Gender differences in Quality of Life among HIV/AIDS Patients

 

Mr. S. Arjun¹., G. Maheswari², Ms. Anupriya. R³, Ms. Atchaya. T³, Ms. Divya. M³, Ms. Jayalakshmi. P³, Ms. Maheswari. E³, Ms. Rajeshwari. E³, Ms. Sujithra. P³

¹Associate Professor, Dhanvantri College of Nursing, Under the Tamilnadu Dr. MGR Medical University, Namakkal District.

²Prof. Dhanvantri College of Nursing, Under the Tamilnadu Dr. MGR Medical University, Namakkal District.

³IV Year B.Sc (N) students, Dhanvantri College of Nursing, Under the Tamilnadu Dr. MGR Medical University, Namakkal District.

 

ABSTRACT:

AIDS and HIV is one of the major problems, affecting quality of life in developing countries. Most of the patients with HIV struggle with many social problems like social stigma, poverty, which might affect quality of life (QOL) in physical, mental and social domains. The study has conducted to comparative study to find out the quality of life (QOL) among male and female patients affected with HIV/AIDS who are an antiretroviral therapy from Government Head Quarters Hospital, Erode. The study consisted total of 60 samples, 30 males and 30 females. The design adopted for the study was descriptive comparative design. The tool used for the present study is WHO QOL-HIV brief scale. The unpaired ‘t’ value is 6.34 is statistically significant at 0.05 level. Regarding the association between the QOL score of subjects and their gender, the obtained chi-square value of 28.7 at df 1 (3.84) was significant at (P<0.05) level. This indicates that the association between the QOL score and gender. The study finding says that there was no significant association between the quality of life of male and female patients affected with HIV/AIDS on ART with their selected demographic variables and clinical profiles.

 

 

INTRODUCTION:

Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. (Basavaraj, 2014).

 

Several factors associated with better QOL among HIV-infected patients have been reported in the international literature, and mainly, the impact of HIV on QOL falls under four major.

 

Sociodemographic characteristics such as male gender, younger age, higher socioeconomic status, and employment have been associated with improvement in QOL. Other variables such as lower HIV viral load, greater CD4+ cell count, fewer or less bothersome HIV symptoms, and higher levels of hemoglobin have been shown to be important clinical/immunological indicators of better QOL. (Ruiz Perez, 2005).

 

However the quality of life (QOL) among male and female patients affected with HIV/AIDS who are an antiretroviral therapy may differs due to so many reasons in India. This is a challenging issue to improve the quality of life of HIV persons for health care workers. Understanding these gender differences may provide potentially useful information for tailoring interventions to enhance QOL among people infected with HIV/AIDS.

The objectives of the study

1.     To assess the quality of life among male patients with HIV/AIDS who are on ART

2.     To assess the quality of life among female patients with HIV/AIDS who are on ART

3.     To compare the level of quality of life between male and female patients with HIV/AIDS who are on ART.

4.     To find out the association between the quality of life of male and female patients affected with HIV/AIDS on ART with their selected demographic variables (age, education, occupation, income, marital status, locality, duration of illness, and duration of receiving ART and Co-morbid conditions).

 

 

Following hypotheses were set for the study, and all hypotheses were tested at 0.05 level of significance.

1.     There is a significant difference between the quality of life among   male and female patients affected with HIV/AIDS receiving ART.

2.     There is a significant association between quality of life among the male patients with HIV/AIDS on ART and selected demographic variable (age, education, occupation, income, marital status, locality, duration of illness, duration of receiving ART).

3.     There is a significant association between quality of life among the female patients with HIV/AIDS on ART and selected demographic variables (age, education, occupation, income, marital status, locality, duration of illness, duration of receiving ART).

