Functional independence and sociodemographic determinants of activities of daily living among patients with thalassemia in Southern Iraq: a cross-sectional analytical study

Thalassemia is a chronic hereditary hemoglobinopathy that may impair functional independence and performance of activities of daily living (ADL) among affected children. This study aimed to assess the level of functional independence in activities of daily living (ADL) and examine its association with selected sociodemographic characteristics among pediatric patients with thalassemia in Southern Iraq. A cross-sectional analytical study was conducted on a purposive non-probability sample of 150 children and adolescents (aged 6–18 years) with transfusion-dependent β-thalassemia who attended the Thalassemia Center in Thi-Qar Province between March and May 2026. Data were collected through structured face-to-face interviews using a socio-demographic questionnaire and the Arabic-adapted Katz Index of Independence in ADL, comprising 18 items grouped into eight domains. Descriptive statistics, the chi-square test with Cramér’s V effect size, and Fisher–Freeman–Halton exact test as sensitivity analyses, and multiple linear regression were used. Multicategory predictors were entered as dummy-coded categorical variables. Most participants (73.3%) demonstrated a moderate level of functional independence in ADLs, 22.0% demonstrated a high level, and 4.7% demonstrated a low level. No statistically significant associations were observed between ADL levels and residence, gender, age group, educational level, or family socioeconomic status (all p > 0.05; Cramér’s V = 0.073–0.192). Likewise, none of these sociodemographic variables independently predicted the total ADL score in the multiple linear regression model (all p > 0.05). Most pediatric patients with thalassemia in Southern Iraq exhibited a moderate level of functional independence in ADLs, with feeding and transfer as the domains with the highest performance. The examined sociodemographic characteristics were not significantly associated with and did not independently predict ADL performance, suggesting that factors other than the sociodemographic characteristics examined in the present study may contribute to functional outcomes; however, these factors were not directly measured.