Quality of life among patients with chronic non-communicable diseases during COVID-19 pandemic in Southern Ethiopia: A cross-sectional analytical study

Abstract

BackgroundThe COVID-19 outbreak became a continuing global health agenda. It has a significant impact on individuals’ quality of life (QOL). Patients with preexisting medical conditions may have severely reduced QOL. The aim of this study was to assess QOL and its associated factors among patients with chronic non-communicable diseases (NCDs) during COVID-19 pandemic at Sidama Regional State, southern Ethiopia.MethodsWe conducted a multicenter, cross-sectional study from 1 June to 1 September 2021. A total of 633 participants took part in the study, using an interviewer-administered structured questionnaire. The QOL was measured using the World Health Organization Quality of Life (WHOQOL-BREF) Scale, which has 12 items. To describe different variables, descriptive statistics were employed. To find independent factors associated with QOL, we used multivariable linear regression analysis. P-value of < 0.05 was declared statistically significant at 95% confidence interval (CI).ResultsThe majority (56.4%) of participants were male and about half (53.1%) had a diagnosis of diabetes mellitus. The multivariable linear regression model showed statistically significant negative association between different independent variables such as age (β = −0.188, 95% CI = −0.238 to −0.139), being female (β = −1.942, 95% CI = −3.237 to −0.647), duration of illness ≤ 5 years (β = −4.222, 95% CI = −6.358 to −2.087), alcohol use in the past 3 months (β = −4.574, 95% CI = −6.905 to −2.243), common mental disorder (CMD) (β = −1.512, 95% CI = −2.924 to −0.100), insomnia (β = −0.274, 95% CI = −0.380 to −0.168), and QOL. Also, there is a statistically significant positive association between QOL and being illiterate (β = 3.919, 95% CI = 1.998–5.841) and living in the rural area (β = 2.616, 95% CI = 1.242–3.990).ConclusionIn general, the findings confirmed that the COVID-19 pandemic had a negative impact on patients with chronic NCDs QOL. The QOL was significantly influenced by age, gender, educational status, residence area, duration of illness, alcohol use, CMD, and insomnia during COVID-19 pandemic. Thus, this study suggests that addressing insomnia, co-morbidities of mental disorders, and alcohol use has the potential effect to improve the QOL of patients with chronic medical illnesses.

The impact of COVID-19 on non-communicable disease patients in sub-Saharan African countries: systematic review

“…The results of this review revealed the presence of a clear relationship between the COVID-19 pandemic, mental health, and risk and protective factors for NCDs. Several studies identified a significant association between increased substance use and increased levels of anxiety and depression [36,37,41,44]. Similar associations were found between missed medical appointment and sedentary lifestyle and, poor treatment control and sedentary lifestyles, physical inactivity and substance use, and poor health-seeking behavior and substance use [25,26,27].…”

“…Among this, 14 studies focused on chronic disease patients, five focused on diabetes, three focused on hypertension, two focused on diseases and/ or hypertension, one focused on cancer, and one focused on cardiovascular disease. The review findings were organized into five frequently reported themes and subthemes: these are 1) disruption of follow-up care and poor health care utilization reported by 11 studies [10,11, 23,24,25,26,27,28,29,30,31]; 2) increased anxiety, stress, depression, and increased mental health problems reported by eight studies [15,32, 34,35,37,38,39,43]; 3) substance use reported by four studies [36,37,41,44]; 4) decreased physical activity and sedentary life reported by three studies [33,36,44]; and 5) increased food insecurity and poor dietary habits due to COVID-19 among NCDs patients, reported in five studies [36,40,42,43,44] Studies included in this review did not focus on the same subject matter. Some studies focused on one theme and others focus on more than two themes; for instance, (Andualem et al, 2020) examined adherence to lifestyle modifications and reported on diet, exercise, smoking, and alcohol, whereas (Abate et al, 2022) examined adherence to physical exercise recommendations and reported only on exercise compliance.…”

“…Another important impact of the COVID-19 pandemic was identified in seven studies that reported a negative impact of pandemic on the mental health and psychological well-being of noncommunicable disease patients [15,32,34,35,37,38,39,43]. Increased stress and anxiety can be a result of fear of contracting the virus, disruptions in healthcare services, social isolation, and economic hardships.…”

“…Factors such as socioeconomic and demographic factors, self-funding for medication costs, disruption of transportation, increased medication costs due to disruption, and poverty have been identified as contributing to the negative impact of the pandemic on NCD prevention and management in sub-Saharan countries [31]. The COVID-19 pandemic has also disrupted referral and supply chain systems, leading to limited availability and affordability of medication in Ethiopia [37,18] and Uganda [22]. Acute health facility staff absenteeism has also been observed in Uganda [35].…”

“…According to these studies, there has been a variable effect on alcohol use during the COVID-19 lockdown. While some studies have reported increased alcohol use and non-adherence to recommendations for alcohol consumption, others have noted an increase in hazardous drinking [36,37,41,44].…”