Background
Aim
Method
Design
Settings
Sampling and participants
Measurements
Total N (%) | Study group with disability, n (%) | Study group without disability, n (%) | |
---|---|---|---|
Total | 277 (100) | 155 (55) | 122 (45) |
Gender | |||
Male | 141 (51) | 79 (51) | 62 (51) |
Female | 136 (49) | 76 (49) | 60 (49) |
Income | |||
No or Irregular | 145 (52) | 92 (59) | 53 (43) |
Yes, regular | 132 (48) | 63 (41) | 69 (57) |
Area of residence | |||
Non-slum urban | 77 (28) | 38 (24) | 39 (32) |
Urban slum | 103 (37) | 63 (41) | 40 (33) |
Rural | 97 (35) | 54 (35) | 43 (35) |
Education | |||
Not attended school | 29 (12) | 22 (18) | 7 (6) |
Attended school ≤10 years | 99 (41) | 50 (41) | 49 (40) |
Attended school ≥10 years | 115 (47) | 49 (41) | 66 (54) |
n (%) | |
---|---|
Cause of disability | |
Poliomyelitis | 103 (67) |
Accident | 16 (10) |
Gangrene | 10 (7) |
Cerebral palsy | 5 (3) |
Stroke | 5 (3) |
Congenital dislocation of hip | 3 (2) |
Burns | 2 (1) |
Spina bifida | 2 (1) |
Diabetes | 2 (1) |
Clubfoot | 1 (1) |
Other | 6 (4) |
Type of assistive device used | |
Trans-tibial prosthesis users | 19 (12) |
Trans-femoral prosthesis users | 11 (7) |
Shoe rise users | 8 (5) |
Ankle-foot orthosis users | 31 (20) |
Knee-ankle-foot orthosis users | 86 (56) |
Other additional assistive devices | |
Crutches | 29 (19) |
Wheelchair | 5 (3) |
Data collection
Data analysis
Results
Characteristics of the study groups
QOL of participants with and without disability
Group with disability, median (n = 155) | Group with disability, mean (95% CI) (n = 155) | Group without disability, median (n = 122) | Group without disability, mean (95% CI) (n = 122) | P value, Mann–Whitney U | |
---|---|---|---|---|---|
General QOL | 16.00 | 14.37 (13.76 to15.00) | 16.00 | 14.75 (14.16 to 15.35) | .464 |
General health | 16.00 | 14.89 (14.29 to 15.49) | 16.00 | 15.51 (14.88 to 16.14) | .164 |
Physical health, total score
|
14.29
|
14.29 (13.83 to 14.75)
|
16.29
|
16.16 (15.78 to 16.54)
|
<.001*
|
Dependence on medication to function in everyday life |
12.00
|
13.39 (12.72 to 14.06)
|
16.00
|
15.64 (14.88 to 16.40)
|
<.001*
|
Pain prevents you from doing what you need to do |
16.00
|
15.33 (14.57 to 16.08)
|
20.00
|
17.41 (16.72 to 18.10)
|
<.001*
|
Enough energy for everyday life |
16.00
|
14.50 (13.83 to 15.19)
|
16.00
|
15.74 (15.07 to 16.41)
|
.020*
|
Mobility, ability to get around |
12.00
|
13.42 (12.73 to 14.11)
|
16.00
|
15.87 (15.19 to 16.55)
|
<.001*
|
Satisfaction with sleep | 16.00 | 15.02 (14.33 to 15.71) | 16.00 | 15.41 (14.72 to 16.10) | .599 |
Satisfaction with ability to perform daily living activities |
16.00
|
15.02 (14.41 to15.63)
|
16.00
|
16.49 (15.94 to 17.04)
|
.001*
|
Satisfaction with capacity for work |
16.00
|
15.05 (14.41 to 15.68)
|
16,00
|
16.59 (16.01 to 17.16)
|
.002*
|
Psychological, total score
|
14.67
|
14.36 (13.94 to 14.79)
|
15.33
|
15.09 (14.69 to 15.50)
|
.017*
|
Enjoyment of life | 16.00 | 14.27 (13.57 to 14.97) | 16.00 | 14.43 (13.76 to 15.10) | .960 |
To what extent do you feel your life to be meaningful |
12.00
|
13.70 (12.97 to 14.43)
|
16.00
|
15.15 (14.41 to 15.89)
|
