Unpacking Self-Rated Health and Quality of Life in Older Adults and Elderly in India: A Structural Equation Modelling Approach

The Study on global AGEing and adult health (SAGE) aims at improving empirical understanding of the health and well-being of older adults in low- and middle-income countries. A total of 321 adults aged 50 years and older were interviewed in rural Pune district, India, in 2007. We used Structural Equation Modelling (SEM) to examine the pathways through which social factors, functional disability, risk behaviours, and chronic disease experience influence self-rated health (SRH) and quality of life (QOL) amongst older adults in India. Both SRH and QOL worsened with increased age (indirect effect) and limitations in functional ability (direct effect). QOL, socio-economic status (SES), and social networking had no significant effect on SRH. Smoking was associated with the presence of at least one chronic illness, but this did not have a statistically significant effect on SRH. Higher social networking was seen amongst the better educated and those with regular income, which in turn positively affected the QOL rating. QOL had a direct, but statistically not significant, effect on SRH. In conclusion, the indirect effects of age on SRH mediated through functional ability, and the effects of SES on QOL mediated through social networking, provide new understanding of how age and socio-economic status affect SRH and QOL. By allowing for measurement errors, solving for collinearity in predictor variables by integrating them into measurement models, and specifying causal dependencies between the underlying latent constructs, SEM provides a strong link between theory and empirics.     

Nausea and vomiting in pregnancy: Blooming or bloomin’ awful? A review of the literature

BackgroundNausea and vomiting in pregnancy (NVP) is a normal, commonly experienced affliction of early pregnancy. Despite this, its impact on women's lives is not necessarily minimal. For some women, the implications of NVP are substantial with multi-faceted effects, hindering their ability to maintain usual life activities, and particularly their ability to work. In an effort to understand the effect of NVP, several researchers have developed NVP measurement tools, which enable an understanding of NVP's effect on quality of life (QOL).ProblemThis paper seeks to provide a review of the literature to explore the impact of NVP on women's quality of life, particularly their ability to maintain social and professional commitments.MethodMedline, CINAHL, PsychINFO, Ebsco, Science Direct, Health Source, Academic Search Premiere, Cochrane databases were extensively searched using Boolean operators with various combinations of relevant terms: nausea, vomiting, pregnancy, emesis, quality of life, QOL, NVPQOL, PUQE, SF-12, SF-36 and limited to those published from 1999 onwards. Papers were scrutinised to include those discussing the impact of normal NVP on women's lives, particularly their QOL with careful exclusion of those addressing hyperemesis gravidarum (HG).FindingsNVP has a significant effect on women's QOL and therefore their ability to maintain day-to-day activities as well as work capacity. This has implications for the woman, her partner, her family and her employers.ConclusionIt is important that all maternity care workers consider the impact of NVP on the woman's QOL and that care is given not to minimise this experience. Further research is warranted which considers ways in which women can best manage this experience in relation to social and professional commitments. Given the authors were able to identify only one Australian study in this area, published in 2000 and utilising non-NVP specific QOL measurement tools, there exists scope for additional local studies using NVP-specific QOL tools to determine the impact of QOL for Australian women and therefore Australian society.     

Correspondence in Residents' and Staff Members' Assessments of the Quality of Life of Children in Residential Care Facilities

This paper employs Shye's (1979, 1985, 1989)Quality of Life (QOL) model to examine the QOLof 920 boys and girls in 46 Residential CareFacilities in Israel, from the perspective ofboth the residents and the staff. Specifically, it examines the degree ofcorrespondence in the residents' and staffs'assessments of the residents' QOL and theassociation between the degree ofcorrespondence and the quality of the facility. Findings showed that while residents and staffmade similar assessments in various areas ofthe residents' cultural and social QOL, theresidents rated their physical QOL higher andtheir psychological QOL lower than the staffdid. Findings also showed that while residentsand staff agreed on the residents' QOL in thepoorest facilities, they disagreed in theothers. In the better facilities, the staffrated the residents' QOL lower than theresidents' did; in the poorer facilities, theresidents rated their QOL lower than the staff. These findings raise concern about staffawareness of the psychological hardships anddistress of the juveniles in their care, aswell as about their ability under thesecircumstances to provide adequate psychologicalcare.     

