EQ-5D-3L Derived Population Norms for Health Related Quality of Life in Sri Lanka (original) (raw)
The effect of socioeconomic factors on quality of life of elderly in Jaffna district of Sri Lanka
PLOS global public health, 2022
Globally, the proportion of the elderly is increasing. In comparison to other Southeast Asian countries, Sri Lanka's population is rapidly aging. The elderly are a vulnerable age group that requires special attention to live a long and healthy life. As, there was a scarcity of data on the elderly's quality of life, studying the level of quality of life and the associated factors of the elderly in the Jaffna district will provide insight into how to plan interventions to improve the elderly's overall well-being in Jaffna District and Sri Lanka as well. The study aimed to determine the quality of life of the elderly in the Jaffna district of Sri Lanka and to study the association of socioeconomic factors with the quality of life. This cross-sectional study was conducted among 813 community-dwelling elderly in the Jaffna District of Sri Lanka. Socioeconomic characteristics were recorded by way of a structured questionnaire. The WHO-QOL-Bref questionnaire was used to assess quality of life in four domains: physical health, psychological, social participation and the environment. The statistical Package of Social Science Software (SPSS) version 21 was used to analyse the data. Univariate, bivariate, and multivariate analyses were applied, p-value less than 0.05 was considered statistically significant. Among the four QOL domains, the mean (SD) score for an environmental domain was (12.1±2.1), (12.0±2.8) for the psychological domain, (11.8±2.3) for the physical health domain, and (10.1±3.0) for the social relationship domain. Factors significantly associated with all domains of QOL included marital status, level of education, living arrangement, employment, level of income, income adequacy and ownership of the house. Furthermore, age, sex, religion, number of children, and presence of monthly income, were significantly associated with at least one domain of QOL of the elderly. According to these findings, the QOL of the elderly in the Jaffna district of Sri Lanka seems low. And it was associated with multiple socio-economic factors. Interventions to improve the QOL of the elderly are anticipated with a higher emphasis on social relationship for the elderly.
Health in rural Sri Lanka: A cross-sectional survey of three rural districts
Ceylon Medical Journal, 2019
Introduction Sri Lanka has a predominantly rural population. However, there is a dearth of research on health and socioeconomic issues in this group. Objective To describe basic socioeconomic characteristics and health profile in a rural population. Methods A descriptive cross-sectional household survey was conducted in 1950 households in three rural districts, selected by a three-stage stratified cluster sampling method. Results The population pyramid showed an ageing population (dependency ratio of 50%). Only 39% had completed GCE (ordinary level). Unemployment rates were high (25% males, 76% females). Agriculture and related work were main occupations. Most lacked amenities (e.g. 61% households lacked a refrigerator) and practiced inappropriate methods of waste disposal (e.g. open burning by 72%). Household illnesses were frequent: episodes of acute illness within two weeks, injuries within past year and chronic illness were reported from 35.9%, 14.9% and 48.3% households. The prevalence of chronic diseases in adults >20 years were high: diabetes 13.5%, hypertension 16.7% and
Health and Quality of Life Outcomes, 2013
Background: Economic evaluations to inform decisions about allocation of health resources are scarce in Low and Middle Income Countries, including in Sri Lanka. This is in part due to a lack of country-specific utility weights, which are necessary to derive appropriate Quality Adjusted Life Years. The EQ-5D-3L, a generic multi-attribute instrument (MAUI), is most widely used to measure and value health states in high income countries; nevertheless, the sensitivity of generic MAUIs has been criticised in some conditions such as cancer. This article describes a protocol to produce both a generic EQ-5D-3L and cancer specific EORTC-8D utility index in Sri Lanka. Method: EQ-5D-3L and EORTC-8D health states will be valued using the Time Trade-Off technique, by a representative population sample (n = 780 invited) identified using stratified multi-stage cluster sampling with probability proportionate to size method. Households will be randomly selected within 30 clusters across four districts; one adult (≥18 years) within each household will be selected using the Kish grid method. Data will be collected via face-to-face interview, with a Time Trade-Off board employed as a visual aid. Of the 243 EQ-5D-3L and 81,290 EORTC-8D health states, 196 and 84 respectively will be directly valued. In EQ-5D-3L, all health states that combine level 3 on mobility with either level 1 on usual activities or self-care were excluded. Each participant will first complete the EQ-5D-3L, rank and value 14 EQ-5D-3L states (plus the worst health state and "immediate death"), and then rank and value seven EORTC-8D states (plus "immediate death"). Participant demographic and health characteristics will be also collected. Regression models will be fitted to estimate utility indices for EQ-5D-3L and EORTC-8D health states for Sri Lanka. The dependent variable will be the utility value. Different specifications of independent variables will be derived from the ordinal EQ-5D-3L to test for the best-fitting model.