RESULTS:

Table 1. Frequency and percentage distribution of subjects on the basis of quality of life in various domains. (N=60)

QOL domains	Very good QOL				Good QOL				Moderate  QOL				Poor  QOL				Very poor QOL
	Males		Females		Males		Females		Males		Females		Males		Females		Males		Females
	f	%	f	%	F	%	F	%	f	%	f	%	f	%	f	%	f	%	f	%
Physical Domain	1	3	0	0	18	60	6	20	9	30	16	53	2	7	6	20	0	0	2	7
Psychological domain	0	0	0	0	16	53	8	27	12	40	16	53	2	7	4	13	0	0	2	7
Level of  dependency	1	3	0	0	15	50	6	20	11	37	20	67	3	10	2	7	0	0	2	7
Social relations	0	0	0	0	16	53	7	23	10	33	16	53	3	10	4	13	1	3	3	10
Environment	2	7	1	3	18	60	5	17	12	40	17	57	6	20	5	17	1	3	2	7
Spiritual domain	1	3	0	0	15	50	6	20	12	40	18	60	1	3	5	17	1	3	1	3
General health Domain	2	7	1	3	15	50	7	23	11	37	16	53	2	7	5	17	0	0	1	3

 

Table 2: Comparison of mean and SD of male and female patients on ART.  (N = 60)

Group	N	Mean	SD	t - Test	Df
Male	30	102	6.17	6.34*	58
Female	30	92	6.07

*Significant at 0.05 level.

 

 

Table 3: Association between the QOL scores and gender among HIV infected persons on ART. (N=60)

HIV patients	Above mean	Below Mean	χ2 value	Df
Male	1	21	28.7	1
Female	21	9

*Significant at 0.05 level.

Table 4. Correlation between different domains of QOL scores of male patients. (N=30)

QOL domains	Physical Domain	Psychological domain	Level of dependency	Social relations	Environment	Spiritual domain	General health domain
Physical Domain	-	0.81*	-	0.54*	-	0.64*	-
Psychological domain	-	-	0.38*	-	0.63*	-	0.53*
Level of dependency	0.62*	-	-	0.47*	-	0.45*	-
Social relations	-	0.57*	-	-	0.43*	-	0.29*
Environment	0.43*	-	0.59*	-	-	0.56*	-
Spiritual domain	-	0.52*	-	0.42*	-	-	0.59*
General health domain	0.39*	-	0.64*	-	0.37*	-	-

*Significant at 0.05 level.

 

Table 5. Correlation between different domains of QOL scores of female patients. (N = 30)

QOL domains	Physical Domain	Psychological domain	Level of dependency	Social relations	Environment	Spiritual domain	General health domain
Physical Domain	-	0.73*	-	0.52*	-	0.54*	-
Psychological domain	-	-	0.68*	-	0.63*	-	0.73*
Level of dependency	0.42*	-	-	0.77*	-	0.5*	-
Social relations	-	0.47*	-	-	0.43*	-	0.44*
Environment	0.23*	-	0.59*	-	-	0.56*	-
Spiritual domain	-	0.47*	-	0.42*	-		0.59*
General health domain	0.49*	-	0.54*	-	0.87*	-	-

*Significant at 0.05 level.

 

 

CONCLUSIONS:

In male HIV patients the mean QOL score is 102 and the female HIV patients the mean QOL score is 92, which is lower than the male HIV patients the mean QOL score. The standard deviation of male HIV patients is 6.17 and the standard deviation female HIV patient is 6.07. The unpaired ‘t’ value is 6.34 is statistically significant at 0.05 level. Regarding the association between the QOL score of subjects and their gender, the obtained chi-square value of 28.7 at df 1 (3.84) was significant at (P<0.05) level. This indicates that the association between the QOL score and gender. The study finding says that there was no significant association between the quality of life of male and female patients affected with HIV/AIDS on ART with their selected demographic variables and clinical profiles.

 

IMPLICATIONS:

This study has many implications in the field of nursing this includes nursing practice, nursing education, nursing research and nursing administration.

 

Nursing Practice:

The findings of the study clearly point out that

·         Enhancing QOL among HIV patients is a big challenge for Nurses and need to take up the challenge to provide comfortable living environment to HIV/AIDS patients.

