Introduction
Methods
Study design and setting
Sample size
Sampling procedure
Measures
Data collection
Statistical analysis
Results
Demographic characteristic of study participants
Joint family system (n = 1053) | Nuclear family system (n = 1010) | All (n = 2063) | |
---|---|---|---|
No. (%) | No. (%) | No. (%) | |
Age | |||
18–30 | 412(39.2) | 308(20.6) | 720(34.9) |
31–40 | 277(26.3) | 359(35.4) | 636(30.8) |
41–50 | 149(14.2) | 240(23.7) | 389(18.8) |
> 50 | 215(20.4) | 103(10.2) | 318(15.4) |
Gender | |||
Males | 553 (52.5) | 505 (50) | 1078 (52.2) |
Females | 500 (47.5) | 505 (50) | 1005(48.7) |
Marital status | |||
Married | 843 (80.0) | 796 (78.8) | 1639 (79.4) |
Widowed/Widower | 36 (3.4) | 24 (2.37) | 60 (2.9) |
Divorced | 4(0.3) | 2 (0.1) | 6 (2.0) |
Separated | 5(0.4) | 4(0.3) | 9 (0.4) |
Never Married | 165 (15.6) | 184(18.2) | 349(16.9) |
Education | |||
No education | 163(15.4) | 159(15.7) | 322(15.6) |
Informal education | 17(1.6) | 30(2.9) | 47(2.2) |
Can read / write | 111(10.5) | 100(9.9) | 211(10.2) |
Primary (up to grade 1) | 344(32.6) | 293(29) | 637(30.8) |
Secondary (up to grade 2) | 321(30.4) | 337(33.3) | 658(31.8) |
Tertiary (up to grade 3) | 97(9.2) | 91(9) | 188(9.1) |
Place of residence | |||
Urban | 297(28.3) | 301(29.8) | 598(29) |
Rural | 756 (71.7) | 709(70.2) | 1465(71) |
Ownership of residence | |||
Owner | 849(80.5) | 750(74.3) | 1599(77.5) |
Not owner | 204(19.5) | 259(25.7) | 463(22.4) |
Occupation | |||
Not working | 397 (37.7) | 413(40.9) | 810(39.3) |
Working | 595 (56.5) | 567(56.1) | 1162(56.3) |
Retired | 61 (5.8) | 30(3) | 91(4.4) |
Socioeconomic status | |||
High | 391(37.1) | 296(29.3) | 687(33.3) |
Intermediate | 375(35.6) | 315(31.2) | 690(33.4) |
Low | 287(27.3) | 399(39.5) | 686(33.3) |
Respondent disease | |||
Physical disability | 13(1.2) | 15(1.5) | 28(1.4) |
Hypertension | 79(7.5) | 75 (7.4) | 154(7.5) |
Diabetes | 34(3.2) | 24(2.4) | 58(2.8) |
Other | 492 (47) | 488(48.3) | 980(47.5) |
None | 435(41.3) | 408(40.4) | 843(41) |
Respondent satisfaction | |||
Satisfied | 921(87.5) | 817(81) | 1738(84.2) |
Unsatisfied | 132(12.5) | 193(19) | 325(15.8) |
Social Capital | |||
Low | 96(9.1) | 118(11.7) | 214(10.4) |
Moderate | 816(77.5) | 755(74.7) | 1571(76.1) |
High | 141(13.4) | 137(13.6) | 278(13.5) |
Joint family system WHO QOL-BREF scores
Physical | Psychological | Relationship | Environmental | General facet | |
