Impact of comorbidities on quality of life and coping abilities among tubercular patients receiving DOTS: An exploratory study.

Abstract

Tuberculosis (TB) continues to be a major health problem worldwide. The presence of other comorbidities among TB patients causes a significant burden on the healthcare system and has a major influence on disease outcomes, quality of life (QOL) and coping abilities among patients. In the present study, a descriptive exploratory approach was used to assess various co-morbidities and their impact on QOL and coping abilities among 95 patients of TB receiving Directly Observed Treatment Short Course (DOTS) at three public hospitals in Punjab through personal interviews by the researcher. Ethical clearance was obtained from the Institutional Ethical Committee and informed consent was taken from the subjects. A self-structured checklist was used to assess the comorbidities and their impact on the patient's QOL was assessed using the WHO QOL Bref Scale. The cope inventory by Carter was used to determine the coping abilities adopted by the subjects. The results of the study revealed that tobacco use (27.4%), hypertension (23.2%), alcohol abuse (22.1%) and diabetes (15.8%) were the most common comorbidities present, among the subjects. Majority of the patients had moderate scores (85-93) of QOL and suggested non-significant association with demographic variables using Kruskal Wallis and Mann Whitney test in all domains of QOL. Majority of the subjects (82.1%) had an average level of coping abilities and suggested non-significant association with demographic variables using chi square test. Further analysis revealed a statistically significant correlation (r = 0.992) between QOL and coping abilities using Spearman's rho correlation test among the subjects. Tubercular patients have a higher prevalence of comorbidities. A positive correlation between QOL and coping suggests that by improving QOL, coping can also be improved.