Predictors of ‘No Problem’ as the Health‑related Quality of Life Status of People Living with HIV on Differentiated Service Delivery in a Nigerian State using the EQ-5D-5L

Predictors of ‘No Problem’ as the Health‑related Quality of Life Status of People Living with HIV on Differentiated Service Delivery in a Nigerian State using the EQ-5D-5L | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Predictors of ‘No Problem’ as the Health‑related Quality of Life Status of People Living with HIV on Differentiated Service Delivery in a Nigerian State using the EQ-5D-5L Abdulmuminu Isah, Ifunanya Mary-Ann Onyia, Onyinyechi Loveth Onugwu, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4471995/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Differentiated service delivery (DSD) aims to improve the overall quality of care that is provided to people living with HIV (PLHIV). One critical measure of self-reported satisfaction with the level of care is quality of life. This study aimed to determine the socio-demographic predictors of the quality of life (QoL) of PLHIV on DSD in a Southeastern Nigerian State. Methods: A cross-sectional study was conducted among PLHIV on DSD across Abia State, Nigeria, from February-April 2022. A sample size of 361 was estimated from the three DSD models in the state: community pharmacy-based, PLHIV-led community antiretroviral group, and health worker/facility-based models. A generic QoL tool (EQ-5D-5L) was used to obtain responses from all consenting PLHIV. Descriptive statistics were used to summarize the variables. Variations in the QoL index value and the predictors of the QoL were determined using one-way ANOVA and binary logistics regression ( no problem versus others ), respectively. P <0.05 was considered statistically significant. Results: A total number of 312 questionnaires were completed (response rate = 86.4%). Female gender was indicated by 162(51.9%) respondents, while 114(36.5%) stated that they were married. The highest level of education by most respondents (n=134, 42.9%) was secondary school. About a-third (115, 36.9%) reported that they have had HIV for 6-10 years. For their QoL, 284(76.3%) PLHIV had no problems (self-care), 66(21.2%) had slight problems (usual activities) and 11(3.5%) had severe problems (anxiety/depression). The index value for all the respondents was 0.837±0.006. PLHIV that were aged <20 years had a value of 0.782±0.221( F =3.923, p =0.004), while those without formal education had 0.711±0.232 ( F =7.981, p ≤0.001). Characteristics that were predictive of no problems status were 16-20 years of diagnosis (β=3.634, p =0.025) [mobility]; self-employment (β=11.204, p =0.013) and 16-20 years of diagnosis (β=15.561, p =0.001) [self-care]; tertiary education (β=0.246, p =0.036) [usual activities]; female gender (β=2.040, p =0.014), and 16-20 years of diagnosis (β=4.777, p =0.005) [pain/discomfort]; and 31-40 years (β=0.147, p =0.005), and not being married (β=0.363, p =0.013)[anxiety/depression]. Conclusions: The PLHIV accessing DSD at Abia State had a good quality of life. Their gender, level of education, employment status, and age were factors that were predictive of good QoL among them. Introduction The HIV epidemic has continued to be a key global public health issue affecting society and has claimed about 40.4 [32.9–51.3] million lives ( 1 ). At the end of 2022, the world health organization (WHO) estimated that there were about 39 million (33.1–45.7 million) people living with HIV globally, with more than two-thirds living in the WHO African Region. ( 1 ). In 2019, the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the National Agency for the Control of AIDS estimated that in Nigeria, there are about 1.8 million people that live with HIV, with a prevalence of 1.4% ( 2 ) while Onovo et al estimated the national HIV prevalence to be 2.1% with approximately 2 million people living with HIV in 2022 ( 3 ). Also, in 2022, 630 000 [480 000–880 000] people died from HIV-related causes and 1.3 million [1 million–1.7 million] people acquired HIV ( 4 ). The "95-95-95" goal was set by the Joint United Nations Programme on HIV and AIDS to attain epidemic control. The aim is to ensure that by 2025, 95% of people living with HIV know their status, 95% of HIV positive people will be on Antiretroviral therapy (ART), and 95% of those on ART will have suppressed Viral load ( 5 ). To expand coverage and fight this epidemic, the concept of differentiated service delivery (DSD) was introduced. Differentiated service delivery is a client-centered strategy that streamlines and modifies HIV services throughout the clinical cascade to take into consideration the preferences and needs of diverse groups of people living with HIV (PLHIV) while minimizing the health system's burden ( 6 , 7 ). In order to meet the various demands and expectations of persons living with HIV, differentiated service delivery entails decreasing or increasing the intensity of the service, the frequency of the service, the service provider, and the location of the service ( 8 ). The quality of life (QoL) of People living with HIV has become a significant public health issue and as such, QoL is increasingly becoming a significant component when evaluating the total well-being of people living with HIV ( 9 ). The QoL of people living with HIV has also become one of the indicators used to assess patient adherence to highly active antiretroviral therapy (HAART) ( 10 ). Additionally, as ART has been made available as a long-term regimen of therapy for PLHIV, the QoL has increased significantly as a measure for assessing the effects of ART. Therefore, research on the quality of life (QoL) of PLHIV will provide additional perspectives on the problems they experience and identify ways to enhance their well-being ( 9 ). Health-related quality of life (HRQoL) is increasingly recognized as a primary outcome in many clinical trials and has increased in relevance as a health outcome indicator ( 11 ). In contrast to other health measures, HRQoL is patient-reported and represents an effort to take into account how health affects practical areas of everyday life. As a result, determining HRQoL is essential to identifying and meeting the requirements of different populations, especially those populations with chronic illnesses like HIV ( 12 ). EQ-5D-5L is the most commonly used generic preference-based multi-attribute utility instruments (MAUIs) health-related quality of life (HRQoL) measure ( 13 ). This instrument is based on self-assessment that consists of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension contains one item that informs on the degree of problems ( 14 ). It is efficient because it is generic, concise, and supported by the value sets required for an economic appraisal ( 15 , 16 ). The EQ-5D has been utilized in various health conditions, has good test reliability, and also is validated for use for many disease conditions ( 17 ). Numerous social problems that affect many PLHIV, including stigma, discrimination, anxiety, cultural standards, poverty, and overstretched health system present real barriers that prevent people from accessing the care they need and this can have an impact on their quality of life (QOL) not solely from the perspective of physical health but also from the perspective of social and mental health ( 10 , 18 , 19 ). Additionally, some of the factors that influence the quality of life of PLHIV include gender, education level, career, knowledge, attitude, and behavior. For several developing countries, access to ARV therapy and adherence remain significant concerns ( 20 ). While PLHIV in high-income countries (HIC) reports significantly lower health-related quality of life than the general population, research on HRQoL of PLHIV in low- and middle-income countries (LMIC) is limited ( 21 ). Based on these concerns, there is the need to conduct a study to evaluate the quality of life of people living with HIV on differentiated service delivery and to determine the sociodemographic predictors of ‘no problems’ in PLHIV in a South-eastern Nigerian State. Thus, the aim of this study was to determine the socio-demographic predictors of good quality of life (QoL) of PLHIV on DSD in a Southeastern Nigerian State Methods Study Design The design of the study was questionnaire-based cross-sectional, carried out for a period of 3 months (February to April 2022). Study Setting The study was conducted at the Differentiated Service Delivery sites in Abia State. Currently, the state has three models of Differentiated Service Delivery namely; community pharmacy-based models (N = 7), patient-led community ART groups (N = 6) and health workers/facility-based models (N = 11). Abia state is located between lat 4o49.30’N-6o02’N and between long 7o08’E-8o04’E in the southeastern part of Nigeria. It has an area of about 5833.77km2, which is roughly 9% of Nigeria’s landmass. It is bounded in the north by Enugu state, in the south by Rivers state, in the east by Cross River and Akwa Ibom states and in the west by Imo state. Study Population and Sample Size The study population consisted of all stable PLHIV aged 18 years and above on differentiated service delivery at Abia state, Nigeria. There were approximately 5000 HIV patients enrolled in differentiated service delivery at the study site. Using Raosoft Online Sample Size Calculator, a sample size of 357 was obtained, assuming a margin of error, confidence level, and response distribution of 5%, 95%, and 50% respectively. To make provisions for possible low participation and withdrawal, an additional 10% sample was added. Thus, a total of 361 questionnaires were distributed to eligible respondents. At the end, 312 copies were completed and returned (response rate = 86.4%). Eligibility criteria Respondents that were included in the study were PLHIV who were 18 years of age and above, stable on ART, and enrolled in any of the differentiated service delivery (DSD) models. PLHIV who had been in any of the DSD models for less than a year were excluded from the study. Study Instrument The questionnaire for data collection consisted of two sections. The first section obtained the socio-demographic characteristics of the respondents (age, gender, sex, marital status, occupational status, and educational status) and a question on the year since they were diagnosed of HIV. The second section of the questionnaire was the EQ-5D-5L. The EQ-5D-5L is a generic instrument developed by the European Quality of Life (EuroQol) Group to measure health-related QoL in the general population, irrespective of the disease conditions. It is a two-part instrument consisting of a descriptive system and a visual analogue scale (EQ-VAS). The