Key result
RHD diagnosis before age 20 linked to ~169% higher odds of poor subjective wellbeing.
Why the study?
There are no studies that assessed subjective wellbeing in rheumatic heart disease patients.
Cross-Sectional (n=384)
No
Odds Ratio: 2.69 (95% CI 1.3–5.58)
p-value: p=0.008
Poor subjective wellbeing affects nearly 10% of rheumatic heart disease patients in Ethiopia and is strongly predicted by younger age at diagnosis, low income, and lack of psychological support.
Flags younger RHD diagnosis age for wellbeing assessment; hypothesis-generating, requiring longitudinal validation before practice change.
BACKGROUND: Subjective wellbeing (SWB) is a self-reported positive life judgment and good feeling. RHD, rheumatic heart disease, is a long-term sequel of single or recurrent acute rheumatic fever. There are no studies that assessed SWB in RHD patients. We aimed to assess SWB among RHD subjects enrolled in chronic care at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. METHODS: This observational cross-sectional study employed a validated Amharic WHO-5 wellbeing index to assess SWB. Sociodemographic and clinical data were collected using structured questionnaire. RHD subjects aged 9 years and above were included. Factors associated with SWB were assessed using logistic regression models. RESULTS: The study included 384 subjects, females 68.2% (262). Children, < 18 years, constituted one third of study subjects, 32.8% (126). Moderate and severe echocardiographic RHD dominated, 85.9% (330) with no associated comorbidity, 84.4% (324). Only 17.2% (66) had surgical or device intervention. Poor SWB was documented in 9.6% of study subjects (95% CI: 6.88-13.04). On multivariable regression, those with younger age RHD diagnosis, < 20 years, had almost three times higher odds of poor SWB, adjusted odds ratio (aOR) 2.69(95% CI: 1.30-5.58, P 0.008). Those with monthly family income of < 1000 Ethiopian Birr had three times higher odds of poor SWB, aOR 2.97(95% CI: 1.24-7.1, P 0.014). Study subjects who had good medication adherence had reduced odds of poor SWB, aOR 0.37(95% CI: 0.18-0.77, P 0.028). Those who received psychologic support from their families also had reduced odds of poor SWB, aOR 0.26(95% CI: 0.11-0.64, P 0.003). CONCLUSION: Poor SWB was documented in one-tenth of RHD patients. Family income, younger age at RHD diagnosis, medication adherence and psychological support predicted poor SWB. Poor SWB has to be considered and assessed among RHD patients particularly among those with younger age at RHD diagnosis and poor family income. Further mixed studies are recommended to assess how medication adherence and psychological supports associate with positive SWB among RHD patients.
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Tadele et al. (2021) conducted a cross-sectional in Rheumatic heart disease (n=384). Younger age at RHD diagnosis (< 20 years) vs. Age at RHD diagnosis ≥ 20 years was evaluated on Poor subjective wellbeing (WHO-5 score < 13) (aOR 2.69, 95% CI 1.30-5.58, p=0.008). Among patients with rheumatic heart disease, younger age at diagnosis (< 20 years) was associated with nearly three times higher odds of poor subjective wellbeing (aOR 2.69).
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