Abstract

PurposeTo assess the quality of life (QoL) of caregivers of children with sickle cell disease (SCD) and to determine the risk factors associated with poor QoL.MethodA cross sectional study was conducted between 01 and 30 June 2015, in a tertiary care center in western Saudi Arabia to assess various dimensions of QoL by using TNO-AZL Questionnaire for Adult’s Health-related Quality of Life (TAAQOL). A total 164 adult caregivers (aged 16 years or more) of children with SCD, who were regularly visiting the department were enrolled (refusal rate = 61.6%). The questionnaire scores were transformed into 0–100 scale; with higher scores indicating less difficulty and better QoL Demographic, socioeconomic data and a satisfaction questionnaire regarding participants’ lifestyle were collected and analyzed as risk factors for impaired QoL, by comparing different QoL dimensions’ scores using independent t-test, Oneway ANOVA, or linear regression, as appropriate.ResultsSixty-three caregivers were included; 79.4% were mothers, age range 21–71 years, 64.5% were from low social class receiving insufficient support and financial needs were unmet for considerable number of families. Analysis of QoL using TAAQOL showed that emotions (median [75th centile] = 44.44 [66.67] for negative and 61.11 [72.22] for positive emotions), sleep quality (66.67 [91.67]) and sexual life (50.00 [83.33]) were the most affected dimensions. Professional achievement (91.67 [100]), cognitive skills (83.33 [100]), and social contact (100 [100]) were relatively preserved. Negative emotions were more marked in mothers and mostly predicted by satisfaction with social relations notably with partner (B = 3.14, p = 0.016), friends (B = 2.51, p = 0.015) and relatives (B = 2.69, p = 0.016). Positive emotions were predicted by the levels of satisfaction of the caregiver with his/her health (B = 2.56, p = 0.001), job achievement (B = 4.54, p = 0.001), living conditions (B = 2.60, p = 0.034) and the condition of the diseased child (B = 2.55, p = 0.011). A strong correlation was found between sleep quality and cognitive skills.ConclusionThere are notable financial and emotional burdens on the caregivers of children with SCD affecting various aspects of their QoL, which are likely to be impacted by the individual levels of social and professional achievement. Physicians and health authorities should give particular attention to the QoL of caregivers and families of children with SCD, to help them cope up with the disease and overcome its related psychological and financial impacts.

Highlights

  • World Health Organization estimated that over 5% of the world population carries genes of hemoglobinopathies

  • Sixty-three caregivers were included; 79.4% were mothers, age range 21–71 years, 64.5% were from low social class receiving insufficient support and financial needs were unmet for considerable number of families

  • There are notable financial and emotional burdens on the caregivers of children with sickle cell disease (SCD) affecting various aspects of their quality of life (QoL), which are likely to be impacted by the individual levels of social and professional achievement

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Summary

Introduction

World Health Organization estimated that over 5% of the world population carries genes of hemoglobinopathies. SCD is relatively prevalent in some cultures with high rates of consanguinity and large family size, such as in the Middle-East region, including Saudi Arabia, where hemoglobinopathies constitute real public health issues [2, 3]. SCD is one of the most common genetic disorders in Saudi Arabia, with an overall prevalence rate of 44.1 (42 carriers and 2.1 cases) per 1000 and marked regional variations reaching up to 134.1 per 1000 in the Eastern Region [3, 4]. SCD is a hemoglobinopathy characterized by a chronic anemia with various acute “painful crises” and chronic symptoms that require daily care and sometimes intensive medication; all negatively impacting physical functioning, sleep, school performance, and overall quality of life (QoL) of patients [5, 6]. An increasing interest to the various aspects of patients’ QoL is noted in the recent publications, highlighting the contribution of different factors such as complications, comorbidities, compliance to treatments, etc. [7, 8]

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