five dimensions (5D) of health included in the descriptive system that was utilized for data collection were mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. There are five levels (5L) for each dimension: level 1 (no problems), level 2 (slight problems), level 3 (moderate problems), level 4 (severe problems), and level 5 (extreme problems). The respondents were expected to choose the level that best described their current health-related situation for each health dimension. These digits, which represent the degree of severity for each dimension, can be added together to provide a 5-digit number that represents the respondent's overall health. Hence, a total of 5 5 (i.e., 3 125) unique health states exist for this measure. Using preference-based, national value sets, these health states can be "valued" or converted to a single index value (utility) ( 22 ). Data Collection Procedure The objective of the study was explained to the eligible participants and written informed consent to participate was obtained from all those who were included in the study after assuring them of anonymity, confidentiality, and voluntariness of participation. They were approached as they came for their regular appointments and the questionnaires were self-administered. They were requested to fill out the questionnaires independently and return them in unmarked envelopes that were provided. Data Analysis The collected questionnaires were coded and the data was analyzed using the IBM SPSS (version-25). Descriptive statistics (frequency, percent, mean, standard deviation) were used to present participants’ socio-demographic and clinical data as well as the EQ-5D-5L health profiles. The EQ-5D-5L index value (maximum possible = 1) was obtained using the excel formula provided by the EuroQoL group. One-way ANOVA was used to compare the index values across socio-demographic characteristics that were more than two. Since there were no value sets for Nigeria at the time of the study, the EQ-5D-5L crosswalk value sets for Zimbabwe were utilized to assess participants' health states. The use of Zimbabwean value sets was justified by the fact that the general health status in Zimbabwe and Nigeria are comparable ( 22 ). Thereafter, the five levels were grouped into two for each dimension: no problem (recoded as 1) and others (transformed and recoded as 0). The predictors of the ‘no problem’ status were then determined using binary logistics regression. For all inferential analysis, statistical significance was assumed for p values less than 0.05. Ethical Considerations Ethical approval was obtained from the Health Research and Ethics Committee of the Faculty of Pharmaceutical Sciences of the University of Nigeria (Ref. No.: FPSRE/UNN/22/0010). The participants were informed of the voluntary nature of their participation in the study and the right to withdraw at any time. They were assured that any information that they provided would be treated as confidential and no identifiable information would be requested from them. Results The total number of people that participated in the study was 312 (response rate = 86.4%). Participants that identified as females were 162(51.9%), with 114(36.5%) of all the respondents reporting that they were married. On occupational status, 136(43.6%) participants reported that they were self-employed, although only 14(4.5%) had not attained any form of formal education. A 6–10-year duration since diagnosis of HIV was reported by 115(36.9%) participants. Table I shows the socio-demographic data of the participants. Table II shows the participants quality of life, categorised by socio-demographic characteristics. The EQ-5D-5L index value for the entire 312 study participants was 0.837 ± 0.006. Based on the ages of the participants, PLHIV who were less than 20 years old had an EQ-5D-5L index score of 0.782 ± 0.221 (F = 3.923, p = 0.004 ) , just as, by using educational status, PLHIV who had no formal education had an EQ-5D-5L index score of 0.711 ± 0.232 (F = 7.981, p ≤ 0.001 ). For the duration of illness, the participants that have been living with HIV for the past 16–20 years had an EQ-5D-5L index score of 0.713 ± 0.202 (F = 12.528, p ≤ 0.001 ). Table III shows the relationship between socio-demographic data and quality of life based on the health status. Among the 312 people that participated in the study, 284(76.3%) participants had no problems with self-care, 235(75.3%) had no problems with pain/discomfort, and 218(69.9%) had no problems with anxiety. For the severe problems, 5(1.6%) participants had severe problems with mobility while 10(3.2%) had severe problems with pain/discomfort. Table IV shows the predictors of ‘ no problems’ health status. The characteristics that were predictive of ‘ no problems’ were 16–20 years of diagnosis (β = 3.634, p = 0.05) [mobility]; self-employment (β = 11.204, p = 0.013) and 16–20 years of diagnosis (β = 15.561, p = 0.001) [self-care]; tertiary education (β = 0.246, p = 0.036) [usual activities]; female gender (β = 2.040, p = 0.014), and 16–20 years of diagnosis (β = 4.777, p = 0.005) [pain/discomfort]; and age (β = 0.147, p = 0.005) [anxiety/depression]. Discussion This study was conducted to determine the quality of life of people living with HIV on differentiated service delivery in a South-eastern Nigerian State. The specific predictors of ‘ no problems ’ health status among the PLHIV were also specifically determined. From the study’s findings, there were more females, A little less than half of the participants were married and just about half of the participants attained secondary education. This is similar to the findings of other other studies conducted in Zaria, Nigeria, ( 23 ), North East Ethiopia ( 24 ), and Togo ( 25 ) about the demographic characteristics of PLHIV. To the best of the researcher’s search, no one has been published on the QoL of PLHIV who are enrolled in the DSD model using the EQ-5D-5L. Thus, the findings of the study could only be explained, then, where necessary, compared with the closest population in other study. The findings revealed that the participants had an overall good quality of life. Popping et al. in their study to evaluate the quality of life among PLHIV in England and the Netherlands using the EQ-5D-5L revealed a mean adjusted HRQoL score of 0.850 ± 0.17 for the Netherlands (higher than that of this study) and 0.832 ± 0.23 for England (similar to that of this study). This higher QoL in the Netherlands may be due to better access to health care, education, a higher standard of living, and higher individual income ( 26 ). Kall et al reported a good quality of life EQ-5D-5L index score of 0.85 ± 0.16 for Romania and 0.88 ± 0.16 for Spain. This is slightly higher than the findings of this study and may be equally attributed to a better quality of care provision to PLHIV and higher income ( 12 ). Comparing the quality of life across the socio-demographics, the study revealed that participants that attained no formal education had a lower quality of life when compared to participants that attained a level of education. A study conducted by Suleiman et al to assess the determinants of Health-related quality of life (HRQOL) among HIV-positive patients at Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria also reported a statistically significant relationship between educational status and HRQoL: participants with secondary or tertiary level of education had a better quality of life ( 23 ). This may be because PLHIV that are more educated will have a better understanding of the disease state and need for adherence to antiretroviral medications which will in turn improve their quality of life. Yaya et al , Anuradha et al and Busi et al also reported that participants with a higher level of education had a better quality of life which is similar to the findings of this study ( 25 , 27 , 28 ). This similarity may be because being educated plays a role in understanding information relating to a good health state. It also allows people to adhere to the instructions provided by healthcare workers and also have a better perception of their condition. However, Akinboro et al had a contrary finding, as a better quality of life in people with no formal and primary education was observed ( 29 ). The study also revealed that the participants that were less than 20 years old had a lower quality of life when compared with other age ranges. However, Anuradha et al in their study that assessed the quality of Life and Its Determinants among People Living with HIV Attending an Antiretroviral Treatment Center in Delhi, India reported that older participants had a better quality of life which is different from that of this study ( 27 ). This may be due to better coping mechanisms which comes with age and more life experiences. The study findings also showed that the majority of the participants had no problems with mobility, very few of them had extreme problems with mobility and almost all the participants reported no problems with self-care. Also, a good proportion of the participants had no problems with usual activities, very few of the participants were unable to do their usual activities while a few of them reported that they had slight problems with pain/discomfort. For the anxiety/depression domain, a good proportion of the study participants had no problems while very few had extreme problems with anxiety/depression. In contrast, but using the WHO STEPwise approach and the Kinyarwanda version of the MOS-HIV Health Survey, Biraguma et al reported that PLHIV in Rwanda had moderate physical and mental health-related dimensions of QOL ( 30 ). In their study, Popping et al. reported that the domain in which PLHIV reported the most problem both in Netherlands and England was the anxiety/depression domain. This health status may be attributed to stigmatization, loneliness, and social isolation, coping with a recent diagnosis of HIV, and the experience of coping with a long-term condition ( 26 ). Similarly, Kall et al also reported that older age is predictive of a lower quality of life which is different from the findings of this study. This may be due to cognitive impairment, the possible presence of comorbidities, and inadequate social interactions ( 12 ). Some of the characteristics that were predictive of ‘ no problems’ in this study were 16–20 years of diagnosis for mobility, self-employment and 16–20 years of diagnosis for self-care, tertiary education for usual activities, female gender and 16–20 years of diagnosis for pain/discomfort and age for anxiety/depression. A study reported that the factors significantly associated with HRQoL were: female gender, attaining primary and secondary education, being over 