BMC Public Health
Background The proportion of elderly individuals is increasing globally. They should be well cared for to enable them to enjoy their full lifespans. Good health is a vital component of one’s overall quality of life. Our study aimed to assess the association of health-related factors with quality of life among elderly individuals in the Jaffna District of Sri Lanka. Methods We conducted a community-based, cross-sectional study among 813 elderly individuals in the Jaffna district of Sri Lanka. Sociodemographic factors and the patterns of health conditions were recorded through an interviewer-administered questionnaire. Quality of life was measured through the World Health Organisation Quality of Life-Bref (WHOQOL-Bref) questionnaire. Results There were slightly more male respondents (53.5%) than females in the study. The median age of the participants was 70 (11) years. Approximately one-third of them had at least one chronic health condition. Musculoskeletal complaints were found to ...
Health-related quality of life among Indian population: The EQ-5D population norms for India
Journal of Global Health
The EuroQol 5 dimensions (EQ-5D) is the most used generic health-related quality of life (HRQoL) instrument for measuring population health and health outcomes. Since there are no EuroQol 5 dimensions 5 levels (EQ-5D-5L) population norms available for India, this study developed the Indian population norms for the EQ-5D-5L. The potential influencing factors of HRQoL of the Indian population have been identified. The data was collected alongside the Indian EQ-5D-5L valuation study (Development of an EQ-5D Value Set for India Using an Extended Design: DEVINE Study). A cross-sectional survey of 3548 adult respondents was conducted across five states of India, in which respondents were asked to report their own health states using the EQ-5D-5L descriptive system and the EuroQol Visual Analog Scale (EQ VAS). The utility score was calculated using the EQ-5D-5L value set based on the preferences of the Indian population. Norm scores were generated for age, sex, and other important socio-demographic variables. The proportion of patients reporting problems in different dimensions of EQ-5D-5L was assessed. The impact of socio-economic determinants on health-related quality of life was evaluated using multiple linear regression. The mean EQ VAS score of the Indian population is 75.18 (95% confidence interval (CI) = 74.50-75.90), whereas mean utility score is 0.848 (95% CI = 0.840-0.857). The EQ VAS scores, and utility scores decreased with age. Males reported higher EQ VAS values than females. The highest mean utility score was observed for males of <20 years (0.936), whereas the lowest mean score was observed for females of >70 years (0.488). The mean VAS score ranged between 85.24 for females of <20 years and 50.67 for females of >70 years. Highest problems were reported in the dimension of "pain / discomfort", closely followed by "anxiety / depression". Age, educational qualification, marital status, substance abuse, presence of ailments, state / region of residence, number of dependent members in the household, and time spent on mobile are the significant determinants of HRQoL of Indian population. These population norms will be used as reference values for comparative purposes in future Indian studies. Economic evaluations can use these average age-specific HRQoL population norms to value the health-state of not having the specific disease under investigation.
Thirteen Dimensions of Health in Elderly Sri Lankans: Results from a National Sri Lanka Aging Survey
Journal of the American Geriatrics Society, 2000
OBJECTIVES: To explore age and sex differences in distribution of 13 health dimensions with a focus on self-rated health (SRH) and the association between SRH and other health dimensions in elderly Sri Lankans. DESIGN: Sri Lanka Aging Survey, a nationally representative cross-sectional survey. SETTING: Community based. PARTICIPANTS: Inhabitants of 13 districts in Sri Lanka aged 60 and older (N 5 2,413). MEASUREMENTS: Self-reported SRH, hearing, activities of daily living (ADLs), instrumental activities of daily living (IADLs), mobility, physical disability, chronic diseases, stress and worry, mood, cognition, social participation, social support, and financial health. RESULTS: The prevalence of being ''healthy'' in most health dimensions, including SRH, declined with age. Men were more likely to report better SRH; independence in ADLs, IADLs, and mobility; absence of physical disability and chronic diseases; and good mental health. Absence of chronic diseases, independence in ADLs and IADLs, freedom from stress and worry, and absence of depression were associated with positive (excellent/very good/good) SRH. The male SRH advantage was not significant in adjusted analyses, and sex did not modify the association between SRH and other health dimensions. CONCLUSION: Several of the dimensions associated with positive SRH are to a certain extent modifiable and therefore provide a potential for improvement in SRH of elderly Sri Lankans. Differences between this study and studies from elsewhere in the associations between different health dimensions and SRH, and in how sex modifies these associations, suggest that some of the associations may depend on cultural context.
