Abstract

Objectives: The usefulness of quality of life (QOL) as an outcome measure in medicine has inspired general population studies to establish normative values. The objectives of the study were to: (1) highlight the pattern of satisfaction with aspects of life circumstances among a nationwide sample of Kuwaiti subjects, using the 26-item WHOQOL Instrument (WHOQOL-Bref); (2) establish the QOL domain normative values; (3) highlight the relationship of QOL with socio-demographic variables and scores on scales for anxiety and depression; and (4) assess the relationship between domains of QOL.

Method: A one-in-three systematic random proportionate sample of consenting Kuwaiti nationals attending the large cooperative stores and municipal government offices in the six governorates, were requested to complete the questionnaires anonymously.

Results: There were 3,303 participants (44.8% m, 55.2% f, mean age 35.4, SD 11.9; range, 16-87). As a group, they were only moderately satisfied with their life circumstances. The domain scores for physical health (14.6 or 66.2%) and psychological health (14.2 or 63.9%) were at the middle of the range for the WHO 23-country report, while the social relations (15.0 or 68.8%) and environment (14.5 or 65.4%) domains were at the upper end of the WHO range. The general facet (GF) score (15.5 or 71.6%) was significantly higher than all domains. Diminished QOL was significantly associated with female gender, older age, social disadvantage, and high scores on anxiety/depression. Depression was the most important predictor of QOL, accounting for over 77% of total variance.

Conclusion: QOL was sensitive to distressing and unfulfilled life circumstances. Hence, coupled with the difficulty of conducting house-to-house surveys in such a conservative society, a cost effective way of tracking societal distress is by including a brief and responsive measure of QOL during national census exercises. Clinicians need to be aware of QOL issues because QOL is associated with clinical and social variables. The differences between GF (representing subjective well-being) and the domains, has implications for QOL theory.