WHOQOL-BREF in Measuring Quality of Life Among Sickle Cell Disease Patients with Leg Ulcers

Abstract

Sickle cell disease (SCD) presents complex clinical manifestations influenced by genetic, social, environmental, and healthcare access factors as well as socioeconomic status. In this context, sickle cell leg ulcers (SLUs) are a debilitating complication of SCD. We aimed to describe sociodemographic data and evaluate the quality of life (QoL) of SCD patients with and without SLUs. We conducted a cross-sectional study including 13 SCD patients with SLUs and 42 without LUs. Clinical data were obtained by reviewing the medical records, and QoL was assessed with the WHOQOL-BREF questionnaire. Our cohort of patients had a mean age of 34.9 years, with 52.8% male, 52.8% identifying as black, and 41.7% identifying as brown. Most had low income, incomplete education, and high unemployment rates. The social habits and relationships of SCD patients showed varying levels of friendship and family closeness, and the majority of SLU+ patients did not practice sports. We failed to find statistical differences in the WHOQOL-BREF domains between SLU+ and SLU- patients. However, higher income and employment status were associated with improved WHOQOL-BREF domain scores in SCD patients, while vaso-occlusive episodes and female gender were linked to lower scores. Our data reinforce the sociodemographic characteristics of SCD. The physical domain was associated with income, occupation, and vaso-occlusion. The psychological domain was associated with income and occupation. The social relationship domain was associated with occupation and female gender. The environmental domain was associated with vaso-occlusion. The WHOQOL-BREF is a reliable tool to measure QoL in SCD.

Keywords: WHOQOL-BREF; quality of life; sickle cell disease; sickle cell leg ulcer.

Figure 1

Associations between WHOQOL-BREF domains and different characteristics in SCD patients. (A) Patients receiving ≥3 times the minimum wage presented increased D1 values. (B) Patients receiving ≥3 times the minimum wage presented increased D2 values. (C) Patients receiving 1–2 times the minimum wage presented the greatest increase in D4 values, followed by patients receiving ≥3 times the minimum wage. p-values were obtained with the Kruskal–Wallis test. (D) Patients who had an occupation presented higher D1 values. (E) Patients with an occupation presented higher D2 values. (F) Patients who had an occupation presented higher D3 values. (G) Patients who experienced vaso-occlusive episodes had decreased D1 values. (H) Patients who experienced vaso-occlusive episodes had decreased D4 values. (I) Female patients exhibited decreased D3 values compared with male patients. p-value was obtained with the Mann–Whitney U test. MW: minimum wage. VO: vaso-occlusion.