·         Nurses can understand the differences in QOL of HIV patients regard to gender which helps to enhance the nursing care for females and encourage them to utilize the facilities.

·         The study helps the nursing community to encourage the females for adopting coping strategies to overcome stress.

 

Nursing Education:

·         Nurses and other health care professionals can be educated on important role in enhancing QOL among HIV patients and their family members about healthy practices for healthy living. 

·         Nursing students can understand the differences in QOL of HIV patients regard to gender which helps to enhance the nursing care for HIV patients.

·         Nursing personal should be given in-service education to update their knowledge and improve their state in nursing education which helps to enhance the QOL of HIV patients.

 

Nursing Research:

·         The findings represent a critical tool for continuous development of a relevant body of knowledge for the body of nursing profession. 

·         The information from this research helps to boost up for performance of nurse in the community and clinical settings.

·         This study can potentially play a pivotal role at each phase of nursing process by helping the nurses to make more critical thinking and take skilful decision. 

·         It also helps the nursing personal to develop inquiry by providing a base for further research. 

 

 

Nursing Administration:

·         Knowledge on the QOL among HIV patients will help nurses to function as nurse advocates. 

·         Nurse advocates can be established by the effective nursing administrators, who take active part in policy making develop protocol and procedures regarding education to HIV/AIDS patients. 

·         Helps the nurse administrator for recommending Government and NGO’s for adequate staffing can be on handed for better quality care and quality of life among HIV/AIDS patients.

 

 

LIMITATIONS:

·         The study was done on small sample size of 60, hence generalization is possible only for the selected populations in Nongovernmental organization in Madurai during the data collection period.

·         This study was limited to 6 weeks data collection period.

·         This study included only the assessing the QOL of HIV/AIDS patients and not having any interventions to enhance the QOL.

 

RECOMMENDATIONS:

·         The study can be conducted using large population to generalize the findings.

·         A longitudinal study can be conducted to assess the QOL of HIV/AIDS patients by introducing any interventions to enhance the QOL.

·         This study can be carried out to evaluate the various treatment modalities to enhance QOL.

·         This study can be done in a time series study with multiple institution of treatment to identify the exact coping strategies suitable for males and females.

 

 

REFERENCES:

1.         Basavaraj, K. H., Navya, M. A., and Rashmi, R. (2010). Quality of life in HIV/AIDS. Indian Journal of Sexually Transmitted Diseases, 31(2), 75.

2.         Perez, I. R., Bano, J. R., Ruz, M. L., del Arco Jimenez, A., Prados, M. C., Liano, J. P., and Muñoz, N. (2005). Health-related quality of life of patients with HIV: impact of sociodemographic, clinical and psychosocial factors. Quality of Life Research, 14(5), 1301-1310.

3.         Hernández-Aguado, I., Avino, M. J., Pérez-Hoyos, S., González-Aracil, J., Ruiz-Pérez, I., Torrella, A., and Trullen, J. (1999). Human immunodeficiency virus (HIV) infection in parenteral drug users: evolution of the epidemic over 10 years. Valencian Epidemiology and Prevention of HIV Disease Study Group. International Journal of Epidemiology, 28(2), 335-340.

4.         Bermudez-Tamayo, C., Martin, J. J. M., Ruiz-Pérez, I., and de Labry Lima, A. O. (2008). Factors associated with improvement in disability-adjusted life years in patients with HIV/AIDS. BMC Public Health, 8(1), 362.

5.         Wang, D., Larder, B., Revell, A., Montaner, J., Harrigan, R., De Wolf, F., and Emery, S. (2009). A comparison of three computational modelling methods for the prediction of virological response to combination HIV therapy. Artificial Intelligence in Medicine, 47(1), 63-74.

 

 

 

Received on 06.03.2019          Modified on 31.05.2019

Accepted on 24.06.2019     © A&V Publications all right reserved