50 years old and living with HIV for over 1 year since HIV diagnosis ( 31 ). Similarly, Ferreira et al in their study to determine the predictors of QoL in PLHIV in Brazil reported that the female gender, being unemployed and being part of the least privileged socioeconomic levels was associated with lower QoL scores in the psychological domain ( 32 ). Shriharsha and Rentala in a similar study also reported that male gender and being graduated predicted the QoL positively while having primary education, being in nuclear family, and also having a history of alcoholic intake negatively predicted the QoL. In the study, the strongest negative predictor of the QoL of PLHIV was depression ( 33 ). Limitations This was a cross-sectional study, so there was no opportunity of making an intervention which could determine whether the quality of life of the respondents will be varied. Also, the EQ-5D value set used to calculate the utility score was that of Zimbabwe since there is no value set for Nigeria. This may cause a bias in the result because of the social and health differences between the two countries. However, recent studies have used it for the Nigerian population and it has been proven to be valid ( 22 , 34 , 35 ). Data collection was also done in DSD centres in a single state in Nigeria. Thus, the findings of this study may not be generalized to PLHIV in other Nigerian states due to differences in the standard of care and variations in practice. Conclusion The people living with HIV that are accessing care at Abia state, Nigeria had a good quality of life. Respondents that had no form of education had a lower quality of life when compared to those that attained a level of education. Also, younger participants had a better quality of life when compared to mid-aged and older participants. Many of the respondents had no problem with self-care while anxiety was the domain in which the majority had extreme problems. The sociodemographic predictors of ‘ no problems’ are age, female gender, 16–20 years since diagnosis, marital status and educational status. Declarations Funding: No fund was received for this study. Competing Interest: The authors declare that they have no interest related to this study to declare. Ethics Approval: Ethical approval to conduct this study was obtained for this study from the Health Research Ethics Committee of the Faculty of Pharmaceutical Sciences, University of Nigeria (Reference Number: FPSRE/UNN/22/0010). Consent to Participate: Informed consent was obtained from all participants included in the study. Consent for Publication: Not Applicable Author Contribution Author Contributions: AI, IMO, POU and MOA conceptualized the design of the study. CCE, AE, BO and GE participated in data collection, while AI, OLO, IMO and MOA conducted the data analysis and interpretation. Whereas VO, PO, OLO and CCE drafted the initial version of the manuscript, AI, IMO, MOA and POU prepared the final version of the manuscript. All the authors approved the manuscript for submission. Data Availability The data related to this study are available with the corresponding author and could be shared upon a reasonable request. References World Health Organization. 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PLOS ONE [Internet]. 2021 Mar 5 [cited 2024 Mar 10];16(3):e0247777. https://dx.plos.org/10.1371/journal.pone.0247777 . Yaya I, Djalogue L, Patassi AA, Landoh DE, Assindo A, Nambiema A et al. Health-related quality of life among people living with HIV/AIDS in Togo: individuals and contextual effects. BMC Res Notes [Internet]. 2019 Dec [cited 2024 Mar 10];12(1):140. https://bmcresnotes.biomedcentral.com/articles/ 10.1186/s13104-019-4171-x . Popping S, Kall M, Nichols BE, Stempher E, Versteegh L, Van De Vijver DAMC et al. Quality of life among people living with HIV in England and the Netherlands: a population-based study. Lancet Reg Health - Eur [Internet]. 2021 Sep [cited 2024 Mar 10];8:100177. https://linkinghub.elsevier.com/retrieve/pii/S266677622100154X . Anuradha S, Makkar A, Nandi P, Rajeshwari K. Quality of life and its determinants among people living with HIV attending an antiretroviral treatment center in Delhi, India. Indian J Public Health [Internet]. 2020 [cited 2024 Mar 11];64(2):148. https://journals.lww.com/ 10.4103/ijph.IJPH_400_19 . Busi N, Nsoh A, O Otieno M, A Ndeso M, Halle-Ekane SE. G. Evaluation of quality of life and associated factors among HIV patients on antiretroviral therapy in North West region of Cameroon. Afr Health Sci [Internet]. 2021 May 23 [cited 2024 Mar 10];21:8–17. https://www.ajol.info/index.php/ahs/article/view/207490 . Akinboro AO, Akinyemi SO, Olaitan PB, Raji AA, Popoola AA, Awoyemi OR et al. Quality of life of Nigerians living with human immunodeficiency virus. Pan Afr Med J [Internet]. 2014 [cited 2024 Mar 10];18. http://www.panafrican-med-journal.com/content/article/18/234/full/ . Biraguma J, Mutimura E, Frantz JM. Health-related quality of life and associated factors in adults living with HIV in Rwanda. SAHARA-J J Soc Asp HIVAIDS [Internet]. 2018 Jan [cited 2024 Mar 10];15(1):110–20. https://www.tandfonline.com/doi/full/ 10.1080/17290376.2018.1520144 . Ahmed A, Saqlain M, Bashir N, Dujaili J, Hashmi F, Mazhar F et al. Health-related quality of life and its predictors among adults living with HIV/AIDS and receiving antiretroviral therapy in Pakistan. Qual Life Res [Internet]. 2021 Jun [cited 2024 Mar 10];30(6):1653–64. https://link.springer.com/ 10.1007/s11136-021-02771-y . Ferreira AC, Teixeira AL, Silveira MF, Carneiro M. Quality of life predictors for people living with HIV/AIDS in an impoverished region of Brazil. Rev Soc Bras Med Trop [Internet]. 2018 Dec [cited 2024 Mar 10];51(6):743–51. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037–86822018000600743&lng=en&tlng=en Shriharsha C, Rentala S. Quality of life among people living with HIV/AIDS and its predictors: A cross-sectional study at ART center, Bagalkot, Karnataka. J Fam Med Prim Care [Internet]. 2019 [cited 2024 Mar 10];8(3):1011. https://journals.lww.com/ 10.4103/jfmpc.jfmpc_411_18 . Fatoye F, Akinfala AE, Gebrye T, Fatoye C, Ojelade TF, Oyewole OO et al. Translation, Cross-Cultural Adaptation, and Psychometric Testing of Yoruba Version of the EQ–5D Questionnaire in Patients With Musculoskeletal Disorders. Front Public Health [Internet]. 2022 Jun 27 [cited 2024 Mar 10];10:902680. https://www.frontiersin.org/articles/ 10.3389/fpubh.2022.902680/full . Jimam NS, Ismail NE, Dayom WD. Evaluation of Psychometric Quality of EQ–5D–5L Scale for Assessing Health-Related Quality of Life of Malaria Patients. Value Health Reg Issues [Internet]. 2020 Sep [cited 2024 Mar 10];22:15–22. https://linkinghub.elsevier.com/retrieve/pii/S2212109919306077 . Tables Table I: Socio-Demographic Data of the Participants Characteristics Frequency Percentage Gender Male 150 48.1 Female 162 51.9 Total 312 100.0 Age (years) Less than 21 26 8.3 21-30 84 26.9 31-40 99 31.7 Greater than 40 103 33.0 Total 312 100.0 Marital status Married 114 36.5 Single 119 38.1 Divorced 33 10.6 Widow/Widower 46 14.7 Total 312 100.0 Educational Status None 14 4.5 Primary 42 13.5 Secondary 134 42.9 Tertiary 122 39.1 Total 312 100.0 Occupational Status None 60 19.2 Government worker 62 19.9 Self-employed 136 43.6 Private sector employee 54 17.3 Total 312 100.0 Years since diagnosis 0-5 110 35.3 6-10 115 36.9 11-15 63 20.2 16-20 24 7.7 Total 312 100.0 Table IIa: Participant’s Quality of Life Categorised by Socio-Demographic Characteristics N EQ-5D-5L Index score Std. Deviation 95% CI Minimum Maximum F p-value Lower Bound Upper Bound Gender Male 150 0.838 0.119 0.819 0.857 .117 .900 .013 .909 Female 162 0.837 0.100 0.821 0.852 .086 .900 Total 312 0.837 0.109 0.825 0.850 .086 .900 Age (years) Less than 20 26 0.782 0.221 0.693 0.871 .086 .900 3.923 .004 21-30 83 0.850 0.073 0.834 0.866 .500 .900 31-40 99 0.857 0.088 0.839 0.874 .363 .900 Greater than 40 103 0.824 0.104 0.804 0.845 .441 .900 Total 312 0.837 0.109 0.825 0.850 .086 .900 Marital status Married 114 0.830 0.104 0.810 0.849 .399 .900 .590 .622 Single 119 0.836 0.129 0.813 0.859 .086 .900 Divorced 33 0.848 0.075 0.821 0.874 .617 .900 Widow/Widower 46 0.853 0.087 0.827 0.878 .526 .900 Total 312 0.837 0.109 0.825 0.850 .086 .900 Educational status None 14 0.711 0.232 0.578 0.845 .086 .900 7.981 .000 Primary 42 0.817 0.143 0.773 0.862 .117 .900 Secondary 134 0.850 0.083 0.836 0.865 .399 .900 Tertiary 122 0.844 0.092 0.828 0.861 .363 .900 Total 312 0.837 0.109 0.825 0.850 .086 .900 Table IIb: Participant’s Quality of Life Categorised by Socio-Demographic Characteristics N EQ-5D-5L Index score Std. Deviation 95% CI Minimum Maximum F p-value Lower Bound Upper Bound Occupational status None 60 0.816 0.157 0.776 0.857 .086 .900 1.722 .162 Government worker 62 0.830 0.100 0.804 0.855 .363 .900 Self-employed 136 0.841 0.098 0.824 0.857 .399 .900 Private sector employee 54 0.861 0.073 0.841 0.881 .511 .900 Total 312 0.837 0.109 0.825 0.850 .086 .900 Years since diagnosis 0-5 110 0.851 0.079 0.836 0.866 .500 .900 12.528 .000 6-10 115 0.843 0.108 0.823 0.863 .086 .900 11-15 63 0.851 0.077 0.832 0.871 .617 .900 16-20 24 0.713 0.202 0.628 0.799 .117 .900 Total 312 0.837 0.109 0.825 0.850 .086 .900 Table III: Participants’ Quality of Life Based on the Level of Health Mobility Self-care Usual activities Pain/discomfort Anxiety Frequency (Percentage) Level 1 (No problems) 262(84.0) 284(91.0) 238(76.3) 235(75.3) 218(69.9) Level 2 (Slight problems) 33(10.6) 14(4.5) 66(21.2) 54(17.3) 57(18.3) Level 3 (Moderate problems) 9(2.9) 11(3.5) 4(1.3) 10(3.2) 22(7.1) Level 4 (Severe problems) 5(1.6) 1(0.3) 2(0.6) 10(3.2) 11(3.5) Level 5 (Extreme problems/Unable to do) 3(1.0) 2(0.6) 2(0.6) 3(1.0) 4(1.3) Total 312(100.0) 312(100.0) 312(100.0) 312(100.0) 312(100.0) Table IV: Characteristics that were predictive of ‘ no problems’ among the participants Independent variable B S.E Wald Sig Exp(B) 95% C.I for Exp(B) Lower Upper Mobility Years since diagnosis 0-5 Ref Ref Ref Ref Ref Ref Ref 16-20 1.290 0.574 5.057 0.025 3.634 1.180 11.191 Self-care Occupational status None Ref Ref Ref Ref Ref Ref Ref Self-employed 2.416 0.975 6.143 0.013 11.204 1.658 75.717 Years since diagnosis 0-5 Ref Ref Ref Ref Ref Ref Ref 16-20 2.745 0.758 13.128 0.000 15.561 3.535 68.681 Usual activities Educational status None Ref Ref Ref Ref Ref Ref Ref Secondary -1.739 0.653 7.101 0.008 0.176 0.049 0.631 Tertiary -1.401 0.669 4.391 0.036 0.246 0.066 0.913 Pain/discomfort Gender Male Ref Ref Ref Ref Ref Ref Ref Female 0.713 0.290 6.028 0.014 2.040 1.155 3.603 Marital status Married Ref Ref Ref Ref Ref Ref Ref Widow/widower -1.251 0.516 5.879 0.015 0.286 0.104 0.787 Years since diagnosis 0-5 Ref Ref Ref Ref Ref Ref Ref 16-20 1.499 0.531 7.966 0.005 4.477 1.581 12.678 Anxiety/depression Age Less than 21 Ref Ref Ref Ref Ref Ref Ref 31-40 years -1.918 0.676 8.063 0.005 0.147 0.039 0.552 Marital status Married Ref Ref Ref Ref Ref Ref Ref Single -1-014 0.407 6.189 0.013 0.363 0.163 0.806 Widow/widower -1.741 0.498 12.227 0.000 0.175 0.066 0.465 Years since diagnosis 0-5 Ref Ref Ref Ref Ref Ref Ref 16-20 1.475 0.536 7.576 0.006 4.372 1.529 12.501 Additional Declarations No competing interests reported. 