Quality of Life as Medicine: Interventions that Induce Salutogenesis. A Review of the Literature

This paper reviews the medical (salutogenic) effect of interventions that aim to improve quality of life. Review of studies where the global quality of life in chronically ill patients was improved independently of subjective and objective factors (like physical and mental health, yearly income, education, social network, self-esteem, sexual ability and problems or work). The methods used were subtypes of integrative medicine (non-drug CAM) like mind body medicine, body psychotherapy, clinical holistic medicine, consciousness-based medicine and sexology. In about 20 papers on QOL as medicine, in cancer, coronary heart disease, chronic pain, mental illness, sexual dysfunction, low self-esteem, low working ability and poor QOL, the most successful intervention strategy seems to be to create a maternal, infantile bonding induced by a combination of conversation therapy and bodywork. The papers examined the treatments of over 2,000 chronically ill or dysfunctional patients and more than 20 different types of health problems. Global QOL measured by SEQOL, QOL5, QOL1, self-rated physical health, self-rated mental health, self-rated sexual functioning, anorgasmia, genital pain, self-rated working ability, self-rated relation to self, well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life’s potentials, and objective functioning. We found “QOL as medicine” able in the treatment of physical disorders and illnesses including chronic pain (Number Needed to Treat (NNT) = 1–3, Number Needed to Harm (NNH) > 500), in mental illness (NNT = 1–3, NNH > 500), in sexual dysfunctions (NNT = 1–2, NNH > 1,000), self-rated low working ability (NNT = 2, NNH > 500), and self-rated low QOL (NNT = 2, NNH > 2,000). We found that QOL improving interventions helped or cured 30–90% of the patients, typically within one year, independent of the type of health problem. “QOL as medicine” seems to be able in improving chronic mental, somatic and sexual health issues without side effects.     

Global QUALITY OF LIFE (QOL), health and ability are primarily determined by our consciousness. Research findings from Denmark 1991–2004

Objective: To explain the global quality of life (QOL) from 2000 indicators representing all aspects of life. Design and setting: Two cross sectional population studies, one prospective cohort study and one retrospective cohort study. Participants: (1) Representative sample of 2500 Danes (18–88 years), (2) 7222 members of the Copenhagen Perinatal Birth Cohort 1959–1961 (31–33 years), (3) 9.006 mothers and their 8820 children born in Copenhagen 1959–1961, (4) 746 Danes (55–66 years). Main outcome measures: Global QOL measured by SEQOL (self evaluation of QOL) containing eight global QOL measures: Well-being, life-satisfaction, happiness, fulfilment of needs, experience of temporal and spatial domains, expression of lifes potentials and objective factors. Results: 2000 associations; strongest between QOL and health, ability, the personal philosophy of life, the relationships to oneself, the partner and friends; weakest between QOL and 1000 early life factors, 1000 life events and 100 objective factors like income. Conclusions: Quality of life is associated with personal health and attitude towards life, rather than objective factors, life style, or life events. We conclude that QOL can be developed independently and thus be used as medicine.     

农村大龄未婚男性的生活质量及其影响因素分析——以冀北地区调查为基础

利用2010年冀北C县农村调查数据,借鉴生活质量的概念和研究框架,分析农村大龄未婚男性的生活质量现状及影响因素。研究结果表明,与已婚男性相比,未婚男性的客观生活质量和主观生活质量均明显偏低;居住方式和父母在世情况显著影响他们所获得的生活支持,工作、收入和社会保障显著影响他们的经济满意度;年龄、生理、心理和收入是影响未婚男性生活总体满意度的重要因素。经济满意度和生活总体满意度之间具有显著的正向相关关系,社会交往满意度和生活总体满意度之间的关系不显著。分析农村大龄未婚男性的生活质量有利于把握其生存状态,也有利于理解其对社会公共安全的影响。     

Using Perceived Health to Test the Construct-related Validity of Global Quality of Life

Quality of life (QOL) is considered as aglobal, yet unidimensional, subjectiveassessment of one's satisfaction with life. Weexamine the construct validity of the availableindicators of global QOL by constructing acausal model in which QOL is viewed as causallyresponding to several dimensions of perceivedhealth. Global QOL is measured with fiveindicators derived from the literature, andperceived health is measured by eightdimensions of the SF-36 Health Survey. Thestructural equation model describes the QOL andperceived health assessments of 306 coronaryartery bypass graft (CABG) patients andprovides a stringent test of theunidimensionality of the global QOL indicators.The evidence regarding QOL is worrisome, butnot devastating. The acceptable model fit wasachieved by introducing direct effects leadingfrom the General Health Perceptions concept totwo of the five indicators of global QOL. Thissuggests that there are some mechanisms thatinfluence these indicators without firstaltering QOL, or that these indicators are notresponding in unison to QOL. Furthermore, theFaces QOL indicator required measurement errorcorrelations to two of the perceived healthindicators. This also suggests that there aremechanisms beyond pure QOL that act upon thisindicator. But the problematic effects anderror correlations are modest, so the evidenceagainst these indicators is not particularlystrong. Overall, the Self-Anchoring StrivingScale (SASS) indicator and the Life-as-a -Wholeindicator (from Multiple Discrepancies Theory)seem to be the cleanest indicators of globalQOL. General health perceptions and perceivedmental health both influenced global QOL, whilethe other six health perception concepts had noconsistent impact on global QOL.     

