Abstract
This study aimed to determine the predictors of Quality of Life (QoL) in Transfusion-Dependent Thalassemia (TDT) patients based on PRECEDE (Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) model. This cross-sectional analytical study was performed on 389 TDT patients who were under treatment in four thalassemia centers in Tehran, Iran. Data gathering instrument consisted of three parts: socioeconomic and demographic information, the Persian version of the six standardized questionnaires for measuring some of the potential predictive factors of QoL in TDT patients based on the PRECEDE model constructs, and a researcher-made questionnaire to assess knowledge of patients about health-and QoL-promoting behaviors and enabling factors involved in health- and QoL-promoting behaviors. Using AMOS 23.0, the structural equation modeling with maximum likelihood estimation was conducted to test the proposed hypotheses. Associations of QoL with all of the PRECEDE model constructs, including anxiety–depression, self-efficacy, perceived barriers, knowledge, enabling factors, and reinforcing factors were significant (all p < 0.001). Anxiety–depression and perceived barriers were the significant negative predictors of QoL in TDT patients, whereas health-promoting lifestyle was the significant positive predictor of QoL in TDT patients. The final conceptual model of the study was adequately fit and can be applied as a framework for future educational-supportive programs aimed at improving the QoL in TDT patients.
Highlights
Thalassemia is the most common hereditary chronic anemia disorder in the world [1], and it has become a major global concern because it affects life expectancy and Quality of Life (QoL) of 100s of 1000s of individuals across the globe [1]
In this study, using the structural equation modeling approach, we aimed to identify the predictors of QoL in Transfusion-dependent Thalassemia (TDT) patients based on the constructs of the PRECEDE model
In this cross-sectional investigation, we studied 389 TDT patients who were under treatment in four major thalassemia centers in Tehran, Iran
Summary
Thalassemia is the most common hereditary chronic anemia disorder in the world [1], and it has become a major global concern because it affects life expectancy and Quality of Life (QoL) of 100s of 1000s of individuals across the globe [1]. Owing to the chronic condition of the disease, Transfusion-dependent Thalassemia (TDT) patients might deal with a variety of complications such as heart failure, arrhythmia, diabetes, hypogonadism, hypothyroidism, HIV infection, and thrombosis [2] that might affect their QoL. Significant advances in treatment modalities and improved clinical management have led to a substantially higher life expectancy of these patients [2,3,4]; the need for improvement in QoL remains a major responsibility of the health care providers and policymakers. Identifying factors affecting QoL in TDT patients can help health educators and health care providers to develop and conduct better psychosocial support and counseling programs as well as clinical interventions to improve treatment outcomes in these patients [7]. Having a model as a conceptual framework to identify factors affecting QoL in TDT patients is an advantage
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