Arthritis Impact on U.S. Life Quality: Morbidity and Mortality Effects From National Health Interview Survey Data 1986–1988 and 1994 Using QWBX1 Estimates of Well-Being

Objective: To estimate the impact ofarthritis using a general health index andNational Health Interview Survey (NHIS) data.Methods: Morbidity data came from NHISPublic Use data, from the years 1986–1988 and1994. The data are 423 400 cases, representing975 421 153 person-years. Quality ofWell-being Scale (QWB) morbidity scores wereimputed from NHIS questions about healthconditions and limitations in functioning. Both the QWB and multiple linear regressionwere used to estimate the effects of arthritiswith and without adjustments for co-morbidity. Mortality data for NHIS-sampled adults weredrawn from the National Death Index by staff ofthe National Center for Health Statistics.Results: The mean QWB for those withself-reported arthritis was 0.608 on a scaleranging from 0.0 (for death) to 1.0 (for fullyfunctional without symptoms or problems). Thisobserved mean for arthritis is 39.2% below the1.000 comparison standard. QWB morbidityscores for self-reported arthritis appear(0.701 – 0.608=) 9.3% more severe than meaneffects of all other health conditions. Mortality adds an average 13.8% to themorbidity burden. Persons with arthritisconstitute 4.7% of the population, but accountfor 9.6% of Quality-Adjusted Life Years(QALYs) lost to morbidity.Conclusions: Self-reported arthritis isassociated with very significant losses inQuality-Adjusted Life in the US population.     

Do We Need to Weight Satisfaction Scores with Importance Ratings in Measuring Quality of Life?

Trauer and Mackinnon (2001; Quality of life research 10, pp. 579–585) recently proposed that weighting satisfaction scores by importance ratings in measuring quality of life is undesirable and unnecessary. However, they didn’t use empirical data to support their claim. In this study, different weighting algorithms developed by Cummins (1997; Comprehensive Quality of Life Scale – Adult: Manual [Deakin, University Australia]), Raphael et al. (1996; Journal of Adolescent Health 19, pp. 366–375), Ferrans and Powers (1985; Advances in Nursing Science 8, pp. 15–24) and Frisch (1992; Comprehensive Casebook of Cognitive Therapy [Plenum Press, New York]) for measuring quality of life (QOL) were applied. Weighted scores computed from these weighting algorithms were compared with unweighted scores in predicting a global life satisfaction measure by correlation and moderated regression analyses. One hundred and thirty undergraduate students at National Taiwan University participated in the study voluntarily. They completed a 15-item questionnaire on quality of campus life developed by the authors. They also completed the Satisfaction with Life Scale (SWLS), a global life satisfaction measure developed by Diener et al. (1985; Journal of Personality Assessment 49, pp. 71–75). The correlation results revealed that the weighted scores computed from different algorithms didn’t have higher correlations to the SWLS than the unweighted scores. The moderated regression results also revealed that item importance did not moderate the relationship between item satisfaction and the overall life satisfaction. All these findings revealed that weighting satisfaction with importance is unnecessary. This paper was a part of the first author’s Master Thesis     

Using quality of life information to set priorities in health policy

Health care has as primary objectives extending life expectancy and improving quality of life in years prior to death. This paper offers a General Health Policy Model as a method for quantifying these outcomes. The model adjusts life expectancy for diminished quality of life, which is measured using a standardized instrument known as the Quality of Well-being (QWB) scale. The Well-year or Quality Adjusted Life Year (QALY) results from these analyses and serves as a single quantitative expression of health benefit. QALY units integrate side effects and benefits of treatment by combining into a single number, mortality, morbidity, and duration of each health state. Examples show the application of the model relevant to a variety of medical and public health problems, including diabetes, arthritis, AIDS, neonatal circumcision, and tobacco tax. It is suggested that the General Health Policy Model has advantages for guiding both individual and public health decisions.     

