Abstract
INTRODUCTION: Disability is a multifaceted global public health issue that adversely affects individuals’ quality of life (QoL), especially in low- and middle-income countries such as Iran. Despite the increasing prevalence of disabilities due to aging populations and chronic diseases, limited data exist on the QoL and its determinants among people with disabilities (PWD) in Iran. This study aims to assess the QoL status and identify related factors among adults with physical disabilities in Iran. METHODS: A cross-sectional analytical study was conducted nationally from 2024 to 2025 involving 867 adults aged 16 years and older with physical disabilities who were members of the Iranian Society for People with Disabilities. Participants were selected via convenience sampling. Data were collected using demographic, socioeconomic, disability assessment (Washington Group Short Set), and WHOQOL-BREF questionnaires. Multiple linear regression analyses were performed to identify factors associated with QoL domains and overall QoL score, adjusting for confounders. Socioeconomic status was derived using Principal Component Analysis. RESULTS: The mean age of participants was 38.08 years; 63.44% were male. Higher education levels were positively associated with better QoL across all domains (physical, psychological, social, environmental) and total QoL scores (p < 0.001). Greater disability severity significantly decreased QoL scores in all domains (p < 0.001). Marital status negatively impacted physical health (β = -3.14, p = 0.04). Wealth index showed positive associations with environmental QoL (β = 1.06, p = 0.01) and a borderline effect on total QoL (p = 0.07). Age negatively influenced environmental QoL (β = -0.14, p = 0.02). Other demographic variables showed no significant effects. CONCLUSION: The study highlights that higher education and lower disability severity are key determinants of better QoL among Iranian adults with physical disabilities. Socioeconomic factors, particularly wealth and education, alongside disability level, significantly influence QoL outcomes. These findings underscore the importance of tailored policies and interventions focusing on education, rehabilitation, and socioeconomic support to enhance the well-being and social participation of PWD in Iran.