Health-Related Quality of Life of Housewives and Career Women with Normal Vaginal Delivery in Enugu, Nigeria

ABSTRACT The birth of a new baby is an important event in the life of a woman that requires some physical and emotional adjustments. This study investigated the differences in health-related quality of life of housewives and career women after normal vaginal delivery in the light of their mother-worker dyad and the associated socio-demographic factors. Three objectives and five hypotheses were raised to guide the study. Response shift theory was used to appraise the quality of life of the mothers as they adapt to changes in their roles post delivery. Longitudinal, prospective descriptive design was used for the study. A sample of 234 newly delivered mothers was drawn from an estimated population of 363 that used six selected hospitals in Enugu through proportionate stratified and convenience sampling techniques. Data were collected by administration of a modified form of the short-form 36 version 2 (SF-36v2TM) health-related quality of life instrument - standardized Iranian version generic 36-item health status profile – and a researcher-developed five-item questionnaire to post partal at 6, 12 and 18 weeks post delivery. Data collection was through personal contacts at the hospital initially, and visits to home/workplace or cell-phone interview at subsequent times. Data were analysed descriptively using frequencies, percentages, mean and standard deviations. T-test was used for group comparison of dimensions of HrQoL of the women while two-way ANOVA was used to establish statistical significant difference in the scores. Both housewives and career women had better HrQoL during their maternity period – 6 and 12 weeks post partum than at 18 weeks. At 18 weeks housewives had better HrQoL than career women; career women reported bodily pains and problems with role physical and social functioning more frequently than housewives. There were significant differences in HrQoL scores of housewives and career women at 18 weeks post partum based on their age, educational status, family income, perceived social support and stress-related job category. The current four months leave maternity should be extended to six months full pay maternity leave so that mothers will have more time to adjust to their increased responsibilities. Paternity leave should be granted to fathers, on request, so that they will have time at home to assist their spouse as may be necessary. Similar studies should be conducted among housewives and career women living in rural areas.

TABLE OF CONTENTS

Page

Title page i

Approval ii

Certification iii

Dedication iv

Acknowledgement v

Table of contents vi

List of tables ix

List of figures x

Abstract xi

CHAPTER ONE: INTRODUCTION

Background to the study 1

Statement of the problem 5

Purpose of the study 6

Objectives of the study 6

Research Hypothesis 7

Significance of the study 7

Scope of the study 8

Operational definition of terms 9

CHAPTER TWO: REVIEW OF RELATED LITERATURE

Conceptual review: The concept of health-related quality of life 10

How health-related quality of life is measured 12

Physiological changes in post-natal period 13

Housewives and their post-natal health-related quality of life 13

Career women and their post-natal health-related quality of life 14

Comparative post-natal quality of life studies 15

Theoretical review: The Response Shift Theory 18

Empirical review 20

Socio-economic status and health-related quality of life 20

Educational status and health-related quality of life 22

Age and health-related quality of life 23

6

Social support and health-related quality of life 23

Summary of reviewed literature 24

CHAPTER THREE: RESEARCH METHODS

Research design 26

Area of study 26

Population of the study 27

Sample 27

Sampling technique 28

Instrument for data collection 30

Validity of instrument 31

Reliability of instrument 32

Ethical considerations 32

Procedure for data collection 33

Method of data analysis 34

CHAPTER FOUR: PRESENTATION OF RESULTS 35

CHAPTER FIVE: DISCUSSION OF FINDINGS

Discussion of findings

HrQoL of housewives and career women at 6, 12 and

18 weeks post partum 46

HrQoL of housewives and career women at 18 weeks

post partum and age 47

HrQoL of housewives and career women at 18 weeks

post partum and educational level 48

HrQoL of housewives and career women at 18 weeks

post partum and family income 49

HrQoL of housewives and career women at 18 weeks

post partum and perceived quality of social support 50

HrQoL of housewives and career women at 18 weeks

post partum and perceived stress-related job category 51

Implications of the findings 52

Limitations of the study 53