Only 14 pages are availabe for public view
Major depression is one of the most common mental disorders in adult populations and is the most common illness that psychologists treat. Major depression is considered to be the fourth leading cause of disability (WHO, 2013). It can affect people at any stage of life and once a person experiences one episode of major depression, that person is likely to experience at least two to three relapses in his or her lifetime (Parashar et al., 2015). Major depression is also the leading cause of suicide in adults, particularly adults aged 65 and older and it is associated with increased morbidity and mortality when related to medical illness (Conwell, 2013).
Quality of life (QOL) is the general well-being of individuals and societies, outlining negative and positive features of life. It observes life satisfaction, including everything from physical health, family, education, employment, wealth, religious beliefs, finance and the environment (Barcaccia & Barbara, 2014).
QOL in depressed patients seems to be even more negatively affected in the presence of psychiatric and medical comorbid conditions such as posttraumatic stress disorder (PTSD), generalized anxiety disorder, panic disorder, personality disorders, substance abuse, congestive heart failure (Saarijarvi et al., 2015). There are many factors affecting QOL of depressed patients are related to low QOL included old age, low level of education, unemployment, employment type, current economic status, seizure frequency, family life/social life dissatisfaction, poor social support, the symptoms of anxiety and depression and ADL dysfunction (Choi-Kwon et al., 2015).
Aim of this study
Assess the quality of life among patients with depression through assess the level of QOL among patients with depression and assess factors affecting quality of life among patients suffering from depression.
This aim was achieved through answering the following research question;
• What is the level of QOL among patient suffering from depression?
• What are the factors affecting QOL among patient suffering from depression?
A descriptive design was used to achieve the aim of this study.
This study had been conducted at the outpatient clinics of El-Abassia Hospital for Psychiatric Mental Health, using a simple convenience sample of patients with major depressive disorders and the data had been collected over three months beginning from February 2018 to the end of April during three days / week (Monday, Tuesday and Thursday).
Subject of study
Study sample included 130 patients at outpatients’ clinic in El Abassia psychiatric mental Hospital.
• Patients who are diagnosed with major depression and free from any other psychiatric disorders.
• Period of depression more than 1 year.
• Both sex males and females.
• Cooperative and able to interact.
Tool of data collection:
The tools used for the study consists of interview questionnaire sheet:
The questionnaire contains two parts used for data collection:
• Socio demographic sheet.
• Factors affecting quality of life among patient with major depression.
• World Health Organization Quality of Life Scale (WHOQOL- Group, 2008).
Part (A): Socio-demographic sheet:
A personal interview sheet among the patients with major depressive disorder.
It was constructed by the Investigator after reviewing literature in this field; the investigator designed the sheets of tool. This section included brief personal profile questions about the participant’s patient as (name, age, sex, marital status, occupation position, monthly income, educational level, work and physical illness).
Part (B): Factors affecting quality of life among patients with major depressive disorder (QOL).
It was constructed by the Investigator after reviewing literature in this field. This questionnaire included four titles with (58 items) to measure factors affecting quality of life among patients with MDD such as: psychological factors consisted of (15items), social factors consisted of (13 items), family factors consisted of (15 items) and vocational factors consisted of (15 items).
The second tool: World Health Organization Quality of Life Scale (WHOQOL- Group, 2008):
World Health Organization Quality of Life Scale (WHOQOL) is a standardized rating scale used to measure one’s perceived QOL in patients presenting with depressive disorders, developed by the WHO (2008), translated and modified by the researcher to measure QOL among patients with depressive disorder. This scale included (26 items), 2 of them for overall quality of life (general QOL and general health) and 24 items distributed on four domains, the Physical domains consisted of (7items), Psychological domains consisted of (7items), Social relationship domains consisted of (5 items) and Environment domains consisted of (5 items).
The main finding of this study can be summarized in the following:
• About more than one half of patients were females represented (57.7%) in the age group ˃37 with Mean age of (37.79 ± 12.7). and their Mean ± SD were 37.79 ± 12.7. This result might be attributed to the nature and availability of study sample during the time data collection.
• Study revealed that, less than half of patients under study were married, this may be due to over stress of daily life, high responsibilities of marriage, their limited of financial resources and unstable work condition.
• Study finding revealed that, more than one third of studied sample were moderate qualification, most of the patients coming to the hospitals are low of socio-economic status, which is associated with low education and low income.
• Study result revealed that, more than half of the patients were working, this could be due to and the working people had too stress life events, difficulty in maintaining family and social relationships.
• Study finding revealed that, more than two third of studied patients did not had physical illness; this may be effective treatment can decrease disability, prolong survival and increase quality of life.
• This study revealed that, the majority of studied patients their family members without mental illness.
• Study finding about factors affecting quality of life the result showed that, the highest percentages of factors affecting QOL among patients with MDD were family factors represented (88.5%) while, the lowest percentages of factors affecting QOL were social factors represented (17.7%).
• Quality of life among patients with MDD revealed that, highest percentage of QOL among patients with MDD under the study was moderate represented (50%) and the lowest percentage of QOL among patients with MDD under the study was poor represented (4%).
• The current study showed that, the highest percentage of subscales of quality of life is the psychological health was poor among the patients with MDD under the study represented (73.1%). While, the lowest percentage of subscale of quality of life is the environment was good among the patients with MDD under the study represented (1.5%).
• There is statistical significant relation between total factors affecting QOL among patient with MDD and sex, P-value <0.05. While, there is no statistical significant relation between total factors affecting QOL and age, marital status and residence, P-value >0.05.
• There is statistical significant relation between total factors affecting QOL among patient with MDD and functional status, P-value <0.05. While, there is no statistical significant relation between total factors affecting QOL and education level and financial income, P-value >0.05.
• There is no statistical significant relation between gender, age, marital status, residence, functional status and quality of life among patients with MDD, P-valve >0.05.
• There is statistical significant relation between education level, financial income and QOL among patients with MDD, P-value <0.05.
• There is no statistical significant relation between QOL, onset of depression and physical illness among patients with MDD, P-value >0.05.
• There is a highly statistical significant relation between QOL and total factors affecting QOL among patients with MDD, P-value <0.001.
• There is no statistical significant relation between QOL and psychological factors, P-value >0.05. While, there is statistical significant between QOL and Social factors, P-value <0.05. Also, there is a highly statistical significant relation between family, professional factors and QOL among patients with MDD, P-value <0.001.
Based on the findings and conclusion of this study, the following recommendations are suggested: -
• Develop an educational program to patients with depression and their families on how to avoid and/or cope with depression to maintain normal life style at highest possible level of QOL.
• Sustainability of supportive psychotherapy and other psychological methods in outpatient clinics to decrease depressive symptoms and enhance their quality of life.
• Self-management program for depressed patients and their families should be initiated.
• Psychiatric mental health care and services should be available for all patients suffering from depression especially in rural areas.
• Effective communication approaches to prevent depression focus on several action surrounding the strengthening of protective factors and the reduction of risk factors should be implemented across the life span.
• It is necessary to increase the public awareness regarding depressive disorders, through media to remove stigma, misconception, fear and anxiety surround it.
• Psycho education should be provided for individuals with depression at all levels of severity and in all care setting and should be provided both verbally and with written educational materials.
• Establishing a day care center (Rehabilitation center) in all psychiatric hospitals in order to enhance rehabilitative activities for patients with depression.