.007*
|
Ability to concentrate | 16.00 | 15.51 (14.87 to 16.15) | 16.00 | 15.21 (14.51 to 15.91) | .381 |
Accept of bodily appearance | 16.00 | 13.89 (13.16 to 14.61) | 16.00 | 14.75 (14.00 to 15.51) | .143 |
Satisfied with yourself | 16.00 | 15.85 (15.27 to 16.42) | 16.00 | 16.49 (15.92 to 17.06) | .164 |
Negative feelings, despair, and depression | 16.00 | 13.57 (12.94 to 14.21) | 16.00 | 14.52 (13.83 to 15.22) | .058 |
Social relationships, total score
| 16.00 | 14.62 (13.99 to 15.24) | 16.00 | 15.56 (14.98 to 16.13) | .080 |
Satisfied personal relationships | 16.00 | 14.50 (13.68 to 15.33) | 16.00 | 15.77 (14.97 to 16.57) | .060 |
Satisfied with sex life | 16.00 | 14.46 (13.27 to 15.65) | 16.00 | 16.32 (15.52 to 17.12) | .072 |
Satisfied with support from friends | 16.00 | 14.60 (13.82 to 15.37) | 16.00 | 14.68 (13.88 to 15.49) | .925 |
Environment, total score
|
13.00
|
12.82 (12.40 to 13.25)
|
14.00
|
13.76 (13.33 to 14.19)
|
.006*
|
Safety and security in daily life |
16.00
|
13.78 (13.02 to 14.55)
|
16.00
|
15.05 (14.29 to 15.81)
| .035* |
Healthy physical environment | 12.00 | 13.11 (12.40 to 13.82) | 12.00 | 13.71 (12.97 to 14.47) | .291 |
Enough money to meet your needs |
8.00
|
9.52 (8.80 to 10.24)
|
12.00
|
11.25 (10.43 to 12.06)
|
.002*
|
Availability of information needed in everyday life | 12.00 | 12.16 (11.48 to 12.83) | 12.00 | 13.15 (12.38 to 13.93) | .072 |
Opportunity for leisure activities | 12.00 | 12.52 (11.78 to 13.27) | 12.00 | 11.77 (10.94 to 12.60) | .156 |
Satisfaction with conditions of your living place | 16.00 | 14.37 (13.67 to 15.07) | 16.00 | 15.28 (14.56 to 16.00) | .098 |
Satisfaction with access to health services |
16.00
|
13.68 (12.98 to 14.37)
|
16.00
|
14.82 (14.16 to 15.48)
|
.032*
|
Satisfied with transportation |
16.00
|
13.58 (12.78 to 14.38)
|
16.00
|
15.08 (14.32 to 15.85)
|
.016*
|
Differences in QOL in relation to gender, income, area of residence, and education
Physical health | Psychological | Social relationships | Environmental | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Group with disability Mean (95% CI) | Group without disability Mean (95% CI) | Group with disability Mean (95% CI) | Group without disability Mean (95% CI) | Group with disability Mean (95% CI) | Group without disability Mean (95% CI) | Group with disability Mean (95% CI) | Group without disability Mean (95% CI) | |||||
Gender | ||||||||||||
Men with disability, n = 79, Men without disability, n = 62 |
14.57 (13.96 to 15.18)
|
16.78 (16.26 to 17.31)
|
<.001*
|
14.57 (14.00 to 15.13)
|
15.49 (14.91 to 16.08)
|
.014*
| 14.72 (13.88 to 15.56) | 16.01 (15.27 to 16.75) | .054 |
13.18 (12.63 to 13.74)
|
14.08 (13.49 to 14.68)
|
.035*
|
Women with disability, n = 76 without disability, n = 60 |
14.08 (13.41 to 14.77)
|
15.52 (15.02 to 16.03)
|
.002*
| 14.22 (13.58 to 14.86) | 14.68 (14.11 to 15.24) | .319 | 14.52 (13.58 to 14.45) | 15.09 (14.20 to 15.98) | .557 | 12.45 (11.87 to 13.15) | 13.43 (12.80 to 14.06) | .054 |
Income levels | ||||||||||||
Group with regular income with disability, n = 63 without disability, n = 69 |
15.17 (14.56 to 15.79)
|
16.27 (15.75 to 16.78)