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Eze","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Cynthia","middleName":"C.","lastName":"Eze","suffix":""},{"id":308621562,"identity":"5772171d-f650-431e-a960-b43dc28f10fe","order_by":4,"name":"Bethel Okeke","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Bethel","middleName":"","lastName":"Okeke","suffix":""},{"id":308621563,"identity":"6ab87175-aa43-4b30-ba44-a0fd623facdf","order_by":5,"name":"Gabriel Ezenri","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Gabriel","middleName":"","lastName":"Ezenri","suffix":""},{"id":308621564,"identity":"6a36b1b0-fa4b-4610-8c09-376087a979a2","order_by":6,"name":"Victor Onwuali","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Victor","middleName":"","lastName":"Onwuali","suffix":""},{"id":308621565,"identity":"573ffe96-9dc9-4ad4-84b2-f17bf937aa93","order_by":7,"name":"Augustus Ezeodimegwu","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Augustus","middleName":"","lastName":"Ezeodimegwu","suffix":""},{"id":308621566,"identity":"bdb474f9-033f-4f41-8a3c-468127622519","order_by":8,"name":"Princess Onyekwuo","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Princess","middleName":"","lastName":"Onyekwuo","suffix":""},{"id":308621567,"identity":"655a6741-f8ea-4372-ac4b-8d74ceb73314","order_by":9,"name":"Maxwell Ogochukwu Adibe","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Maxwell","middleName":"Ogochukwu","lastName":"Adibe","suffix":""},{"id":308621568,"identity":"0be73152-4e2d-4f2b-a8bf-710cc2a95b1e","order_by":10,"name":"Patrick Ogochukwu Udeogaranya","email":"","orcid":"","institution":"Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, 410001, Nsukka, Enugu State.","correspondingAuthor":false,"prefix":"","firstName":"Patrick","middleName":"Ogochukwu","lastName":"Udeogaranya","suffix":""}],"badges":[],"createdAt":"2024-05-24 10:53:59","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4471995/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4471995/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62852383,"identity":"93bbeea8-ee41-4e25-bdac-5aba43e5f985","added_by":"auto","created_at":"2024-08-20 08:47:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":982463,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4471995/v1/0d772014-0e90-401c-9c23-f22bb163ab6a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Predictors of ‘No Problem’ as the Health‑related Quality of Life Status of People Living with HIV on Differentiated Service Delivery in a Nigerian State using the EQ-5D-5L","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe HIV epidemic has continued to be a key global public health issue affecting society and has claimed about 40.4 [32.9\u0026ndash;51.3] million lives (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). At the end of 2022, the world health organization (WHO) estimated that there were about 39\u0026nbsp;million (33.1\u0026ndash;45.7\u0026nbsp;million) people living with HIV globally, with more than two-thirds living in the WHO African Region. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In 2019, the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the National Agency for the Control of AIDS estimated that in Nigeria, there are about 1.8\u0026nbsp;million people that live with HIV, with a prevalence of 1.4% (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) while Onovo \u003cem\u003eet al\u003c/em\u003e estimated the national HIV prevalence to be 2.1% with approximately 2\u0026nbsp;million people living with HIV in 2022 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Also, in 2022, 630 000 [480 000\u0026ndash;880 000] people died from HIV-related causes and 1.3\u0026nbsp;million [1 million\u0026ndash;1.7 million] people acquired HIV (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe \"95-95-95\" goal was set by the Joint United Nations Programme on HIV and AIDS to attain epidemic control. The aim is to ensure that by 2025, 95% of people living with HIV know their status, 95% of HIV positive people will be on Antiretroviral therapy (ART), and 95% of those on ART will have suppressed Viral load (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). To expand coverage and fight this epidemic, the concept of differentiated service delivery (DSD) was introduced.\u003c/p\u003e \u003cp\u003eDifferentiated service delivery is a client-centered strategy that streamlines and modifies HIV services throughout the clinical cascade to take into consideration the preferences and needs of diverse groups of people living with HIV (PLHIV) while minimizing the health system's burden (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). In order to meet the various demands and expectations of persons living with HIV, differentiated service delivery entails decreasing or increasing the intensity of the service, the frequency of the service, the service provider, and the location of the service (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe quality of life (QoL) of People living with HIV has become a significant public health issue and as such, QoL is increasingly becoming a significant component when evaluating the total well-being of people living with HIV (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The QoL of people living with HIV has also become one of the indicators used to assess patient adherence to highly active antiretroviral therapy (HAART) (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Additionally, as ART has been made available as a long-term regimen of therapy for PLHIV, the QoL has increased significantly as a measure for assessing the effects of ART. Therefore, research on the quality of life (QoL) of PLHIV will provide additional perspectives on the problems they experience and identify ways to enhance their well-being (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Health-related quality of life (HRQoL) is increasingly recognized as a primary outcome in many clinical trials and has increased in relevance as a health outcome indicator (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In contrast to other health measures, HRQoL is patient-reported and represents an effort to take into account how health affects practical areas of everyday life. As a result, determining HRQoL is essential to identifying and meeting the requirements of different populations, especially those populations with chronic illnesses like HIV (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEQ-5D-5L is the most commonly used generic preference-based multi-attribute utility instruments (MAUIs) health-related quality of life (HRQoL) measure (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This instrument is based on self-assessment that consists of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension contains one item that informs on the degree of problems (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). It is efficient because it is generic, concise, and supported by the value sets required for an economic appraisal (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). The EQ-5D has been utilized in various health conditions, has good test reliability, and also is validated for use for many disease conditions (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNumerous social problems that affect many PLHIV, including stigma, discrimination, anxiety, cultural standards, poverty, and overstretched health system present real barriers that prevent people from accessing the care they need and this can have an impact on their quality of life (QOL) not solely from the perspective of physical health but also from the perspective of social and mental health (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdditionally, some of the factors that influence the quality of life of PLHIV include gender, education level, career, knowledge, attitude, and behavior. For several developing countries, access to ARV therapy and adherence remain significant concerns (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile PLHIV in high-income countries (HIC) reports significantly lower health-related quality of life than the general population, research on HRQoL of PLHIV in low- and middle-income countries (LMIC) is limited (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Based on these concerns, there is the need to conduct a study to evaluate the quality of life of people living with HIV on differentiated service delivery and to determine the sociodemographic predictors of \u0026lsquo;no problems\u0026rsquo; in PLHIV in a South-eastern Nigerian State. Thus, the aim of this study was to determine the socio-demographic predictors of good quality of life (QoL) of PLHIV on DSD in a Southeastern Nigerian State\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThe design of the study was questionnaire-based cross-sectional, carried out for a period of 3 months (February to April 2022).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy Setting\u003c/h2\u003e \u003cp\u003eThe study was conducted at the Differentiated Service Delivery sites in Abia State. Currently, the state has three models of Differentiated Service Delivery namely; community pharmacy-based models (N\u0026thinsp;=\u0026thinsp;7), patient-led community ART groups (N\u0026thinsp;=\u0026thinsp;6) and health workers/facility-based models (N\u0026thinsp;=\u0026thinsp;11). Abia state is located between lat 4o49.30\u0026rsquo;N-6o02\u0026rsquo;N and between long 7o08\u0026rsquo;E-8o04\u0026rsquo;E in the southeastern part of Nigeria. It has an area of about 5833.77km2, which is roughly 9% of Nigeria\u0026rsquo;s landmass. It is bounded in the north by Enugu state, in the south by Rivers state, in the east by Cross River and Akwa Ibom states and in the west by Imo state.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population and Sample Size\u003c/h2\u003e \u003cp\u003eThe study population consisted of all stable PLHIV aged 18 years and above on differentiated service delivery at Abia state, Nigeria. There were approximately 5000 HIV patients enrolled in differentiated service delivery at the study site. Using Raosoft Online Sample Size Calculator, a sample size of 357 was obtained, assuming a margin of error, confidence level, and response distribution of 5%, 95%, and 50% respectively. To make provisions for possible low participation and withdrawal, an additional 10% sample was added. Thus, a total of 361 questionnaires were distributed to eligible respondents. At the end, 312 copies were completed and returned (response rate\u0026thinsp;=\u0026thinsp;86.4%).