Spirituality has been identified as an important dimension of quality-of-life. The objective of this study was to review the literature on quality-of-life and spirituality, their association, and assessment tools. A search was conducted of the keyterms 'quality-of-life' and 'spirituality' in abstract or title in the databases PsycINFO and PubMed/Medline between 1979-2005, complemented by a new search at PUBMED from 2006-2016. Quality-of-life is a new concept, which encompasses and transcends the concept of health, being composed of multiple domains: physical, psychological, environmental, among others. The missing measure in health has been defined as the individual's perception of their position in life in the context of culture and value system in which they live and in relation to their goals, expectations, standards, and concerns. There is consistent evidence of an association between quality-of-life and religiosity/spirituality (R/S), through studies with reasonable methodological rigour, using several variables to assess R/S (e.g. religious affiliation, religious coping, and prayer/spirituality). There are also several valid and reliable instruments to evaluate quality-of-life and spirituality. Further studies are needed, however, especially in Brazil. Such studies will provide empirical data to be used in planning health interventions based on spirituality, seeking a better quality-of-life. In the last 10 years, research is consistently growing about quality-of-life and spirituality in many countries, and also in many areas of health research.

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Quality-of-life and spirituality

Health-related quality of life (HRQOL) has become a concept commonly used in the related research. Using the World Health Organization Quality of Life Questionnaire for Brief Version (WHOQOL-BREF), this study evaluated the Quality of Life (QOL) of people living with HIV/AIDS (PLWHA) in Zhejiang province, China, and assessed the influences of demographic, laboratory and disease-related variables on QOL. This cross-sectional study was conducted among PLWHA aged ≥ 18 years in Taizhou municipality, Zhejiang province, China, between August 1 and October 31, 2014. A multiple linear regression model was used to analyze the influential factors. Of 403 subjects, 72.48% were male, 72.46% had received a high- school or above education, 94.79% were of Han ethnicity, and 65.51% were non farmers. The total score of QOL was 15.99±1.99. The scores of QOL in physiological, psychological, social relation, and environmental domains were 14.99 ±2.25, 14.25 ±2.12, 13.22 ±2.37, and 13.31 ±1.99 respectively. Except the total score of QOL and the score of environmental domain (p<0.05), the scores in other domains had no significant difference with the results of the national norm level. The multiple linear regression model identified the physical domain related factors to be age (β = -0.045), CD4 count (β = 0.002), and ART adherence(β = 1.231). And it also showed that psychological domain related factors included CD4 count (β = 0.002) and WHO clinical stage (β = -0.437); social domain related factors included WHO clinical stage (β = -0.704) and ART adherence (β = 1.177); while environmental domain related factors included WHO clinical stage (β = -0.538), educational status(β = 0.549) and ART adherence(β = 1.078).Those who are young, with higher level of education, higher CD4 count and good access and adherence of ART, are likely to have better QOL among PLWHA in Zhejiang province. This suggests that in addition to ART, many other factors should be taken into consideration to improve the QOL of PLWHA. The relatively lower scores the subjects received in social relation and environmental domains also suggest that social relation and environmental interventions need to be strengthened.

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Quality of Life of People Living with HIV/AIDS: A Cross-Sectional Study in Zhejiang Province, China.

Objective To evaluate quality of life and the associated factors in people living with HIV/AIDS. Methods A cross-sectional study was performed with 146 people with HIV, receiving outpatient treatment. The instruments used were: a questionnaire for socioeconomic, demographic, epidemiological and clinical evaluation and the WHOQOL-HIV BREF scale for the quality of life evaluation. A descriptive analysis and a stepwise forward multiple linear regression test were performed. Results There was a predominance of male gender, lower educational level, and people who were asymptomatic. The Level of Independence and Environment domains had the worst scores. Having a paid occupation, the income per capita, having a religion, a longer time since diagnosis, and adherence to treatment were positively associated with quality of life. A homo-affective relationship, having been stigmatized or suffered prejudice, the presence of psychosocial symptoms, and having acquired opportunistic infections were predictors associated with a poorer quality of life. Conclusion Quality of life had associated predictors and compromise in two areas of the scale.

