Publication date: May 31, 2025

Chronic diseases are a major threat to human health, substantially reducing quality of life (QOL). Since the COVID-19 pandemic there have been surprisingly few surveys specifically focusing on the QOL of individuals living with chronic diseases. This study addresses this gap and assesses the QOL and associated factors of those with chronic diseases in the immediate aftermath of the COVID-19 pandemic. We conducted a cross-sectional study in six cities of Hubei Province, China, from May to August 2021, using a multi-stage cluster sampling technique to select 1,560 study participants. A 12-Item Short Form Survey (SF-12) Scale assessed QOL. Multivariate linear regression analyses and the Shapley decomposition technique identified related factors and the extent of contribution to QOL. We enjoyed a very high response rate to our invitation to participate; of these 1,507 questionnaires were considered valid (96. 6%), and of these 354 patients reported a chronic disease (23. 5%). The Physical Component Score (PCS) and Mental Component Score (MCS) among respondents were 59. 13 +/- 20. 17 and 71. 14 +/- 13. 55, respectively. The results of the regression analysis indicated that those who were 60 years or older and reported a recent acute illness in the immediate two-week period prior to survey were more likely to exhibit poorer PCS, whereas those with annual income of 30,000-100,000 Yuan, engaged in regular exercise and reported having eating regularly (regular eating to encourage relatively stable blood sugar levels as opposed to irregular meals/eating) were more likely to have higher PCS. Those reporting an acute illness in the immediate two-week period prior to survey also had lower MCS, but this was mitigated if the person had medical insurance, an annual income of 50,001-100,000 Yuan, regularly exercised, and a more nutritious diet. The Shapley decomposition results revealed that factors such as age (31. 2%), income (24. 8%), the presence of an illness in the immediate two-week period prior to survey (14. 8%), regular meals (13. 5%), regular physical exercise (10%), and alcohol consumption (5. 7%) contributed to improved PCS, whereas the factors associated with improved MCS included regular meals (33. 8%), length of illness/recovery of two-weeks (23%), comparatively higher annual income (16. 2%), regular physical exercise (13. 9%), and access to medical insurance (11. 1%). The QOL of those with chronic disease in our study sample was significantly lower than those of healthy individuals. Higher annual income, regular physical exercise, the presence of an acute illness in the immediate two-week period prior to survey, consistent meal routines, adequate medical insurance and age were influencing factors of QOL for those with chronic diseases. Countermeasures should be implemented to promote healthy lifestyles and strengthen the prevention and control of chronic diseases.

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