---|---|---|---|---|---|
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |
Type of residence | |||||
Urban | 68.6 ± 15.6 | 71.0 ± 14.4 | 74.1 ± 15.8 | 59.9 ± 14.2 | 69.4 ± 16.0 |
Rural | 63.7 ± 14.9 | 65.9 ± 14.7 | 71.0 ± 16.6 | 53.7 ± 14.5 | 69.2 ± 16.9 |
P value (t test) | < 0.001 | < 0.001 | < 0.001 | < 0.001 | 0.891 |
Gender | |||||
Male | 66.7 ± 15.6 | 69.0 ± 14.5 | 72.4 ± 16.8 | 56.5 ± 13.6 | 68.6 ± 17.3 |
Female | 63.4 ± 14.6 | 66.6 ± 14.2 | 72.3 ± 17.0 | 56.5 ± 14.2 | 70.0 ± 15.8 |
P value (t test) | < 0.001 | < 0.006 | 0.896 | 0.988 | 0.161 |
Age | |||||
< 30 | 67.8 ± 14.0 | 68.7 ± 13.4 | 73.8 ± 15.4 | 56.9 ± 14.00 | 70.4 ± 15.4 |
31–40 | 65.3 ± 14.6 | 68.4 ± 15.1 | 72.1 ± 17.0 | 56.0 ± 14.3 | 69.7 ± 17.1 |
41–50 | 64.3 ± 16.0 | 68.2 ± 13.8 | 72.0 ± 18.0 | 57.0 ± 15.3 | 69.4 ± 17.7 |
> 50 | 60.4 ± 16.8 | 65.1 ± 15.3 | 69.7 ± 18.6 | 56.0 ± 14.4 | 66.4 ± 17.4 |
P value (F statistic) | < 0.001 | 0.020 | 0.038 | 0.829 | 0.041 |
Residence ownership | |||||
Owner | 65.0 ± 15.2 | 67.7 ± 14.21 | 72.6 ± 16.8 | 56.5 ± 14.3 | 68.3 ± 17.2 |
Not owner | 66.1 ± 15.1 | 70.2 ± 16.4 | 70.1 ± 16.5 | 58.2 ± 15.0 | 69.6 ± 18.5 |
P value (t test) | 0.590 | 0.208 | 0.276 | 0.340 | 0.361 |
Marital status | |||||
Married | 64.6 ± 15.0 | 67.8 ± 14.4 | 73.0 ± 16.9 | 56.5 ± 14.4 | 69.3 ± 16.7 |
Widow | 56.2 ± 15.7 | 60.4 ± 15.2 | 65.5 ± 17.2 | 52.0 ± 13.9 | 61.4 ± 18.3 |
Divorced | 76.8 ± 10.7 | 76.0 ± 10.4 | 60.4 ± 14.2 | 53.1 ± 6.8 | 65.6 ± 12.0 |
Separated | 69.6 ± 20.7 | 63.5 ± 15.0 | 68.7 ± 17.2 | 52.3 ± 8.6 | 65.6 ± 21.3 |
Never married | 69.4 ± 14.8 | 70.0 ± 13.6 | 71.0 ± 16.3 | 57.9 ± 14.1 | 71.3 ± 15.3 |
P value (F statistic) | < 0.001 | 0.006 | 0.038 | 0.227 | 0.029 |
Education | |||||
No education | 59.5 ± 15.8 | 62.9 ± 16.0 | 67.8 ± 19.4 | 54.5 ± 15.2 | 62.3 ± 19.0 |
Informal education | 65.4 ± 19.5 | 71.1 ± 16.0 | 72.9 ± 14.7 | 58.8 ± 17.1 | 71.1 ± 13.5 |
Can read / write | 63.0 ± 16.6 | 63.9 ± 14.9 | 68.6 ± 18.9 | 55.3 ± 13.8 | 66.2 ± 16.8 |
Primary (up to grade 5) | 66.0 ± 14.5 | 68.1 ± 13.4 | 73.3 ± 16.2 | 57.2 ± 13.6 | 69.2 ± 16.2 |
Secondary (up to grade 12) | 67.5 ± 14.8 | 71.1 ± 13.7 | 74.0 ± 15.3 | 57.2 ± 14.0 | 73.1 ± 15.0 |
Tertiary (up to grade 16 or above) | 63.3 ± 14.0 | 68.8 ± 13.1 | 75.7 ± 16.0 | 56.4 ± 14.7 | 71.8 ± 16.1 |
P value (F statistic) | < 0.001 | < 0.001 | < 0.001 | 0.317 | < 0.001 |