|
.009*
| 15.25 (14.68 to 15.82) | 15.45 (14.96 to 15.94) | .465 | 15.82 (15.02 to 16.62) | 15.50 (14.73 to 16.27) | .472 | 13.82 (13.24 to 14.39) | 13.87 (13.32 to 14.43) | .768 |
Group without regular income with disability, n = 92 without disability, n = 53 |
13.68 (13.14 to 14.37)
|
16.03 (15.46 to 16.60)
|
<.001*
| 13.75 (13,24 to 14.37) | 14.63 (13.95 to 15.31) | .062 |
13.78 (12.92 to 14.65)
|
15.64 (14.73 to 16.54)
|
.009*
|
12.14 (11.63 to 12.75)
|
13.61 (12.92 to 14.31)
|
.004*
|
Area of residence | ||||||||||||
Group: non-slum urban with disability, n = 38 without disability, n = 39 | 15.01 (14.06 to 15.95) | 15.79 (15.17 to 16.42) | .379 | 15.04 (14.31 to 15.76) | 14.87 (14.16 to 15.58) | .629 | 15.46 (14.38 to 16.53) | 16.22 (15.15 to 17.30) | .283 | 13.58 (12.74 to 14.42) | 14.17 (13.40 to 14.95) | .450 |
Group urban slum with disability, n = 63without disability, n = 40 |
13.77 (13.01 to 14.55)
|
16.37 (15.64 to 17.11)
|
<.001*
|
13.95 (13.33 to 14.73)
|
14.97 (14.25 to 15.69)
|
.040*
| 14.39 (13.26 to 15.54) | 15.75 (14.80 to 16.70) | .219 |
12.23 (11.48 to 12.98)
|
13.94 (13.11 to 14.77)
|
.002*
|
Group: rural with disability, n = 54 without disability, n = 43 |
14.50 (13.82 to 15.18)
|
16.30 (15.68 to 16.94)
|
<.001*
| 14.37 (13.62 to 15.13) | 15.41 (14.68 to 16.14) | .057 | 14.28 (13.32 to 15.25) | 14.78 (13.77 to 15.78) | .580 | 13.06 (12.46 to 13.65) | 13.22 (12.56 to 13.88) | .765 |
Education | ||||||||||||
Group, school ≤10 years with disability, n = 50without disability, n = 49 |
14.49 (13.89 to 15.39)
|
16.05 (15.41 to 16.69)
|
.004*
| 14.36 (13.68 to 15.25) | 14.98 (14.31 to 15.65) | .158 | 15.34 (14.36 to 16.33) | 15.35(14.45 to 16.24) | .971 | 12.97 (12.34 to 13.81) | 13.29 (12.61 to 13.96) | .386 |
Group school > 10 years with disability, n = 49 without disability, n = 66 | 15.78 (15.17 to 16.39) | 16.32 (15.86 to 16.78) | .197 | 15.76 (15,24 to 16.17) | 15.10 (14.55 to 15.65) | .090 | 16.76 (16.06 to 17.46) | 15.79 (15.01 to 16.57) | .084 | 13.99 (13.46 to 14.52) | 14.03 (13.45 to 14.62) | .993 |
Physical health | Psychological | Social relationships | Environmental | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
mean (95% CI) | mean (95%CI) | mean (95%CI) | P value | mean (95% CI) | mean (95% CI) | mean (95% CI) | P value | mean (95% CI) | mean (95% CI) | mean (95% CI) | P value | mean (95% CI) | mean (95% CI) | mean (95% CI) | P value | |
Gender | ||||||||||||||||
Men with disability, n = 79 women with disability, n = 76 | 14.57 (13.96 to 15.18) | 14.08 (13.41 to 14.77) | .292 | 14.57 (14.00 to 15.13) | 14.15 (13.58 to 14.86) | .548 | 14.72 (13.88 to 15.56) | 14.52 (13.58 to 15.45) | .946 | 13.18 (12.63 to 13.74) | 12.45 (11.87 to 13.15) | .162 | ||||
Income levels | ||||||||||||||||
Group with disability with regular income, n = 63 without no or irregular income, n = 92 |
15.17 (14.56 to 15.79)
|
13.68 (13.14 to 14.37)
|
.003*
|
15.25 (14.68 to 15.82)
|
13.75 (13.24 to 14.38)
|
.002*
|
15.82 (15.02 to 16.61)
|
13.78 (12.92 to 14.65)
|
.002*
|
13.82 (13.14 to 14.39)
|
12.14 (11.63 to 12.75)
|
<.001*
| ||||
Area of residence | ||||||||||||||||
