self-management (aOR 18.30; 95% CI 7.98-44.5, p<0.001) and recent hospitalisation (within the past 3 months) (aOR 4.58; 95% CI 1.58-13.26, p=0.005) were associated with higher odds of poor overall QOL. Poor physical health was associated with increasing age (aOR 1.01; 95% CI 1.05-1.15, p<0.001) and comorbidities (aOR 6.08; 95% CI 1.76-20.40, p=0.003). Being married (aOR 0.33; 95% CI 0.12-0.92, p=0.030) was protective, whereas unemployment (aOR 3.28; 95% CI 1.61-7.05, p=0.002) was associated with higher odds of poor psychological QOL. Males (aOR 2.99; 95% CI 1.63-5.52, p<0.001) and past alcohol users (aOR 2.16; 95% CI 1.15-4.04, p=0.016) had higher odds of poor social relationships. The poor environment domain of QOL was predicted by lower education (aOR 5.79; 95% CI 1.75-24.50, p<0.008). Poor self-management was significantly associated with poor QOL across all domains (p<0.001). Conclusion Urban residence, diabetes self-management and recent hospitalisation are associated with overall QOL. Enhancing self-management and reducing acute hospitalisations can improve QOL outcomes; however, understanding sub-domain differences helps guide targeted interventions.