Disease | |||||
Physical disability | 58.8 ± 17.5 | 61.8 ± 18.1 | 69.2 ± 12.9 | 51.7 ± 13.5 | 63.5 ± 14.8 |
Hypertension | 61.3 ± 18.0 | 65.2 ± 15.4 | 79.0 ± 18.0 | 57.0 ± 15.8 | 65.7 ± 17.8 |
Diabetes | 57.0 ± 19.2 | 61.8 ± 18.8 | 69.4 ± 19.3 | 56.5 ± 15.6 | 59.2 ± 24.9 |
Other | 64.0 ± 15.1 | 66.8 ± 14.0 | 72.0 ± 17.1 | 55.1 ± 14.2 | 69.2 ± 16.4 |
None | 68.0 ± 13.8 | 70.1 ± 13.8 | 73.7 ± 16.1 | 58.2 ± 13.8 | 71.1 ± 15.5 |
P value (F statistic) | < 0.001 | < 0.001 | 0.095 | 0.017 | < 0.001 |
Employment status | |||||
Not working | 62.8 ± 16.3 | 66.3 ± 14.5 | 72.0 ± 16.9 | 56.4 ± 14.4 | 66.5 ± 17.4 |
Working | 66.8 ± 14.0 | 69.0 ± 14.8 | 72.4 ± 17.0 | 56.5 ± 14.3 | 71.3 ± 15.8 |
Retired | 63.0 ± 18.3 | 67.5 ± 14.4 | 74.3 ± 17.0 | 59.0 ± 14.9 | 68.1 ± 17.0 |
P value (F statistic) | < 0.001 | 0.016 | 0.605 | 0.402 | < 0.001 |
Socioeconomic status | |||||
High | 67.8 ± 15.3 | 71.5 ± 13.2 | 76.5 ± 15.1 | 61.2 ± 13.3 | 74.3 ± 15.3 |
Intermediate | 65.6 ± 15.1 | 68.4 ± 14.1 | 73.1 ± 15.6 | 56.9 ± 13.5 | 69.1 ± 15.4 |
Low | 60.7 ± 15.3 | 62.2 ± 14.6 | 65.8 ± 18.7 | 50.0 ± 14.4 | 62.8 ± 17.6 |
P value (F statistic) | < 0.001 | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
Social capital | |||||
High SC | 67.1 ± 14.9 | 71.3 ± 13.7 | 76.8 ± 16.1 | 59.8 ± 14.0 | 74.7 ± 14.5 |
Moderate SC | 65.2 ± 15.1 | 67.8 ± 14.7 | 72.4 ± 16.5 | 56.4 ± 14.2 | 69.0 ± 16.3 |
Low SC | 62.3 ± 16.4 | 64.4 ± 14.4 | 66.3 ± 18.2 | 50.9 ± 16.6 | 64.1 ± 19.9 |
P value (F statistic) | 0.059 | < 0.001 | < 0.001 | 0.005 | < 0.001 |
Multivariate linear regression model for joint family system
Physical Domain | Psychological Domain | Relationship Domain | Environmental Domain | |
---|---|---|---|---|
β (95% CI) | β (95% CI) | β (95% CI) | β (95% CI) | |
Fixed effects | ||||
Residence | ||||
Urban | Ref. | Ref. | Ref. | Ref. |
Rural | −4.59(−7.77 to −1.41) | −3.54(−6.4 to −0.63) | – | −5.32(−8.75 to − 1.89) |
Gender | ||||
Male | Ref. | Ref. | Ref. | Ref. |
Female | −3.94(−5.88 to −2.01) | −3.10(−4.7 to −1.47) | −1.11(− 3.06 to −0.84 | – |
Age (Decades) | −0.22(− 0.29 to − 0.19 | −0.11(− 0.2 to − 0.05) | −0.12(− 0.19 to − 0.05) | – |
Disease | ||||
None | Ref. | Ref. | Ref. | Ref. |
Physical disability | −10.3(− 17.8 to − 2.80) | − 8.79(− 15.8 to − 1.7) | – | – |
Hypertension | −5.26(−9.3 to − 1.85 | −5.26(− 8.87 to − 1.7) | – | – |