The effect of World War I and the 1918 influenza pandemic on cohort life expectancy of South Australian males born in 1881–1900

Cohort lifetime distribution functions have been estimated for the twenty separate calendar year cohorts of South Australian males born in 1881–1900. A cohort life expectancy at birth was calculated from each of these distribution functions, and a composite assessment made of the reduction in cohort life expectancy at birth due to both World War I 1914–1918 and the 1918 Influenza Pandemic. By partitioning each cohort, the cohort life expectancy at birth of the subgroup that had overseas military service is estimated to be 85 to 90 per cent of the cohort life expectancy at birth of the subgroup that remained in South Australia.     

A Comparative Study of Handicap-free Life Expectancy of China in 1987 and 2006

After the first large scale national sampling survey on handicapped persons in 1987, China conducted its second national sampling survey in 2006. Using the data from these two surveys and the national life tables, we computed and compared the expected years of life free of handicapped condition by the Sullivan method. The expected years of life lived with handicap for the Chinese population increased from 4.87 years for males and 5.81 years for females in 1987 to 5.55 years and 6.32 years in 2006, respectively. The same trend was observed for people in working ages (15–64) and old ages (65+). However, the expected years of life lived with handicap decreased for children (0–14). Our results also showed that the effect of skeletal handicap increased notably for both sexes. Healthy life expectancy is an important indicator in measuring quality of life of a population. Our study utilized this measurement to quantify one aspect of quality of life of the Chinese population.     

International Well-being Index: The Austrian Version

The International Well-being Index (IWI) measures both personal and national well-being. It comprises two subscales: the Personal Well-being Index (PWI) and the National Well-being Index (NWI). The aim of this paper is to test the psychometric properties (validity and reliability) of the translated scale in Austria. Convergent validity is assessed using the Scales of Psychological Well-Being, the Satisfaction with Life Scale and the Positive and Negative Affect Scale. In addition, a Visual–Analog Scales capturing “satisfaction with life as a whole” was applied. The participants were 581 students of the Medical University Innsbruck (female: 47.7%; age: 23.2 ± 3.7). Internal consistency (Cronbach’s α) of the IWI was for both scales > .70 (PWI: .85; NWI: .83). The exploratory factor analysis of the IWI identified a 2-factor-structure identical with the two scales of the IWI explaining 54.2% of the variance. The convergent validity hypotheses were confirmed, construct validity was partly confirmed for the PWI being a deconstruction of a first factor called “satisfaction with life” (38.1% explained variance). Happy participants scored higher on the PWI (84.3 ± 7.9 vs. 68.7 ± 13.7; p < .001) and NWI (64.3 ±  15.8 vs. 57.9 ±  15.1; p < .001) scores than unhappy participants. It is concluded that the Austrian version of the IWI is a reliable and valid instrument to assess personal and national well-being. Further studies including a representative sample should be carried out on a recurring basis to use the IWI as an indicator for social science research in Austria.     

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

In drug treatment outcome literature, a focus on objective and socially desirable indicators of change (e.g. no drug use) has predominated, while outcome indicators that are important for drug users themselves (e.g. quality of life, satisfaction with treatment) have largely been neglected. Nonetheless, Quality of Life (QoL) has become an important concept to evaluate effectiveness of treatment in mental health care research and disability studies. Given the almost exclusive focus on Health-related Quality of Life (HRQOL) in substance abuse research and the neglect of clients’ perspectives in this field, we explore in this study the concept of QoL as perceived by drug users. Focus group discussions (n = 9) were organised in various treatment settings and community services for drug users in the region of Ghent, Belgium to identify important dimensions of QoL and their interpretation by drug users. Data were clustered and analysed based on the theoretical framework of Robert Schalock (Quality of life. Volume 1: Conceptualization and measurement, 1996). The domains ‘personal relationships’, ‘social inclusion’ and ‘self-determination’ were discussed most frequently by the participants. They stressed the importance of a supportive social network in particular. It can be concluded that QoL is not primarily associated by drug users with health and it involves much more than the aspects typically represented in measures of HRQOL.     

