Health-related quality of life and associated psychosocial and clinical factors among mothers whose neonates admitted to neonatal intensive care units in Amhara Regional State Referral Hospitals, Northwest Ethiopia: a multicenter study

Abstract

Mothers’ health-related quality of life (HRQoL) is frequently compromised when their neonates are admitted to neonatal intensive care units (NICUs), leading to psychological distress, sleep disturbances, and impaired maternal–infant bonding. These adverse experiences may be further intensified by neonatal clinical complications and maternal psychosocial vulnerabilities. Despite this, empirical evidence on HRQoL and its associated psychosocial and clinical determinants among Ethiopian mothers remains very limited. Therefore, this study aimed to assess mothers’ HRQoL and to identify the associated psychosocial and clinical factors among mothers of neonates admitted to NICUs in referral hospitals of the Amhara Regional State, Northwest Ethiopia. A facility-based cross-sectional study was conducted from December 12, 2023, to March 15, 2024 among 636 mothers selected via systematic random sampling in the NICUs of selected referral hospitals. Health-related quality of life (HRQoL) was measured using the validated WHOQOL-BREF instrument, comprising 23 items in four domains. The mean score of each domain and the total HRQoL score (range 0–92) were calculated, with higher scores indicating better quality of life. Data were collected via structured interviews and hospital chart review. Simple and multiple linear regression analyses were conducted to identify psychosocial and clinical factors associated with HRQoL. A total of 651 eligible mothers were approached, of whom 636 participated, yielding a response rate of 97.7%. The overall mean (± SD) score of mothers’ health-related quality of life was 41.87 ± 3.47. The mean scores (± SD) for the physical, psychological, social, and environmental domains were 12.65 ± 2.09, 13.86 ± 1.99, 2.60 ± 1.04, and 13.72 ± 2.02, respectively. Factors significantly associated with mothers’ HRQoL included being married (β = 4.19; 95% CI: 3.02, 5.37), history of antenatal care follow-up at hospitals (β = -1.17; 95% CI: -1.99, -0.36), gestational age ≤ 34 weeks (β = -1.97; 95% CI: -3.21, -0.72), low birth weight (β = -1.15; 95% CI: -3.26, -1.06), receiving information about the neonate’s health status (β = 1.12; 95% CI: 1.03, 2.01), length of NICU stay (β = -0.24; 95% CI: -0.28, -0.04), and poor social support (β = -0.89; 95% CI: -1.40, -0.38). The findings of this study demonstrate that mothers whose neonates were admitted to the NICU experience reduced health-related quality of life. Therefore, to improve maternal quality of life, a range of effective interventions is needed, including strengthening social support and providing timely information about the health status of their neonates.