Diabetes | −8.05(− 13.13 to − 2.9) | −6.17(− 10.9 to − 1.3) | – | – |
Others | −4.26(− 6.59 to − 1.94) | − 3.36(− 5.5 to − 1.18) | – | – |
Socio-economic status | ||||
High | Ref. | Ref. | Ref. | Ref. |
Intermediate | −0.33(−2.39 to 1.73) | − 2.20(− 4.1 to − 0.25) | −3.09(− 5.37 to − 0.80) | −3.76(− 5.61 to − 1.90) |
Low | − 3.81(− 6.17 to − 1.45) | − 7.60(− 9.8 to − 5.40) | −9.86(− 12.4 to − 7.30) | −9.06(− 11.2 to − 6.94) |
Social capital | 0.12(0.06 to 0.17) | 0.13(0.08 to 0.19) | 0.16(0.10 to 0.22) | 0.13(0.08 to 0.18) |
Random-effects | ||||
Level 1: Union Council | ||||
Gender | 0.02(0.00 to 4.54) | 0.97(0.24 to 3.95) | 0.43(0.21 to 4.53) | 2.44(1.38 to 4.30) |
Age | 0.02(0.00 to 6.64) | 0.05(0.00 to 0.51) | 0.06(0.02 to 0.18) | 0.05(0.01 to 0.24) |
Social capital | 0.04(0.01 to 0.21) | 0.06(0.03 to 0.11) | 0.02(0.00 to 1.22) | 0.02(0.00 to 1.39) |
Constant | 3.0(1.02 to 8.81) | 0.01(0.00 to 0.48) | 0.01(0.00 to 0.20) | 0.99(0.52 to 10.86) |
Level 2: Cluster number | ||||
Constant | 3.30(2.04 to 5.36) | 4.20(3.07 to 5.75) | 5.50(4.15 to 7.31) | 5.10(3.96 to 6.57) |
Residual | 13.07(12.4 to 13.71) | 12.14(11.5 to 12.7) | 14.6(13.97 to 15.34) | 11.5(10.93 to 12.0) |
Nuclear family system WHOQOL-BREF scores
Physical | Psychological | Relationship | Environmental | General facet | |
---|---|---|---|---|---|
Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | Mean ± SD | |
Type of residence | |||||
Urban | 67.4 ± 15.8 | 70.5 ± 15.2 | 73.0 ± 16.0 | 58.5. ± 14.8 | 66.6 ± 18.5 |
Rural | 63.7 ± 14.8 | 65.5 ± 15.2 | 70.8 ± 16.0 | 52.6 ± 15.0 | 67.1 ± 18.6 |
P value (t test) | < 0.001 | < 0.001 | < 0.001 | < 0.001 | 0.714 |
Gender | |||||
Male | 66.0 ± 15.6 | 68.4 ± 14.4 | 72.5 ± 14.9 | 55.6 ± 14.7 | 66.0 ± 18.9 |
Female | 63.6 ± 14.8 | 65.5 ± 16.1 | 70.4 ± 17.2 | 53.2 ± 15.5 | 68.0 ± 18.1 |
P value (t test) | < 0.001 | < 0.003 | 0.037 | 0.011 | 0.079 |
Age | |||||
< 30 | 67.8 ± 14.4 | 68.3 ± 15.0 | 69.6 ± 16.8 | 54.5 ± 15.4 | 68.8 ± 17.9 |
31–40 | 64.2 ± 14.0 | 66.0 ± 15.1 | 72.4 ± 15.7 | 53.4 ± 14.8 | 66.8 ± 18.2 |
41–50 | 64.0 ± 15.2 | 67.7 ± 15.3 | 72.5 ± 15.5 | 55.4 ± 14.1 | 65.7 ± 18.2 |
> 50 | 60.4 ± 17.3 | 64.6 ± 16.9 | 71.2 ± 15.9 | 54.5 ± 17.6 | 64.7 ± 21.6 |
P value (F statistic) | < 0.001 | 0.079 | 0.87 | 0.476 | 0.128 |
Residence ownership | |||||
Owner | 64.8 ± 15.0 | 66.9 ± 15.1 | 71.3 ± 15.9 | 54.1 ± 15.0 | 68.3 ± 17.2 |
