Study of impact of antitubercular therapy on quality of life.

Introduction: Many aspects of tuberculosis (TB) and its treatment can compromise patients' quality of life (QOL). Treatment of active TB requires prolonged therapy with multiple drugs that can lead to adverse reactions. There is considerable social stigma associated with TB, leaving the individual feeling shunned and isolated. Hence, it is necessary that for a thorough assessment of patients' health status, overall impact of TB on patient's QOL should be considered. Materials and Methods:Thirty newly diagnosed smear positive cases of pulmonary TB, of either gender were interviewed using - WHO QOL BREF, which is a 26-item scale designed by WHO. It has four domains viz.: Physical health, psychological health, social relationships, and environment. Interviews were conducted thrice: Before starting treatment, after 2 months, and after 4 months of treatment. Controls ( n = 30) were selected from the general population and interviewed using same questionnaire. Results:Before treatment, scores in all domains were significantly lower in patients than controls. Worst affected were physical domain followed by psychological. Gradual increase in scores was observed over the course of treatment, indicating positive effect of medical intervention on QOL. Despite improvements, the scores in physical and psychological domain after 4 months of treatment were still significantly lower in patients than in controls. Conclusion: Measurement of QOL in TB is essential to have an in-depth understanding of effect of disease on various dimensions of health. This would enable health care professionals to devise relevant interventions such as patient counselling which would be useful in further improving quality of TB control programs.

Validation of WHO QOL-BREF instrument in indian adolescents.

Objective. To test the psychometric properties of World Health Organization Quality of Life (WHO QOL-BREF) instrument in Indian adolescents. Methods. Of 1900 schools in Lucknow city, 20 schools were invited to participate. To make WHO QOL-BREF instrument culturally appropriate for Indian adolescents, a minor modification was done by replacing one item in Social domain “Are you satisfied with your sex life?” with “Are you satisfied with the respect you receive from others?”. The revised WHO QOL-BREF was administered to subjects in school after obtaining written parental consent. Results. From August 2007 – January 2008, 525 adolescents were recruited (mean age 14.04±2.09 yr; 52.38 % males). Adolescents reported highest HRQoL in social relations and lowest in environment domain. The instrument showed good internal consistency (Cronbach’s a=0.87; p-value<0.01) as well as good content, construct and predictive validity (pvalues< 0.05). Psychological domain had best predictive validity, whereas, social relations domain had best content validity. Conclusion. The study provides evidence that revised WHO QOL-BREF is a reliable and valid instrument and can be used in Indian adolescents.