Sexual, mental, and multidimensional determinants of health-related quality of life in Parkinson's disease using the revised Wilson and Cleary model

Abstract

According to the World Health Organization (WHO), the global disability burden associated with Parkinson’s disease (PD) has increased by 81% in recent decades. Consequently, health-related quality of life (HRQoL) has become a crucial patient-reported outcome measure. Due to the multidimensional and sequential nature of the determinants of HRQoL, it is imperative to determine the relative contributions of various predictors to HRQoL among people with PD, thereby informing both research and clinical practice. A cross-sectional study was conducted among 284 consecutively recruited individuals with PD receiving follow-up care at four tertiary hospitals and patients’ organization in Addis Ababa, Ethiopia. HRQoL and health satisfaction were measured using the WHOQoL scale, sexual dysfunction using the Medical Outcomes Study Sexual Functioning Scale, and anxiety and depression using the Hospital Anxiety and Depression Scale. Hierarchical regression analysis was conducted based on the revised Wilson and Cleary Model (WCM) of HRQoL. Statistical significance was set at a p -value of < 0.05, with a 95% confidence interval. According to the revised WCM, individual characteristics (29.6%, p < 0.001), interpersonal characteristics, (25.2%, p < 0.001), biological functions (2%, p = 0.109), mental health symptoms (7.1%, p < 0.001), sexual dysfunction (1.5%, p < 0.001), and health satisfaction (3%, p < 0.001) together explained 68.5% of the variance in HRQoL. Age, sex, coping, social support, PD-related stigma, depression, sexual dysfunction, and health satisfaction were identified as independent predictors of HRQoL. All dimensions of the revised WCM, except for the predictors included under biological function, directly contributed to HRQoL among people with PD. These findings highlight the need for a comprehensive biopsychosocial approach in both research and clinical practice to enhance HRQoL of individuals with PD.