Not owner | 65.3 ± 17.0 | 67.8 ± 17.1 | 72.3 ± 17.5 | 54.4 ± 16.2 | 69.6 ± 18.5 |
P value (t test) | 0.700 | 0.560 | 0.509 | 0.818 | 0.361 |
Marital status | |||||
Married | 63.9 ± 14.7 | 67.2 ± 15.0 | 72.6 ± 15.3 | 54.5 ± 14.9 | 67.3 ± 18.1 |
Widow | 53.3 ± 19.2 | 49.3 ± 20.6 | 56.3 ± 24.2 | 37.4 ± 09.6 | 43.7 ± 26.0 |
Divorced | 76.8 ± 12.6 | 73.0 ± 8.9 | 66.7 ± 23.6 | 73.4 ± 15.5 | 81.2 ± 8.9 |
Separated | 72.6 ± 11.5 | 76.4 ± 15.0 | 68.7 ± 17.2 | 57.3 ± 11.0 | 79.2 ± 7.2 |
Never married | 70.1 ± 15.4 | 68.3 ± 14.8 | 68.9 ± 15.7 | 55.5 ± 15.7 | 68.3 ± 17.2 |
P value (F statistic) | < 0.001 | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
Education | |||||
No education | 58.3 ± 15.3 | 59.8 ± 16.9 | 66.8 ± 16.2 | 48.0 ± 15.7 | 58.0 ± 22.5 |
Informal education | 63.2 ± 17.9 | 76.2 ± 13.5 | 74.4 ± 10.9 | 58.0 ± 14.0 | 70.7 ± 16.1 |
Can read / write | 60.6 ± 14.9 | 64.0 ± 16.4 | 69.0 ± 16.1 | 52.5 ± 14.5 | 63.2 ± 18.3 |
Primary (up to grade 5) | 65.5 ± 14.8 | 67.4 ± 14.6 | 72.7 ± 15.7 | 55.3 ± 14.2 | 67.7 ± 17.8 |
Secondary (up to grade 12) | 68.0 ± 14.9 | 70.0 ± 14.7 | 72.3 ± 16.5 | 56.4 ± 15.2 | 69.4 ± 17.0 |
Tertiary (up to grade 16 or above) | 67.4 ± 12.6 | 70.0 ± 13.7 | 73.9 ± 14.9 | 55.5 ± 15.4 | 74.7 ± 12.2 |
P value (F statistic) | < 0.001 | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
Disease | |||||
Physical disability | 56.4 ± 21.4 | 62.2 ± 17.4 | 51.70 ± 13.5 | 55.4 ± 14.0 | 63.3 ± 22.9 |
Hypertension | 61.3 ± 15.2 | 66.8 ± 15.9 | 57.0 ± 15.8 | 52.6 ± 17.4 | 66.7 ± 17.7 |
Diabetes | 53.3 ± 15.7 | 62.5 ± 16.3 | 56.5 ± 15.6 | 47.8 ± 15.0 | 63.5 ± 16.8 |
Other | 63.4 ± 15.3 | 65.6 ± 15.6 | 55.1 ± 14.2 | 54.1 ± 15.4 | 64.9 ± 19.8 |
None | 68.2 ± 14.0 | 69.2 ± 14.4 | 58.20 ± 13.8 | 55.6 ± 14.3 | 70.0 ± 16.5 |
P value (F statistic) | < 0.001 | 0.002 | 0.249 | 0.109 | < 0.001 |
Employment status | |||||
Not working | 63.4 ± 15.6 | 65.0 ± 17.1 | 70.4 ± 16.4 | 53.0 ± 15.8 | 64.5 ± 21.1 |
Working | 66.0 ± 14.6 | 68.7 ± 13.7 | 72.3 ± 15.8 | 55.4 ± 14.7 | 69.0 ± 16.8 |
Retired | 63.3 ± 18.9 | 62.7 ± 16.3 | 70.4 ± 15.8 | 54.3 ± 14.5 | 63.8 ± 21.1 |
P value (F statistic) | 0.034 | < 0.001 | 0.195 | 0.047 | < 0.001 |
Socioeconomic status | |||||
High | 68.9 ± 13.7 | 72.3 ± 14.4 | 74.3 ± 15.6 | 60.4 ± 14.3 | 74.4 ± 15.5 |
Intermediate | 65.3 ± 14.9 | 69.0 ± 13.1 | 74.1 ± 14.9 | 55.8 ± 13.6 | 68.7 ± 15.6 |
Low | 61.5 ± 15.8 | 61.6 ± 16.0 | 67.4 ± 16.4 | 48.8 ± 15.0 | 60.4 ± 19.9 |
