Quality of life of individuals with disabilities - concepts and concerns

Abstract

Introduction: The number of people with disabilities has grown tremendously for the last 15 years in Bulgaria. Standardized quality of life instruments can be helpful in the development of public policies which target the needs of this population. The quality of life (QoL) paradigm is a challenging perspective for considering, planning and implementing changes within the area of disabilities. Moreover, an interview with a disabled person about her/his subjective health is a human care with a positive impact on the overall well-being of the individual. This paper aims at stimulating a debate on these topics by investigating the “QoL” and “disability” territories. Further, a study on QoL of individuals with disabilities is presented. The objectives of this study are: (1) to measure the QoL of a representative sample of 305 individuals with disabilities, who are patients from a general Territory Expert Medical Commission – TEMC * (St. Marina University Hospital, Varna) by using the WHO generic questionnaire (WHOQOL–BREF) - 26 questions; four-domains structure: Physical health, Psychological health, Social relationships, Environment. (2) To define the influence of the four domains on QoL. (3) To analyze the relationship between QoL and socio-demographic characteristics. (4) To assess the influence of physical pain on QoL. Methods: A cross-sectional study was conducted in 2011 using a representative sample of the register of a general TEMC (n=305, >18 years old). Respondents were selected through the method of multi-stage random selection. Results: As a result of multiple-regression analyses it was found out that all the domains have influence on QoL but the most influential is the “Environment” domain (0.394), followed by “Physical health” domain (0.354), “Psychological health” domain (0.261) and “Social relationships” domain (0.169). The total multiple regression coefficient – R is 0.984 (R 2 =0.969). The patients who reported higher levels of pain – 95.80 % - have lower QoL. No relations were found between socio-demographic characteristics of the patients and their QoL. Nowadays, the TEMC mission has to cover not only expert assessment and integration of persons with disabilities into society. The TEMC mission should also involve the improvement of QoL of the people with disabilities. A medico-social approach for handicap-assessment is proposed as a prerequisite for sustainable development of the public health policies concerning people with disabilities.