Determinants of quality of life among patients attending monk healers and primary healthcare centers in Thailand

Abstract

INTRODUCTION The study aimed to assess the levels of Quality of Life (QoL) and to identify the associated factors in users of two different health services (monk healers and health centers) in Thailand. METHODS In a cross-sectional design, 1251 patients were systematically (consecutively) recruited from three monk healers and three health centers and were assessed with questions on sociodemographic and clinical information, and QoL. Qol was measured using the World Health Organization Quality of Life (WHOQol)-8, for four QoL subdomains: psychological, physical, social and environmental. RESULTS The overall QoL mean of 68.9 was significantly higher in primary care attendees than in monk healer attenders (mean of 66.6) (p<0.01). The social QoL domain had the highest scores, 72.5 and 72.1, in attendees of primary care and monk healers, respectively, followed by physical with 69.6 and 69.4, psychological with 66.1 and 62.9, and environmental with 67.3 and 62.2. In adjusted linear regression analyses in the monk setting, higher education (p<0.05), married (p<0.01), and increasing age (p<0.001) were associated with greater overall QoL, and having chronic conditions (p<0.001) was negatively associated with all QoL indicators. Furthermore, in the primary care setting, higher formal education (p<0.05) was associated with overall QoL and psychological (p<0.05), physical (p<0.05), and environmental QoL (p<0.01). Having a smoking disorder was inversely associated with environmental QoL (p<0.05). Having multiple chronic conditions was negatively associated with the psychological (p<0.001) and environmental (p<0.001) QoL subdomains as well as overall QoL (p<0.05). CONCLUSIONS Sociodemographic characteristics such as younger age and lower education level, and clinical factors such as having chronic conditions, were associated with lower QoL in both monk and primary care treatment settings. Actions are indicated to improve QoL in both treatment settings in Thailand.