Group with disability non-slum urban, n = 38 urban slum, n = 63 rural, n = 54 | 15.01 (14.06 to 15.95) | 13.67 (13.01 to 14.55) | 14.50 (13.81 to 15.18) | .057 | 15.04 (14.31 to 15.76) | 13.95 (13.33 to 14.73) | 14.37 (13.62 to 15.13) | .063 | 15.46 (14.37 to 16.53) | 14.39 (13.25 to 15.54) | 14.28 (13.32 to 15.25) | .348 |
13.58 (12.74 to 14.42)
|
12.17 (11.47 to 12.98)
|
13.06 (12.46 to 13.65)
|
.026*
|
Education | ||||||||||||||||
Group with disability no school, n = 22 school ≤10 years, n = 50 school > 10 years, n = 49 |
13.81 (12.28 to 15.38)
|
14.49 (13.88 to 15.39)
|
15.78 (15.17 to 16.39)
|
.024*
|
12.90 (11.54 to 14.28)
|
14.36 (13.68 to 15.27)
|
15.76 (15.17 to 16.39)
|
<.001*
|
12.15 (10.50 to 13.81)
|
15.34 (14.36 to 16.33)
|
16.76 (16.06 to 17.46)
|
<.001*
|
12.02 (10.64 to 13.41)
|
12.97 (12.34 to 13.81)
|
13.99 (13.46 to 14.52)
|
.010*
|
Variables associated with low QOL
People with vs. without disability | ||||
---|---|---|---|---|
Univariate | Adjusted** | |||
OR | 95% CI | OR | 95% CI | |
Physical health QOL |
3.54*
|
3.54 to 5.90
|
2.23*
|
1.26 to 3.93
|
Psychological QOL |
1.80*
|
1.80 to 2.95
| 1.21 | 0.69 to 2.11 |
Social relationship QOL | 1.37 | 1.37 to 2.22 | 0.80 | 0.46 to 1.39 |
Environmental QOL |
1.91*
|
1.91 to 3.08
| 1.30 | 0.77 to 2.22 |
Physical health QOL | Psychological QOL | Social relationship QOL | Environmental QOL | ||||||
---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | ||
Without disability | Female vs. male |
2.68*
|
1.16 to 6.20
| 1.53 | 0.71 to 3.30 | 1.39 | 0.67 to 2.88 | 1.13 | 0.55 to 2.33 |
With physical disability | Female vs. male | 1.50 | 0.79 to 2.85 | 1.26 | 0.67 to 2.36 | 0.75 | 0.40 to 1.41 | 1.58 | 0.83 to 3.00 |
Without disability | No or irregular income vs. regular income | 0.94 | 0.42 to 2.12 | 1.37 | 0.64 to 2.94 | 0.77 | 0.37 to 1,61 | 1.10 | 0.53 to 2.29 |
With physical disability | No or irregular income vs. regular income |
2.10*
|
1.09 to 4.03
|
2.67*
|
1.37 to 5.23
|
2.32*
|
1.20 to 4.49
|
2.80*
|
1.44 to 5.43
|
Without disability | Rural vs. non-slum urban | 0.68 | 0.26 to 1.82 | 0.62 | 0.24 to 1.57 | 2.36 | 0.95 to 5,83 | 1.53 | 0.63 to 3.68 |
Urban slum vs. non-slum urban | 0.85 | 0.32 to 2.26 | 0.69 | 0.27 to 1.75 | 1.21 | 0.47 to 3,10 | 0.77 | 0.31 to 1.94 | |
With physical disability | Rural vs. non-slum urban | 1.92 | 0.82 to 4.45 |
4.04*
|
1.57 to 10.39
| 1.85 | 0.79 to 4,31 | 1.78 | 0.77 to 4.13 |
Urban slum vs. non-slum urban |
3.30*
|
1.42 to 7.63
|
4.69*
|
1.86 to 11.82
| 1.66 | 0.73 to 3,78 |
3.30*
|
1.42 to 7.63
| |
Without disability | Attended ≤10 years vs. attended > 10 years | 1.38 | 0.60 to 3.16 | 0.88 | 0.40 to 1.95 | 1.13 | 0.53 to 2.41 | 1.23 | 0.58 to 2.61 |
Not attended vs. attended > 10 years | 1.25 | 0.22 to 7.08 | 0.80 | 0.14 to 4.46 | 1.23 | 0.25 to 5.96 | 1.23 | 0.25 to 5.96 | |
With physical disability | Attended ≤10 years vs. attended > 10 years |
4.08*
|
1.76 to 9.47
|
4.81*
|
1.94 to 11.98
|
3.79*
|
1.52 to 9.43
|
3.09*
|
1.36 to 7.04
|
Not attended vs. attended > 10 years |
3.00*
|
1.06 to 8.52
|
9.52*
|
3.01 to 30.15
|
11.85*
|
3.63 to 38.75
|
4.42*
|
1.50 to 12.98
|