Social Capital Associated with Quality of Life Mediated by Employment Experiences: Evidence from a Random Sample of Rural-to-Urban Migrants in China

Working-age migrants need to possess adequate social capital in order to secure a stable and satisfactory job so that they can pursue a better quality of life (QOL). The positive relationship between social capital and vocational experiences, including successful employment, has been well established. In this study we focused on testing a multi-step mediation model linking social capital with employment experiences, and further to QOL. Survey data from rural-to-urban migrants randomly selected from Wuhan, China were analyzed. Social capital, including bonding and bridging capital, was measured using the Personal Social Capital Scale; employment experiences were measured using five job-related items; and QOL was measured using the Brief Symptoms Inventory. Structural equation modeling analysis indicated that job security and job satisfaction were positively and significantly associated with QOL, and social capital measures were significantly associated with higher QOL (primarily for males). Furthermore, job security and job satisfaction fully mediated the relationship between social capital and QOL after controlling for covariates. Findings of this study suggest the significance of social capital, job security and satisfaction in improving migrants’ QOL, implying the importance of vocational experiences in mediating the effect from social capital to QOL. If the findings can be confirmed with longitudinal data, these factors should be considered in decision making to improve rural-to-urban migrants’ QOL in China.     

Construct and Criterion Validity of a Norwegian Instrument for Health Related Quality of Life Among Elderly Women Living at Home

Purpose of the study: The aim of the current study is to validate an instrument consisting of five items and first used in the Nord-Trondelag Health Survey (HUNT-5), as a measure of health related quality of life (QOL) in a population of elderly women living at home. Design and methods: A random sample of 307 women aged 75 years and over (mean 80.8 years, response rate 74.5%) and living at home were interviewed using the HUNT-5 instrument, the 20-question version of the General Health Questionnaire (GHQ-20) and the respondents’ records of their health status and functional ability. Results: No significant relationships were found between age and the sumscores of GHQ-20 and HUNT-5. Factor analysis indicated that HUNT-5 is primarily unidimensional. The Cronbach α for HUNT-5 was 0.79 and that for GHQ-20 was 0.87. The correlation between the HUNT-5 and the GHQ-20 sumscores was 0.75 (p < 0.001). There were significant correlations between some of the health and function items and the two QOL instruments (ranging from 0.14 to 0.68). Implications: This evaluation supports the psychometric validity of HUNT-5 for elderly women living at home. It is important to take into consideration the women’s own experience of their health and functional ability in planning therapy and in obtaining the best possible QOL for them.     

Measuring Quality of Life

This paper considers quality of life (QOL) to be a global, yet unidimensional, subjective assessment of one's satisfaction with life. This conceptualization is consistent with viewing QOL assessments as resulting from the interaction of multiple causal dimensions, but it is inconsistent with proposals to limit QOL to health-related quality of life (HRQOL). We test the unidimensional yet global conceptualization of QOL using data from coronary artery bypass graft (CABG) patients. The Self-Anchoring Striving Scale (SASS) and four other indicators derived from the literature, all seemed to function as indicators of a single concept (QOL) that was repeatedly drawn upon as the patients determined their responses to these indicators. However, only about half the variance in each indicator was attributable to that common QOL source. Several structural equation models are used to assess whether the superior performance of the Life 3 indicator is an artifact of the repetition of an item within this indicator. The data convincingly indicate that the superior performance is not a memory artifact, and that even the repetition of an identically worded item prodded the patients into drawing yet again upon the same QOL factor that grounded all the other measures.     