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003eRespondents that were included in the study were PLHIV who were 18 years of age and above, stable on ART, and enrolled in any of the differentiated service delivery (DSD) models. PLHIV who had been in any of the DSD models for less than a year were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStudy Instrument\u003c/h2\u003e \u003cp\u003eThe questionnaire for data collection consisted of two sections. The first section obtained the socio-demographic characteristics of the respondents (age, gender, sex, marital status, occupational status, and educational status) and a question on the year since they were diagnosed of HIV. The second section of the questionnaire was the EQ-5D-5L. The EQ-5D-5L is a generic instrument developed by the European Quality of Life (EuroQol) Group to measure health-related QoL in the general population, irrespective of the disease conditions. It is a two-part instrument consisting of a descriptive system and a visual analogue scale (EQ-VAS). The five dimensions (5D) of health included in the descriptive system that was utilized for data collection were mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. There are five levels (5L) for each dimension: level 1 (no problems), level 2 (slight problems), level 3 (moderate problems), level 4 (severe problems), and level 5 (extreme problems). The respondents were expected to choose the level that best described their current health-related situation for each health dimension. These digits, which represent the degree of severity for each dimension, can be added together to provide a 5-digit number that represents the respondent's overall health. Hence, a total of 5\u003csup\u003e5\u003c/sup\u003e (i.e., 3 125) unique health states exist for this measure. Using preference-based, national value sets, these health states can be \"valued\" or converted to a single index value (utility) (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Procedure\u003c/h2\u003e \u003cp\u003eThe objective of the study was explained to the eligible participants and written informed consent to participate was obtained from all those who were included in the study after assuring them of anonymity, confidentiality, and voluntariness of participation. They were approached as they came for their regular appointments and the questionnaires were self-administered. They were requested to fill out the questionnaires independently and return them in unmarked envelopes that were provided.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe collected questionnaires were coded and the data was analyzed using the IBM SPSS (version-25). Descriptive statistics (frequency, percent, mean, standard deviation) were used to present participants\u0026rsquo; socio-demographic and clinical data as well as the EQ-5D-5L health profiles. The EQ-5D-5L index value (maximum possible\u0026thinsp;=\u0026thinsp;1) was obtained using the excel formula provided by the EuroQoL group. One-way ANOVA was used to compare the index values across socio-demographic characteristics that were more than two. Since there were no value sets for Nigeria at the time of the study, the EQ-5D-5L crosswalk value sets for Zimbabwe were utilized to assess participants' health states. The use of Zimbabwean value sets was justified by the fact that the general health status in Zimbabwe and Nigeria are comparable (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Thereafter, the five levels were grouped into two for each dimension: no problem (recoded as 1) and others (transformed and recoded as 0). The predictors of the \u0026lsquo;no problem\u0026rsquo; status were then determined using binary logistics regression. For all inferential analysis, statistical significance was assumed for p values less than 0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e\u003cp\u003eEthical approval was obtained from the Health Research and Ethics Committee of the Faculty of Pharmaceutical Sciences of the University of Nigeria (Ref. No.: FPSRE/UNN/22/0010). The participants were informed of the voluntary nature of their participation in the study and the right to withdraw at any time. They were assured that any information that they provided would be treated as confidential and no identifiable information would be requested from them.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe total number of people that participated in the study was 312 (response rate\u0026thinsp;=\u0026thinsp;86.4%). Participants that identified as females were 162(51.9%), with 114(36.5%) of all the respondents reporting that they were married. On occupational status, 136(43.6%) participants reported that they were self-employed, although only 14(4.5%) had not attained any form of formal education. A 6\u0026ndash;10-year duration since diagnosis of HIV was reported by 115(36.9%) participants. \u003cb\u003eTable I\u003c/b\u003e shows the socio-demographic data of the participants.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable II\u003c/b\u003e shows the participants quality of life, categorised by socio-demographic characteristics. The EQ-5D-5L index value for the entire 312 study participants was 0.837\u0026thinsp;\u0026plusmn;\u0026thinsp;0.006. Based on the ages of the participants, PLHIV who were less than 20 years old had an EQ-5D-5L index score of 0.782\u0026thinsp;\u0026plusmn;\u0026thinsp;0.221\u003cem\u003e(F\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.923, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004\u003cem\u003e)\u003c/em\u003e, just as, by using educational status, PLHIV who had no formal education had an EQ-5D-5L index score of 0.711\u0026thinsp;\u0026plusmn;\u0026thinsp;0.232 \u003cem\u003e(F\u003c/em\u003e\u0026thinsp;=\u0026thinsp;7.981, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.001\u003cem\u003e).\u003c/em\u003e For the duration of illness, the participants that have been living with HIV for the past 16\u0026ndash;20 years had an EQ-5D-5L index score of 0.713\u0026thinsp;\u0026plusmn;\u0026thinsp;0.202 \u003cem\u003e(F\u003c/em\u003e\u0026thinsp;=\u0026thinsp;12.528, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.001\u003cem\u003e).\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable III\u003c/b\u003e shows the relationship between socio-demographic data and quality of life based on the health status. Among the 312 people that participated in the study, 284(76.3%) participants had \u003cem\u003eno problems\u003c/em\u003e with self-care, 235(75.3%) had \u003cem\u003eno problems\u003c/em\u003e with pain/discomfort, and 218(69.9%) had \u003cem\u003eno problems\u003c/em\u003e with anxiety. For the severe problems, 5(1.6%) participants had severe problems with mobility while 10(3.2%) had severe problems with pain/discomfort.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable IV\u003c/b\u003e shows the predictors of \u0026lsquo;\u003cem\u003eno problems\u0026rsquo;\u003c/em\u003e health status. The characteristics that were predictive of \u0026lsquo;\u003cem\u003eno problems\u0026rsquo;\u003c/em\u003e were 16\u0026ndash;20 years of diagnosis (β\u0026thinsp;=\u0026thinsp;3.634, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.05) [mobility]; self-employment (β\u0026thinsp;=\u0026thinsp;11.204, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.013) and 16\u0026ndash;20 years of diagnosis (β\u0026thinsp;=\u0026thinsp;15.561, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) [self-care]; tertiary education (β\u0026thinsp;=\u0026thinsp;0.246, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.036) [usual activities]; female gender (β\u0026thinsp;=\u0026thinsp;2.040, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.014), and 16\u0026ndash;20 years of diagnosis (β\u0026thinsp;=\u0026thinsp;4.777, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005) [pain/discomfort]; and age (β\u0026thinsp;=\u0026thinsp;0.147, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005) [anxiety/depression].\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study was conducted to determine the quality of life of people living with HIV on differentiated service delivery in a South-eastern Nigerian State. The specific predictors of ‘\u003cem\u003eno problems\u003c/em\u003e’ health status among the PLHIV were also specifically determined. From the study’s findings, there were more females, A little less than half of the participants were married and just about half of the participants attained secondary education. This is similar to the findings of other other studies conducted in Zaria, Nigeria, (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), North East Ethiopia (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), and Togo (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) about the demographic characteristics of PLHIV. To the best of the researcher’s search, no one has been published on the QoL of PLHIV who are enrolled in the DSD model using the EQ-5D-5L. Thus, the findings of the study could only be explained, then, where necessary, compared with the closest population in other study.\u003c/p\u003e \u003cp\u003eThe findings revealed that the participants had an overall good quality of life. Popping \u003cem\u003eet al.