Khat Use and Its Impacts on Quality of Life: A Theory Generating Qualitative Meta-Synthesis

Khat is an evergreen shrub that is used by individuals in East Africa and countries in the southern Arabian Peninsula and is increasingly spreading to other regions of the globe. This qualitative meta-synthesis study aims to develop a comprehensive model that may be useful in better understanding Khat users’ quality of life by inductively synthesizing existing qualitative research. A theory-generating qualitative meta-synthesis method was applied to search multiple databases and retrieve 131 studies. A two-staged review was done to select a sample of 12 studies for meta-synthesis. Each of the 12 selected studies was evaluated for quality appraisal using the 10 questions of the Critical Appraisal Skills Program (CASP) checklist. The findings section from each study were extracted, coded, and thematically analyzed using Nvivo12 software. Findings showed that Khat use negatively impacts multiple life domains. Mental health suffers due to addiction symptoms like restlessness, insomnia, psychosis, depression, anxiety, aggression, and mood disturbances. Physically, users face sexual and reproductive health issues, gastrointestinal problems, appetite and weight loss, dental issues, and eye problems. Economically, Khat leads to wasted resources, debt, low work performance, absenteeism, and decreased income. Family life deteriorates with increased spousal conflict, relationship strain, and divorce. Socially, users experience isolation and stigma and engage in crime. The study presents a comprehensive model that was developed to help understand the impacts of Khat on users’ quality of life. The model portrays that Khat has an all-rounded and interconnected impact on users’ quality of life.