The Use of Common Area <Emphasis Type="Italic">k</Emphasis>-Sample Test in Evaluating Targeting Methodologies: An Application to the Case of Egypt

The quality of life (QOL) is a measure of social wellbeing and life satisfaction of individuals in an area. Measuring its spatial dynamics is of great significance as it can assist the policy makers and practitioners in improving the balance between urbanization and living environment. This study proposes an approach to spatially map and examine the relationships between QOL, land use/land cover (LULC) and population density in an urban environment. The city of Lahore, Pakistan was selected as the case study area. The QOL was evaluated through the data related to physical health, psychological, social relationships, environment (natural and built), economic condition and development, and access to facilities and services. The weights/relative importance of each QOL domain was determined through the analytic hierarchy process by processing the data collected from local field experts. Overall QOL was computed by applying the domain weights to the data; spatial mapping of QOL domains and overall QOL was conducted afterwards. The spatial dynamics of QOL were examined, and its interrelationships with LULC and population density were analyzed. The relationship between these three variables turned out to be spatially dynamic. The proposed approach assists the spatial mapping and analyses of QOL, LULC and population, and by examining the spatial dynamics of these variables, contributes to devising appropriate land management and QOL improvement strategies and policies in the metropolitan regions.     

Gender Differences in the Relationship of Social Activity and Quality of Life in Community-Dwelling Taiwanese Elders

This study explores the gender differences in the relationship between social activity and quality of life (QOL). A cross-sectional survey of 220 community-dwelling elderly people was conducted in southern Taiwan. Social activity was classified into six categories. The brief version of the World Health Organization QOL (WHOQOL-BREF) was used to measure QOL. Findings revealed that the associations of six types of social activities with QOL were weaker among women than men. The regression analyses further showed that for women, only religious activity was positively related to total QOL, while for men only involvement in formal group activity was positively related to total QOL.     

Demographic Characteristics as Predictors of Quality of Life in a Population of Psychiatric Outpatients

Studies examining relationships between demographic variables in a general population of psychiatric outpatients and quality of life (QOL), in which QOL was assessed according to current recommendations, have not been performed yet. The aim of this study was to examine one particular aspect of this relationship: the question to what extent QOL scores can be predicted by demographic variables. In a sample of adult Dutch psychiatric outpatients (n=495), demographics were recorded and the participants completed a questionnaire for measuring QOL (WHOQOL-100). The relationships of the demographic variables with the WHOQOL-100 domains Social Relationships and Environment, were stronger than those with the domains Physical Health and Psychological Health. The latter had only significant relationships with educational level and sick leave, which explain little of the variance of the concerning QOL domain. In general, the demographic characteristics used, explained only a relatively small part of the variance in QOL scores. An exception was sick leave, which, in participants with a job, explained an extensive part (27.4%) of the variance of scores on the domain Physical Health.     

Theoretical Perspectives Guiding QOL Indicator Projects

Most of the theoretically based QOL indicators projects can be classified in terms of six major theoretical concepts: (a) socio-economic development (b) personal utility, (c) just society, (d) human development, (e) sustainability, and (f) functioning. I explain the core aspects of these six theoretical paradigms and show how they help guide QOL researchers to select and develop QOL indicators that are significantly and qualitatively distinct. A taxonomy of QOL indicators guided by a given theoretical concept is likely to be very different from others taxonomies guided by different theoretical concepts. Thus, the objective of this paper to explain these theoretical paradigms and show how they guide QOL researchers to select and develop QOL indicators that are significantly and qualitatively distinct.     

Impact of health and fitness-related behavior on quality of life

While the relationships between (a) health behavior and health status and (b) health status and perceived quality of life (QOL) have received some attention, the association between health behaviors and QOL has not been determined. The primary objective of this study was to assess the effects of health behaviors on QOL that are independent of the effects of health status. A sample of approximately 5 000 randomly selected U.S. Navy personnel was split into halves and analyses performed on each to establish the replicability of the findings. At step one of a multiple regression procedure, health status variables were forced into the equation; next, health behavior variables were entered. As expected, the block of health status variables was significantly related to QOL: self-assessed health and fitness status and lower reporting of physical symptoms accounted for 16% and 18% of the variance in QOL for the two subsamples. After controlling for health status, two behavioral measures made unique contributions to the prediction of QOL: behaviors related to avoiding unnecessary risks as a driver or pedestrain and avoiding or minimizing accidents. Wellness maintenance behaviors also were associated with QOL in one subsample. After controlling for health status, health behavior measures contributed an additional 11% and 6% of the explained variance in QOL for the two subsamples. Results indicate that health behaviors influence QOL independently of health status.     