\u003c/em\u003e in their study to evaluate the quality of life among PLHIV in England and the Netherlands using the EQ-5D-5L revealed a mean adjusted HRQoL score of 0.850 ± 0.17 for the Netherlands (higher than that of this study) and 0.832 ± 0.23 for England (similar to that of this study). This higher QoL in the Netherlands may be due to better access to health care, education, a higher standard of living, and higher individual income (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Kall \u003cem\u003eet al\u003c/em\u003e reported a good quality of life EQ-5D-5L index score of 0.85 ± 0.16 for Romania and 0.88 ± 0.16 for Spain. This is slightly higher than the findings of this study and may be equally attributed to a better quality of care provision to PLHIV and higher income (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eComparing the quality of life across the socio-demographics, the study revealed that participants that attained no formal education had a lower quality of life when compared to participants that attained a level of education. A study conducted by Suleiman \u003cem\u003eet al\u003c/em\u003e to assess the determinants of Health-related quality of life (HRQOL) among HIV-positive patients at Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Nigeria also reported a statistically significant relationship between educational status and HRQoL: participants with secondary or tertiary level of education had a better quality of life (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). This may be because PLHIV that are more educated will have a better understanding of the disease state and need for adherence to antiretroviral medications which will in turn improve their quality of life. Yaya \u003cem\u003eet al\u003c/em\u003e, Anuradha \u003cem\u003eet al\u003c/em\u003e and Busi \u003cem\u003eet al also\u003c/em\u003e reported that participants with a higher level of education had a better quality of life which is similar to the findings of this study (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). This similarity may be because being educated plays a role in understanding information relating to a good health state. It also allows people to adhere to the instructions provided by healthcare workers and also have a better perception of their condition. However, Akinboro \u003cem\u003eet al\u003c/em\u003e had a contrary finding, as a better quality of life in people with no formal and primary education was observed (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe study also revealed that the participants that were less than 20 years old had a lower quality of life when compared with other age ranges. However, Anuradha \u003cem\u003eet al\u003c/em\u003e in their study that assessed the quality of Life and Its Determinants among People Living with HIV Attending an Antiretroviral Treatment Center in Delhi, India reported that older participants had a better quality of life which is different from that of this study (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). This may be due to better coping mechanisms which comes with age and more life experiences.\u003c/p\u003e \u003cp\u003eThe study findings also showed that the majority of the participants had \u003cem\u003eno problems\u003c/em\u003e with mobility, very few of them had \u003cem\u003eextreme problems\u003c/em\u003e with mobility and almost all the participants reported \u003cem\u003eno problems\u003c/em\u003e with self-care. Also, a good proportion of the participants had \u003cem\u003eno problems\u003c/em\u003e with usual activities, very few of the participants were \u003cem\u003eunable to do\u003c/em\u003e their usual activities while a few of them reported that they had \u003cem\u003eslight problems\u003c/em\u003e with pain/discomfort. For the anxiety/depression domain, a good proportion of the study participants had \u003cem\u003eno problems\u003c/em\u003e while very few had \u003cem\u003eextreme problems\u003c/em\u003e with anxiety/depression. In contrast, but using the WHO STEPwise approach and the Kinyarwanda version of the MOS-HIV Health Survey, Biraguma \u003cem\u003eet al\u003c/em\u003e reported that PLHIV in Rwanda had moderate physical and mental health-related dimensions of QOL (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn their study, Popping \u003cem\u003eet al.\u003c/em\u003e reported that the domain in which PLHIV reported the most problem both in Netherlands and England was the anxiety/depression domain. This health status may be attributed to stigmatization, loneliness, and social isolation, coping with a recent diagnosis of HIV, and the experience of coping with a long-term condition (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Similarly, Kall \u003cem\u003eet al\u003c/em\u003e also reported that older age is predictive of a lower quality of life which is different from the findings of this study. This may be due to cognitive impairment, the possible presence of comorbidities, and inadequate social interactions (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSome of the characteristics that were predictive of ‘\u003cem\u003eno problems’\u003c/em\u003e in this study were 16–20 years of diagnosis for mobility, self-employment and 16–20 years of diagnosis for self-care, tertiary education for usual activities, female gender and 16–20 years of diagnosis for pain/discomfort and age for anxiety/depression. A study reported that the factors significantly associated with HRQoL were: female gender, attaining primary and secondary education, being over 50 years old and living with HIV for over 1 year since HIV diagnosis (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Similarly, Ferreira \u003cem\u003eet al\u003c/em\u003e in their study to determine the predictors of QoL in PLHIV in Brazil reported that the female gender, being unemployed and being part of the least privileged socioeconomic levels was associated with lower QoL scores in the psychological domain (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Shriharsha and Rentala in a similar study also reported that male gender and being graduated predicted the QoL positively while having primary education, being in nuclear family, and also having a history of alcoholic intake negatively predicted the QoL. In the study, the strongest negative predictor of the QoL of PLHIV was depression (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e "},{"header":"Limitations","content":"\u003cp\u003eThis was a cross-sectional study, so there was no opportunity of making an intervention which could determine whether the quality of life of the respondents will be varied. Also, the EQ-5D value set used to calculate the utility score was that of Zimbabwe since there is no value set for Nigeria. This may cause a bias in the result because of the social and health differences between the two countries. However, recent studies have used it for the Nigerian population and it has been proven to be valid (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Data collection was also done in DSD centres in a single state in Nigeria. Thus, the findings of this study may not be generalized to PLHIV in other Nigerian states due to differences in the standard of care and variations in practice.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe people living with HIV that are accessing care at Abia state, Nigeria had a good quality of life. Respondents that had no form of education had a lower quality of life when compared to those that attained a level of education. Also, younger participants had a better quality of life when compared to mid-aged and older participants. Many of the respondents had \u003cem\u003eno problem\u003c/em\u003e with self-care while anxiety was the domain in which the majority had \u003cem\u003eextreme problems.\u003c/em\u003e The sociodemographic predictors of \u0026lsquo;\u003cem\u003eno problems\u0026rsquo;\u003c/em\u003e are age, female gender, 16\u0026ndash;20 years since diagnosis, marital status and educational status.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNo fund was received for this study.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting Interest:\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no interest related to this study to declare.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthics Approval:\u003c/strong\u003e \u003cp\u003e Ethical approval to conduct this study was obtained for this study from the Health Research Ethics Committee of the Faculty of Pharmaceutical Sciences, University of Nigeria (Reference Number: FPSRE/UNN/22/0010).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent to Participate:\u003c/strong\u003e \u003cp\u003e Informed consent was obtained from all participants included in the study.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for Publication:\u003c/strong\u003e \u003cp\u003eNot Applicable\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAuthor Contributions: AI, IMO, POU and MOA conceptualized the design of the study. CCE, AE, BO and GE participated in data collection, while AI, OLO, IMO and MOA conducted the data analysis and interpretation. Whereas VO, PO, OLO and CCE drafted the initial version of the manuscript, AI, IMO, MOA and POU prepared the final version of the manuscript. All the authors approved the manuscript for submission.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data related to this study are available with the corresponding author and could be shared upon a reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. World Health Organization. 2023 [cited 2024 Mar 12]. 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J Fam Med Prim Care [Internet]. 2019 [cited 2024 Mar 10];8(3):1011. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://journals.lww.com/\u003c/span\u003e\u003cspan address=\"https://journals.lww.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jfmpc.jfmpc_411_18\u003c/span\u003e\u003cspan address=\"10.4103/jfmpc.jfmpc_411_18\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFatoye F, Akinfala AE, Gebrye T, Fatoye C, Ojelade TF, Oyewole OO et al. Translation, Cross-Cultural Adaptation, and Psychometric Testing of Yoruba Version of the EQ\u0026ndash;5D Questionnaire in Patients With Musculoskeletal Disorders. Front Public Health [Internet]. 2022 Jun 27 [cited 2024 Mar 10];10:902680. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.frontiersin.org/articles/\u003c/span\u003e\u003cspan address=\"https://www.frontiersin.org/articles/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fpubh.2022.902680/full\u003c/span\u003e\u003cspan address=\"10.3389/fpubh.2022.902680/full\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJimam NS, Ismail NE, Dayom WD. Evaluation of Psychometric Quality of EQ\u0026ndash;5D\u0026ndash;5L Scale for Assessing Health-Related Quality of Life of Malaria Patients. Value Health Reg Issues [Internet]. 2020 Sep [cited 2024 Mar 10];22:15\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://linkinghub.elsevier.com/retrieve/pii/S2212109919306077\u003c/span\u003e\u003cspan address=\"https://linkinghub.elsevier.com/retrieve/pii/S2212109919306077\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable I: Socio-Demographic Data of the Participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Frequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Percentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e48.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e51.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e21-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e31-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eGreater than 40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e36.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eWidow/Widower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e14.