Quality of life of older adults in two contrasting neighbourhoods in Accra, Ghana

Psychometric properties of the WHOQOL-BREF in a population of older adults in prison: measuring quality of life in a carceral setting

PURPOSE

Valid and reliable measurement is critical to the assessment and evaluation of health interventions. However, few scholars have examined the psychometric properties of "gold standard" measures in carceral settings, and no research has explored the reliability, validity and factor structure of the 26-item World Health Organization Quality of Life (WHOQOL) BREF among older adults incarcerated in prison, a large and growing population marked by substantial chronic and life-limiting illness. This study aims to examine the reliability, validity and factor structure of the WHOQOL-BREF.

DESIGN/METHODOLOGY/APPROACH

Secondary data from a large-scale study with older adults (age 45+) incarcerated in a Midwestern state were used (N = 499). Floor and ceiling effects were examined, as was the reliability of the measure (Cronbach's alpha). The structural validity of a four-factor and second-order four-factor model of the WHOQOL-BREF was examined using confirmatory factor analysis. Model data fit was examined using chi-square, standardized root mean square residual, comparative fit indices, Akaike information criterion and the Bayesian Information Criterion. Pearson product-moment correlation coefficients were also used to assess validity.

FINDINGS

Results indicate adequate construct validity and reliability for the WHOQOL-BREF using the current sample. Model-data fit indexes also reveal adequate structure of the measure relative to other older adult samples. Non-random data and item exclusion are noteworthy limits, and future researchers are encouraged to co-conceptualize and operationalize life quality with older adults who are incarcerated.

ORIGINALITY/VALUE

To the best of the authors' knowledge, this is the first study to explore the psychometric properties of the WHOQOL-BREF among older adults incarcerated in prison.

Health-related quality of life of persons living with tuberculosis: A cross-sectional study

Background

Tuberculosis is a chronic infectious disease that can affect the quality of life of persons living with tuberculosis in resource-limited settings. There is a dearth of research on the quality of life of persons living with tuberculosis within Greater Accra, Ghana.

Purpose

This study investigated the quality of life and its related factors among persons living with tuberculosis in the Greater Accra region of Ghana.

Methods

This descriptive cross-sectional survey assessed the physical, psychological, social relationship and environmental quality of life of 250 persons living with tuberculosis in four public health facilities using the World Health Organization's Quality of Life Brief Questionnaire instrument.

Results

Respondents' mean (standard deviation) physical, psychological, social relationship and environmental health-related quality of life domain scores were 46.19 (21.27), 50.67 (23.95), 40.9 (21.74) and 51.91 (20.13) respectively out of 100. Sociodemographic factors which influenced all four quality of life domains were their marital and employment statuses. Respondents' site of TB infection (pulmonary or extrapulmonary) and phase of treatment influenced their physical, psychological and social domains. Other determinants of the quality of life were their sex, highest level of education and average monthly income.

Conclusions

The quality of life of persons living with tuberculosis was found to be poor and influenced by the patients' socioeconomic status. Strategies that identify and address any deterioration in the quality of life of persons living with TB are required throughout their management.

Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review

Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.

Quality of life of older adults and associated factors in Ghanaian urban slums: a cross-sectional study

OBJECTIVE

This study provides insight into the quality of life (QoL) of older adults living in urban slums in Ghana.

DESIGN

The study employed a community-based, cross-sectional design to assess QoL among older adults in two slums between April and May 2020. QoL was assessed using the WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire.

SETTINGS

Participants were drawn from two slums in Ghana, one in a fishing-dominated community and the other in an industrial community.

PARTICIPANTS

This study included 400 participants aged 60 and above who had lived in either slum for at least 1 month and were able to communicate verbally.

RESULTS

Although the means of all participants' transformed scores were poor in the physical and psychological domains, they were moderate in all other domains. When viewed as a whole, the perceived overall QoL is neither poor nor good and participants were neither satisfied nor dissatisfied with their health. Participants had a moderate level of QoL in the WHOQOL-BREF psychological (mean score 45.7), social (mean score 57.0) and environmental (mean score 51.6) domains. The mean score for physical QoL of older adults was 43.3, which denotes poor QoL. In all domains, male participants have a significantly higher mean QoL than their female counterparts. An analysis of variance comparing the living arrangements of participants showed that those who lived with extended family had high mean scores in environmental QoL, overall QoL and satisfaction with health. Regression analysis revealed that QoL was influenced mostly by the environmental (46.2%), followed by the psychological (43.7%), physical (31%) and social (20.4%) domains.

CONCLUSIONS

The findings from this study show that older adults living in slums had moderate psychological, social and environmental QoL and poor physical QoL. Although the mean scores for QoL are higher than anticipated, health policy development must take into account the specific needs of older adults.