Safe drinking water and satisfaction with environmental quality of life in some oil and gas industry impacted cities of Nigeria

The availability and safety of drinking water and the environmental quality of life was investigated in five cities located in an oil-producing area of Nigeria using questionnaire-based scales, discussion and laboratory tests. Polythene-packaged sachet water and commercial and non-commercial private boreholes largely met the drinking water requirement of the cities. Consumption of sachet water was high (14.0–20.0 points vs. 25.0 points) but regression analysis indicated strong negative relationships with income group (β = −0.75, P < 0.005) and educational level (β = −0.77, P < 0.005) of respondents (658). Private borehole water was prevalent (18.7–19.9 vs. 20.0) while public water supplies were almost non-existent (4.8–5.6 vs. 20.0) in the cities. Vulnerability to contamination in all water sources was indicated following unacceptable counts of total and faecal coliform bacteria in 10–62.5 and 3–25% of samples, respectfully. Respondents were not satisfied with environmental quality of life indicated by the quality of housing, school, health services, refuse disposal, recreation, streetlight, transport and police (3.43–4.01 vs. 10). It is concluded that modernization and industrialization due to the oil and gas industries, tended to increase individualization to the negligence of common services as evidenced by the preponderance of private boreholes and sachet water.     

The Well-Being of 12 - to 16-Year-Old Adolescents and their Parents: Results from 1999 to 2003 Spanish Samples

This study adopts satisfaction with life as a whole and satisfaction with specific life domains as indicators to analyse the relationships between the well-being of 12 to 16-year-old adolescents and some related constructs such as self-esteem, perceived control and perceived social support. Well-being indicators from a 2003 Spanish sample using an 11-point scale (N = 1,634) are compared with an equivalent 1999 Spanish sample using a 5-point scale (N = 1,618). The different results obtained from the 2003 sample with a Principal Component Analysis (PCA) using a shorter and a longer list of life domains are also discussed. A sub-sample of the adolescents’ results from the 2003 sample are compared with their parents’ answers, using the same well-being indicators. Using a list of 8 life domains, and despite the change of scale used, overall results show no relevant changes in adolescents’ satisfaction with life domains between 1999 and 2003 in Spain and are in agreement with normative data expected from western societies [Cummins: 1998, Social Indicators Research 43, pp. 307–334; Cummins et al.: 2001, Australian Unity Well-being Index (Australian Centre on Quality of Life, Deakin University, Melbourne)]. Adolescents’ overall life satisfaction has been shown to correlate consistently with the other well-being related constructs. However, it clearly decreases with age over the period studied. The results also show that increasing the list of life domains has a major impact on the structure of the results obtained. When we compare results from parents with those from their own child, outstanding differences in well-being appear between generations: few domain satisfaction dimensions show significant correlation between parents and children and more than 20% of the population studied shows high discrepancies in the answers in four domains.     

Measuring longevity achievements under welfare interdependencies: a case for joint life expectancy indicators

Whereas period life expectancy constitutes an intuitive indicator of the survival conditions prevailing at a particular period, this paper argues that, given the existence of welfare interdependencies, that widespread indicator is nonetheless an incomplete measure of the longevity achievements relevant for human well-being. The central importance of coexistence for human-beings implies that usual life expectancy measures should be complemented by joint life expectancy indicators, which measure the average coexistence time under particular survival conditions. After a study of the theoretical foundations of ‘single’ and ‘joint’ life expectancy indicators, it is shown that joint life expectancy measures tend to enrich significantly the comparison of longevity achievements across countries and periods. Moreover, the introduction of joint life expectancy indicators—as a complement to conventional life expectancy measures—into multi-variable indexes such as the United Nations’ HDI is also shown to affect international rankings of standards of living to a non negligible extent.