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eEducational Status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e39.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eOccupational Status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eGovernment worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e19.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003ePrivate sector employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eYears since diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e36.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e16-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable IIa: Participant\u0026rsquo;s Quality of Life Categorised by Socio-Demographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eEQ-5D-5L Index score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eStd. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.087557603686637%\" colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.101382488479263%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"bottom\"\u003e\n \u003cp\u003eLower Bound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"bottom\"\u003e\n \u003cp\u003eUpper Bound\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e.909\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.821\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.782\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.871\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e3.923\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e21-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.834\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.866\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e31-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eGreater than 40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.804\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.845\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.830\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.810\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.849\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e.590\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e.622\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.813\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.848\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.821\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eWidow/Widower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.827\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.878\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eEducational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.711\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.578\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\"\u003e\n \u003cp\u003e0.845\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e7.981\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.090909090909092%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.817\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.862\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.865\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.828\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable IIb: Participant\u0026rsquo;s Quality of Life Categorised by Socio-Demographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"827\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.324062877871825%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.970979443772672%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.804111245465538%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.980652962515115%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eEQ-5D-5L Index score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.068923821039903%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eStd. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.412333736396615%\" colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.189842805320435%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.552599758162032%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.892382103990326%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.804111245465538%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"bottom\"\u003e\n \u003cp\u003eLower Bound\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"bottom\"\u003e\n \u003cp\u003eUpper Bound\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.324062877871825%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eOccupational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.970979443772672%\" valign=\"top\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.804111245465538%\" valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.980652962515115%\"\u003e\n \u003cp\u003e0.816\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.068923821039903%\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.706166868198308%\"\u003e\n \u003cp\u003e0.776\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.706166868198308%\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.189842805320435%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.552599758162032%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.892382103990326%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e1.722\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.804111245465538%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e.162\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003eGovernment worker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.830\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.804\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.855\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.841\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003ePrivate sector employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.841\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.324062877871825%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eYears since diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.970979443772672%\" valign=\"top\"\u003e\n \u003cp\u003e0-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.804111245465538%\" valign=\"top\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.980652962515115%\"\u003e\n \u003cp\u003e0.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.068923821039903%\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.706166868198308%\"\u003e\n \u003cp\u003e0.836\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.706166868198308%\"\u003e\n \u003cp\u003e0.866\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.189842805320435%\" valign=\"top\"\u003e\n \u003cp\u003e.500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.552599758162032%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.892382103990326%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e12.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.804111245465538%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003e6-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.843\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.823\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003e11-15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.851\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.832\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.871\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003e16-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.628\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.799\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.86541737649063%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.17717206132879%\" valign=\"top\"\u003e\n \u003cp\u003e312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.243611584327088%\"\u003e\n \u003cp\u003e0.837\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.776831345826235%\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.825\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.265758091993186%\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.947189097103918%\" valign=\"top\"\u003e\n \u003cp\u003e.086\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.458262350936968%\" valign=\"top\"\u003e\n \u003cp\u003e.900\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable III: Participants\u0026rsquo; Quality of Life Based on the Level of Health\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"616\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"bottom\"\u003e\n \u003cp\u003eMobility\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"bottom\"\u003e\n \u003cp\u003eSelf-care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003eUsual activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003ePain/discomfort\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"79.74068071312804%\" colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eFrequency (Percentage)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel 1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(No problems)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e262(84.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e284(91.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003e238(76.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003e235(75.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e218(69.