Gender differences in the relationship of social activity and quality of life in community-dwelling Taiwanese elders

This study explores the gender differences in the relationship between social activity and quality of life (QOL). A cross-sectional survey of 220 community-dwelling elderly people was conducted in southern Taiwan. Social activity was classified into six categories. The brief version of the World Health Organization QOL (WHOQOL-BREF) was used to measure QOL. Findings revealed that the associations of six types of social activities with QOL were weaker among women than men. The regression analyses further showed that for women, only religious activity was positively related to total QOL, while for men only involvement in formal group activity was positively related to total QOL.     

Quality of Life from the Voting Booth: The Effect of Crime Rates and Income on Recent U.S. Presidential Elections

Quality of Life (QOL) is often measured with surveys of citizen’s satisfaction. In contrast, the current research uses already-existing voting data to infer citizens’ perceptions of QOL. Under this model, citizens decide how much their QOL has improved (or declined) since the last election, and then vote to reward (or punish) the incumbent party accordingly. Analysis of the popular vote for the incumbent party then allows inference on how citizens judge their QOL and how they weight the various domains. Previous research has concluded that voters reward an incumbent who improves the economic domain prior to election. I test whether voters also reward declining crime rates, and estimate how citizens weight the relative importance of each in determining QOL. I analyze the vote shares by state from U.S. presidential elections from 1972 to 1996. Results show that changes in crime rates do influence vote share, consistent with the responsibility hypothesis, but to a smaller degree than the economic domain does. The method described provides convergent evidence that citizens weight domains differentially, and can provide the weights for a national QOL index.     

Comprehensive Evaluation of the Objective Quality of Life of Chinese Residents: 2006 to 2009

This study performs a comprehensive evaluation of the objective quality of life (QOL) of the 31 provincial administrative divisions in Mainland China from 2006 to 2009 with principal component analysis (PCA). The objective QOL in China generally decreases gradually from the eastern coastal regions to the western inland regions, with a significant gap between the east and the west. Furthermore, the QOL shows an irrational developmental pattern with the natural conditions and the geographical position as the foundations, and economic development as the dominant factor. Cluster analysis is then used to analyze further the regional structural characteristics of the QOL in China. The results indicate the existence of mutual distinctions and internal differentiations among the eastern, middle, and western regions. The temporal analysis shows that the QOL in China demonstrates a continuous increase from 2006 to 2009, with a growth rate that speeds up annually. However, the increase does not mean a harmonious development in all aspects of society, but the rapid progress of socio-economic well-being, and the slow development or even deterioration of eco-environment and social security. The tendencies of the QOL in the four socio-economic regions coincide with that of the national average and the QOL of the middle and western regions increase significantly faster than that of the eastern region. However, the disparities between the eastern region and the middle and western regions expand because of the huge base of regional development differences in China.     

Quality of Life in Cities: Setting up Criteria for Amman-Jordan

In recent years, the interest grew in research on measuring the “quality of life” (QOL) in cities. This interest comes from the success QOL measurement achieved in understanding communities’ needs, tracking changes in different aspects of life and assessing the most desired types of future development among citizens. This research highlights the importance of measuring QOL in Jordan. It examines the opportunity and applicability of carrying out QOL measurement studies in Amman, the capital city. It outlines different scopes, visions and approaches that can be used to study and measure QOL and the most suitable mechanism that can work firmly. A professional top–bottom approach was used for that. Thirty-three experts with different backgrounds were interviewed in order to determine the appropriate scopes and visions for studying QOL, define the most significant aspects affecting QOL in Amman, and define the appropriate domains to be studied. Results were analyzed, limitations were defined and the final set of representative domains was stated. Domains were ranked according to their relevance and the important -underneath- aspects were defined in the form of models, each representing a certain domain. The paper attempts by the end to set the stage for setting up criteria for measuring QOL in Amman and to open the way for future QOL research to take place in Jordan.     

Personality and quality of life

The present study investigated a possible association between personality, mental absorption and quality of life (QOL) in a sample of young males (N=411). Mental absorption was assessed with Tellegen's Absorption Scale (ABS). Using a 6 dimensional QOL-scale we found the Millon Behavior Health Inventory (MBHI) dimensions Basic coping style, Psychogenic attitudes, Psychosomatic correlates and Prognosic indices, to be firmly related to QOL, explaining 44% of the variance of a QOL scale which was derived through factor analysis. Mental absortion was weakly related to QOL. The discussion revolves around the relationship between personality and perceptual style, health report behavior and personality as possible biasing factor in evaluative QOL-investigations.