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Quality of life and its predictors among aging people in urban and rural Nepal

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Abstract

Purpose

We studied the quality of life (QoL) of the elderly in Nepal and their special needs. Nepal is a low- and middle-income country where the elderly population is growing significantly.

Methods

A random selection of informants from the Kavre district was carried out in this cross-sectional, population-based, door-to-door survey. The district has a mixture of urban and rural communities. In Nepal, families generally take care of their elderly. Hardly any placement is made in institutions. A validated Nepali version of World Health Organization Quality of Life 8-question scale (WHOQoL-8) estimated QoL among the elderly (≥ 60 years; N = 439). Other variables of interest were socio-demographics, substance use, physical and psychological health, and family support. Depression was measured by Geriatric Depression Scale short form [GDS-15]. Due to a high illiteracy rate, a structured and culturally adapted questionnaire was presented in an interview format. The relationships between the variables and QoL were analyzed using independent sample t tests, linear regression and Pearson’s correlations.

Results

The mean QoL score was 25.7 (± 4.2); 49.2% rated their QoL as good. Positive predictors of QoL were: urban residence (p = 0.03); employment (p = 0.02); absence of chronic physical health problems (p = 0.02); absence of depression (p < 0.001); adequate time given by family (p = 0.001), and reports of non-abusive family relationships (p < 0.001). A negative correlation was found between geriatric depression and the QoL score (r = − 0.697; p < 0.001).

Conclusion

QoL of the elderly in Nepal may potentially improve by care directed towards their physical and psychological health, by strengthening family relations, and by financial independence

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Data availability

Personal identification details of the participants were separated from the completed questionnaires. The data were stored in a locked room at Kathmandu University School of Medical Sciences (KUSMS). No information relating to identifiable individuals was disseminated beyond the few researchers immediately involved in the study. The data sets used and analyzed in the current study are available from the corresponding author on reasonable request.

Abbreviations

BMI:

Body mass index

BP:

Blood pressure

EUROHIS:

European Health Interview Surveys

FCHV:

Female community health volunteer

GDS:

Geriatric Depression Scale

IRC-KUSMS:

Institutional Review Committee of Kathmandu University School of Medical Sciences

LAMI:

Low- and middle-income

QoL:

Quality of life

SD:

Standard deviation

SAR:

South Asian Region

WHOQoL-8:

World Health Organization Quality of Life 8-question scale

WHOQOL-BREF:

World Health Organization Quality of Life-26 items brief version

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Acknowledgements

We would like to honor Late Kedar Manandhar for his major contribution; he was the person who conceptualized this research endeavor. We would also like to thank the University Grants Commission (UGC), Nepal, for the academic research grant; and Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal for technical support.

Funding

This academic research project was funded by the University Grants Commission (UGC), Nepal (Faculty Research Grant; awarded No FRG-74/75-HS-15; Date 27 Sept, 2018).

Author information

Authors and Affiliations

  1. Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal

    Ajay Risal, Sabina Manandhar, Kedar Manandhar & Dipak Kunwar

  2. Department of Psychiatry, Kathmandu University School of Medical Sciences, Dhulikhel Hospital, Kathmandu University Hospital, GPO Box 11008, Dhulikhel, Kavre, Nepal

    Ajay Risal & Dipak Kunwar

  3. Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal

    Kedar Manandhar

  4. Sheer Memorial Hospital College of Nursing, Banepa, Kavre, Nepal

    Nirmala Manandhar

  5. Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway

    Are Holen

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Contributions

AR, KM, and NM, with the support from AH were involved in the conception and design of the study. SM, AR, KM, DK, and NM were responsible for the data acquisition. AR performed the data analysis and interpretation. AR drafted the initial manuscript, and also did the necessary modifications for making the manuscript acceptable for publication. All authors revised the manuscript critically for intellectual content and approved the submitted version.

Corresponding author

Correspondence to Ajay Risal.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethical approval for the study was obtained from The Institutional Review Committee of the Kathmandu University School of Medical Sciences (IRC-KUSMS), Dhulikhel Hospital, Kavre, Nepal. Participants provided informed consent. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees.

Informed consent

Prior to the interviews, all prospective participants were given information about the study. Those who were literate, read the written information that had been approved by the ethics committees. The information described the nature and the purpose of the study. For those who were illiterate, field interviewers read out loud the same information in the presence of other family members. Ample opportunity was allowed for all participants and their family members to ask questions and to discuss what it meant. Fingerprints, signature, or verbal informed consent were given by each participant according to their literacy status. Illiterate participants provided consent in the presence of at least one reliable or legally authorized family member.

Consent for publication

The information sheet read by the literate participant or read out to the illiterate participant as explained above clearly mentioned that those who participated also gave their consent to utilize the information in a de-identified format for scientific and popular paper publications.

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Risal, A., Manandhar, S., Manandhar, K. et al. Quality of life and its predictors among aging people in urban and rural Nepal. Qual Life Res 29, 3201–3212 (2020). https://doi.org/10.1007/s11136-020-02593-4

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