P value (F statistic) | < 0.001 | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
Social capital | |||||
High SC | 66.2 ± 14.4 | 68.1 ± 13.4 | 73.3 ± 15.2 | 57.9 ± 13.6 | 68.9 ± 18.3 |
Moderate SC | 65.2 ± 15.1 | 67.6 ± 15.2 | 71.8 ± 15.7 | 54.6 ± 14.7 | 67.7 ± 18.3 |
Low SC | 60.7 ± 16.2 | 62.0 ± 17.6 | 67.1 ± 18.5 | 48.6 ± 17.7 | 60.8 ± 19.3 |
P value (F statistic) | 0.006 | < 0.001 | 0.004 | < 0.001 | < 0.001 |
Multivariate linear regression model for nuclear family system
Physical Domain | Psychological Domain | Relationship Domain | Environmental Domain | |
---|---|---|---|---|
β (95% CI) | β (95% CI) | β (95% CI) | β (95% CI) | |
Fixed effects | ||||
Residence | ||||
Urban | Ref. | Ref. | Ref. | Ref. |
Rural | −2.55(−5.42 to 0.33) | −1.90(−4.9 to − 1.13) | – | −3.69(− 7.27 to −0.09) |
Gender | ||||
Male | Ref. | Ref. | Ref. | Ref. |
Female | −2.64(−4.59 to − 0.68) | −3.56(− 5.5 to − 1.65) | − 1.92(− 3.91 to 0.07) | – |
Age (Decades) | −0.27(− 0.35 to − 0.20) | −0.15(− 0.2 to) -0.06 | −0.12(− 0.05 to 0.12) | – |
Disease | ||||
None | Ref. | Ref. | Ref. | Ref. |
Physical disability | −8.78(− 16.1 to − 1.50) | – | – | – |
Hypertension | − 3.58(−7.4 to 0.24) | – | – | – |
Diabetes | − 13.0(− 19.0 to − 7.0) | – | – | – |
Others | −4.75(− 7.02 to − 2.47) | – | – | – |
Socio-economic status | ||||
High | Ref. | Ref. | Ref. | Ref. |
Intermediate | −3.86(−6.2 to − 1.54) | − 3.47(− 5.8 to − 1.15) | −0.58(− 3.10 to 1.95) | − 4.20(− 6.37 to − 2.02) |
Low | −7.37(−9.73 to − 5.01) | −9.91(− 12.3 to − 7.5) | −6.54(− 9.89 to − 4.05) | − 9.89(− 12.1 to − 7.66) |
Social capital | 0.07(0.01 to 0.12) | 0.12(0.07 to 0.18) | 0.11(0.05 to 0.16) | 0.18(0.13 to 0.23) |
Random-effects | ||||
Level 1: Union Council | ||||
Gender | 0.91(0.03 to 6.57) | 0.99(0.30 to 3.99) | 0.43(0.21 to 4.53) | 2.36(1.31 to 4.22) |
Age | 0.02(0.00 to 6.64) | 0.08(0.08 to 0.65) | 0.06(0.02 to 0.18) | 0.09(0.04 to 0.17) |
Social capital | 0.03(0.00 to 0.26) | 0.08(0.06 to 0.17) | 0.02(0.00 to 1.22) | 0.01(0.00 to 1.39) |
Constant | 1.39(0.02 to 11.49) | 0.04(0.00 to 0.90) | 0.01(0.00 to 0.20) | 0.00(0.00 to 0.03) |
Level 2: Cluster number | ||||
Constant | 4.44(3.15 to 6.26) | 4.45(4.07 to 5.86) | 5.20(4.15 to 7.31) | 5.26(4.04 to 6.84) |
Residual | 13.32(12.6 to 13.9) | 10.14(11.8 to 12.9) | 14.6(13.97 to 15.34) | 12.1(11.51 to 12.8) |