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel 2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Slight problems)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e33(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e14(4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003e66(21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003e54(17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e57(18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel 3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Moderate problems)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e9(2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e11(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003e4(1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003e10(3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e22(7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel 4\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Severe problems)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e5(1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e1(0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003e2(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003e10(3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e11(3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel 5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Extreme problems/Unable to do)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e3(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e2(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003e2(0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003e3(1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e4(1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.25931928687196%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e312(100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e312(100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.448946515397083%\" valign=\"top\"\u003e\n \u003cp\u003e312(100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.962722852512155%\" valign=\"top\"\u003e\n \u003cp\u003e312(100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.776337115072934%\" valign=\"top\"\u003e\n \u003cp\u003e312(100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable IV: Characteristics that were predictive of \u0026lsquo;\u003cem\u003eno problems\u0026rsquo;\u003c/em\u003e among the participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eIndependent variable\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eS.E\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eWald\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eSig\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eExp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.16%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e95% C.I for Exp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.63636363636363%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.36363636363637%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"38.63636363636363%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"61.36363636363637%\" valign=\"top\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMobility\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eYears since diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e0-5\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e16-20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e1.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e5.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e3.634\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e1.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e11.191\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-care\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eOccupational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e2.416\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.975\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e6.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e11.204\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e1.658\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e75.717\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eYears since diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e0-5\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e16-20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e2.745\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.758\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e13.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e15.561\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e3.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e68.681\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUsual activities\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eEducational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e-1.739\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.653\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e7.101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e0.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e-1.401\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.669\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e4.391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e0.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePain/discomfort\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e6.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e2.040\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e1.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e3.603\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Widow/widower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e-1.251\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.516\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e5.879\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eYears since diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e0-5\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e16-20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e1.499\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e7.966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e4.477\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e1.581\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e12.678\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnxiety/depression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e31-40 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e-1.918\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.676\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e8.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e0.552\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e-1-014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.407\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e6.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e0.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e0.806\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;Widow/widower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e-1.741\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.498\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e12.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e0.175\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e0.465\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003eYears since diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e0-5\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.68%\" valign=\"top\"\u003e\n \u003cp\u003e16-20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e1.475\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.12%\" valign=\"top\"\u003e\n \u003cp\u003e0.536\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.6%\" valign=\"top\"\u003e\n \u003cp\u003e7.576\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.92%\" valign=\"top\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.4%\" valign=\"top\"\u003e\n \u003cp\u003e4.372\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.88%\" valign=\"top\"\u003e\n \u003cp\u003e1.529\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.28%\" valign=\"top\"\u003e\n \u003cp\u003e12.501\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4471995/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4471995/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Differentiated service delivery (DSD) aims to improve the overall quality of care that is provided to people living with HIV (PLHIV). One critical measure of self-reported satisfaction with the level of care is quality of life. This study aimed to determine the socio-demographic predictors of the quality of life (QoL) of PLHIV on DSD in a Southeastern Nigerian State.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A cross-sectional study was conducted among PLHIV on DSD across Abia State, Nigeria, from February-April 2022. A sample size of 361 was estimated from the three DSD models in the state: community pharmacy-based, PLHIV-led community antiretroviral group, and health worker/facility-based models. A generic QoL tool (EQ-5D-5L) was used to obtain responses from all consenting PLHIV. Descriptive statistics were used to summarize the variables. Variations in the QoL index value and the predictors of the QoL were determined using one-way ANOVA and binary logistics regression (\u003cem\u003eno problem\u003c/em\u003e versus \u003cem\u003eothers\u003c/em\u003e), respectively. \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05 was considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e A total number of 312 questionnaires were completed (response rate = 86.4%). Female gender was indicated by 162(51.9%) respondents, while 114(36.5%) stated that they were married. The highest level of education by most respondents (n=134, 42.9%) was secondary school. About a-third (115, 36.9%) reported that they have had HIV for 6-10 years. For their QoL, 284(76.3%) PLHIV had no problems (self-care), 66(21.2%) had slight problems (usual activities) and 11(3.5%) had severe problems (anxiety/depression). The index value for all the respondents was 0.837±0.006. PLHIV that were aged \u0026lt;20 years had a value of 0.782±0.221(\u003cem\u003eF\u003c/em\u003e=3.923, \u003cem\u003ep\u003c/em\u003e=0.004), while those without formal education had 0.711±0.232 (\u003cem\u003eF\u003c/em\u003e=7.981, \u003cem\u003ep\u003c/em\u003e≤0.001). Characteristics that were predictive of \u003cem\u003eno problems\u003c/em\u003e status were 16-20 years of diagnosis (β=3.634, \u003cem\u003ep\u003c/em\u003e=0.025) [mobility]; self-employment (β=11.204, \u003cem\u003ep\u003c/em\u003e=0.013) and 16-20 years of diagnosis (β=15.561, \u003cem\u003ep\u003c/em\u003e=0.001) [self-care]; tertiary education (β=0.246, \u003cem\u003ep\u003c/em\u003e=0.036) [usual activities]; female gender (β=2.040, \u003cem\u003ep\u003c/em\u003e=0.014), and 16-20 years of diagnosis (β=4.777, \u003cem\u003ep\u003c/em\u003e=0.005) [pain/discomfort]; and 31-40 years (β=0.147, \u003cem\u003ep\u003c/em\u003e=0.005), and not being married (β=0.363, \u003cem\u003ep\u003c/em\u003e=0.013)[anxiety/depression].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003eThe PLHIV accessing DSD at Abia State had a good quality of life. Their gender, level of education, employment status, and age were factors that were predictive of good QoL among them.\u003c/p\u003e","manuscriptTitle":"Predictors of ‘No Problem’ as the Health‑related Quality of Life Status of People Living with HIV on Differentiated Service Delivery in a Nigerian State using the EQ-5D-5L","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-10 15:02:42","doi":"10.21203/rs.3.rs-4471995/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"95fc6fae-ff1f-41c3-9c75-884de5b98d5c","owner":[],"postedDate":"June 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-31T12:38:08+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-10 15:02:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4471995","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4471995","identity":"rs-4471995","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}