Galle Medical Journal, 2019
Chronic ill health due to non-communicable diseases have already posed a great threat to the well-being of older people in Sri Lanka impairing their quality of life to a greater extent. This study was aimed to examine the impact of some chronic disease conditions on quality of life (QOL) of older people in Galle, Sri Lanka. This cross-sectional study was conducted in 70 older people (male=21, female=49) aged 60 years. Validated self-reported version of World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire which measures QOL in four dimensions; physical, psychological, environmental and social was used to assess the QOL. The age range of the participants was 60-90 years (mean = 70.3 years, SD = 6.2 years). Of the total, 41 subjects were living with their spouse and 22 were widowed. Visual impairment (67%), hypertension (47%) and arthritis (34%) were the most prevalent chronic diseases reported. QOL mean scores for all the four domains which measured in a 1-100 scale were all higher than 65 for both men and women. Further, mean scores of QOL in all the domains in both sexes were found to be low among those who were suffering from chronic conditions, although significant differences were found in physical and psychological domains between those with and without cardiovascular diseases and hypertension (p < 0.1). QOL of older people in Galle is relatively higher compared to the QOL of community dwelling older people in many other countries. Although NCDs and other chronic conditions are prevalent in this study population, cultural and environmental factors may have contributed to improve the QOL of this population group.
Prevalence of Physical Disability among Urban Community-dwelling Adults in Sri Lanka
Disability, CBR & Inclusive Development, 2015
Purpose: Assessment of physical disability at the community level is essential for rehabilitation and supply of services. This study aimed to assess the prevalence of physical disability among adults in an urban community in Sri Lanka.Methods: A descriptive cross-sectional study was conducted among 2460 adults (18-59 years of age) who were selected using cluster sampling. Physical disability was measured using a Physical Impairment Examination Tool (PIET) and World Health Organisation Disability Assessment Schedule II (WHODAS II). Results: Prevalence of physical disability was 4.2% (95% CI= 3.5-5.1). Physical disability was higher among people in the age group of 40-59 years (6.5%, n=64) than among those in the age group of 18-39 years (2.6%, n=39) (P<0.05). Physical disability was more prevalent among females (4.4%, 95% CI= 4.2-4.6) than males (2.6%, 95% CI: 2.4-2.8), and among Tamils (7.8%, 95% CI=5.1%- 10.5%) than Sinhalese (3.3%, 95% CI=2.4%- 4.1%). It was higher among those ...
Purpose: Against the backdrop of the ever-increasing aging population in Sri Lanka and the scarcity of local evidence on quality of life (QoL) among rural elderly, this study was conducted to assess the QoL of the community-dwelling older adults in rural Sri Lanka.Methods: This cross-sectional study was conducted among community-dwelling older adults (60-74 years) in a selected rural setting in Sri Lanka. Statistically significant associations of QoL were determined by using the K-means cluster analysis followed by multivariable analysis.Results: The final sample consisted of 3573 community-dwelling older adults (response rate 97.8%). The mean (SD) age of the sample was 66.7 (4.3) years and the majority were females (n=2130, 59.6%). Amongst the six QoL domains assessed (physical, psychological, social, functional, environmental and spiritual domains), the highest and the lowest mean (SD) scores were reported for the functional [63.4(16.9)] and the physical [52.9(15.0)] domains respe...
Valuing EQ-5D health states for Sri Lanka
Quality of Life Research, 2014
Purpose The aim of this study was to derive an algorithm to estimate utility values for the EQ-5D-3L health states based on the preferences of a population sample from Sri Lanka. Methods The time trade-off method was used to directly value 198 EQ-5D-3L health states in a general population sample (n = 780) from Sri Lanka. Stratified cluster sampling with random selection within clusters was used to select the sample from four districts. Each participant valued 15 health states via face-to-face interviews. The best fit model was selected using consistency, parsimony, and goodness of fit. Based on logical inconsistency, numerous sub-samples were also used for model specification. For each model, the numbers of illogical orderings in the resulting value set were also examined. Results Generalised least squares with random effects were found to be the best specification. The sub-sample consisting of participants with less than seven logical inconsistent observations produced no illogical ordering in the final value set and is considered the preferred model. Compared to value sets in other countries, a high disutility is associated with level 3 deficits in the mobility dimension. More than 50 % of health states in the Sri Lankan value set are deemed worse than death health states. Conclusions Sri Lankan utility values for EQ-5D-3L states deviate markedly from existing values for upper middle and high-income countries. It is important to have country-specific utility values to conduct cost-utility analysis.