https://www.scielo.br/pdf/ape/v28n6/1982-0194-ape-28-06-0510.pdf

Qualidade de vida e fatores associados em pessoas vivendo com HIV/AIDS

Background. This study examined health-related quality of life and associated factors among HIV positive women receiving antiretroviral therapy in health facilities of Jimma town. Methods. A cross-sectional study was conducted, and consecutive sampling technique was employed to select 377 HIV positive women who were on antiretroviral therapy. Quality of life was measured using WHOQOL-BREF tool. Descriptive statistics, bivariate, and multivariable logistic regression analyses were performed. P values < 0.05 and adjusted odds ratio with 95% of confidence interval were used to determine statistical significance and report associations between the quality of life and independent variables. Results. Among the sampled participants, 344 were interviewed, yielding 91% of response rate. The mean ± standard deviation age of the respondents was 34.07 ± 8.76 years and 80.5% of them were urban dwellers. The proportion of women reporting good health-related quality of life was found to be 46.5%. Specific to each domain, the mean ± standard deviation of level of independence domain was the highest (14.08 ± 3.07) followed by physical (13.46 ± 2.95), social relationships (13.27 ± 3.91), psychological (12.97 ± 2.47), environmental (12.94 ± 3.25), and spiritual (12.39 ± 2.84) domains. Good social support (AOR: 4.99; 95% CI: [2.88, 8.34]), higher wealth status (AOR: 1.85; 95% CI: [1.02, 3.39]), and being on antiretroviral therapy for shorter duration (AOR: 1.85; 95% CI [1.14, 3.03]) were independently associated with better overall health-related quality of life among the participants. Conclusions. The study demonstrated high proportion of HIV positive women on ART had poor health-related quality of life which was affected by wealth index, social support, and duration on antiretroviral therapy.

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Health-Related Quality of Life and Associated Factors among Women on Antiretroviral Therapy in Health Facilities of Jimma Town, Southwest Ethiopia

The objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo. In total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10–2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94–6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11–11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28–2.61]) were associated with a better overall quality of life (score ≥ 77.3).

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Health-related quality of life among people living with HIV/AIDS in Togo: individuals and contextual effects

INTRODUCTION: Few reports from Nigeria have examined the quality of life (QOL) of people living with HIV/AIDS (PLWHA) despite the fact that Nigeria has the second largest number of PLWHA in the world. This study evaluated the QOL of Nigerians living with HIV/AIDS using the World Health Organization Quality of Life Questionnaire for HIV-Brief Version (WHOQOL-BREF) instrument and assessed the impact of demographic laboratory and disease-related variables on QOL. METHODS: This cross-sectional study involved 491 consecutive PLWHA aged >/= 18 years attending the dedicated clinic to PLWHA in South-west Nigeria. RESULTS: The lowest mean QOL scores were recorded in the environment and social domains. Participants aged >/= 40 years had better QOL in the environment (p = 0.039) and spirituality (p = 0.033) domains and those in relationships had better QOL in the social relationship domain (p = 0.002). Subjects with no or primary education and those who rated their health status as good gave significantly higher ratings in all QOL domains. Participants with AIDS had significant lower QOL in the level of independence domain (p = 0.018) and those with CD4 count >/= 350 cells /mm3 had better QOL scores in the physical psychological and level of independence domains. Subjects without tuberculosis co-infection and those on antiretroviral therapy (ART) reported significantly better QOL in the physical psychological level of independence and spirituality domains. CONCLUSION: Marital relationship absence of tuberculosis CD4 count >/= 350 cells /mm3 and use of ART positively impacted QOL of our patients.

Opeyemi Roseline Awoyemi

Papers

Quality of life of Nigerians living with human immunodeficiency virus