Measuring trends in child well-being: an evidence-based approach

This paper first reviews the goals of the founding documents of the social indicators and quality-of-life movements of the 1960s and 1970s. It next describes the current state of knowledge with respect to the founding goals of this field. The focus then turns to the topic of measuring changes in child and youth well-being in the United States over the past few decades. In particular, the evidence-based approach used in the construction of the recently developed composite Child and Youth Well-Being Index (CWI) is described. Some findings from the CWI regarding changes in child and youth well-being in the period 1975–2004 are reported. Trends in the CWI then are compared with data on trends in subjective well-being of high school seniors – similarities of trends in these two series provide validating support for the interpretation of the CWI as an index of changes in the quality-of-life of children and youth. Using data on some additional indicator series, most of which were initiated in the 1990s, an Expanded CWI is then described. The qualitative pattern of change in the expanded CWI is shown to be similar to that of the basic CWI, except that the expanded CWI shows a more pronounced decline in the early-1990s and a slower rate of improvement into the early-2000s. The paper concludes with some possible directions for future work. Revision of a paper presented at the Measuring Child Well-Being: The Pros and Cons of Composite Indices Session, American Statistical Association Annual Meeting, Minneapolis, MN, August 7–11, 2005. We thank Kristin Moore for useful comments. The research on the Child and Youth Well-Being Index reported herein was supported by a grant from the Foundation for Child Development.     

Quality of Life in Macau,China

We report the initial findings of an ongoing, long-term investigation into subjective quality of life in Macau, a Special Administrative Region of China. Data were collected via quarterly public surveys (2007 to 2009; n = 8,230), as part of the Macau Quality of Life Report. The main aims of the study were to: (a) ascertain the public’s satisfaction with life and with the regional situation in Macau; (b) confirm the utility of the International Wellbeing Index (IWI) as a measure of subjective life quality; and (c) contribute to ongoing discussion in the literature on quality of life in China. The data indicated moderate levels of personal (PWI = 64.4; range 63–66.7) and national (NWI = 59.7; 57.4–63.7) wellbeing across the study period, which implies that residents in Macau are generally satisfied with life. The lowest scores were reported in the first quarter of 2009, a period of great economic uncertainty in Macau and the world, but were positioned within the normative range. The IWI demonstrated good psychometric performance, consistent with previous studies in China and the West, which confirmed its utility. These findings are discussed in relation to the IWI’s theoretical underpinnings and the literature.     

Comparing Self-Rated Health, Satisfaction and Quality of Life Scores Between Diabetics and Others Living in The Bella Coola Valley

Objective: To investigate the relative effect that diabetes has on self-rated health, satisfaction with various specific domains of life, and satisfaction with quality of life operationalized as happiness, satisfaction with life as a whole, and satisfaction with overall quality of life. Design: Mixed methods – mailed survey and chart review. Study Population: All people aged 17 years or older, residing in the Bella Coola Valley in September 2001 and having a chart at the Bella Coola Medical Clinic. Main outcome measures: Self-rated health, self-rated stress, rating of self-care received, global life satisfaction (Life as whole; Overall standard of living; Overall quality of life; and Overall happiness); and satisfaction with various domains of life. Results: A total of 968 useable surveys were returned for a response rate of 56 (968/1734). Age was negatively related to General Health, but positively related to Life Satisfaction. Not being of Aboriginal descent was positively related to all of the four global health indicators and to Subjective Well-Being. After accounting for age, race, and weight, we found that diabetics report significantly poorer self-rated health, and lower satisfaction with health scores compared to people without diabetes. Participants with diabetes who were the least compliant with their treatment regimens rated their current health significantly lower than those who were the most compliant. People with diabetes were, however, no more likely to be unhappy or dissatisfied with their lives as a whole or with the overall quality of their lives compared to people without diabetes. Among people with diabetes, however, those who used insulin did report significantly less satisfaction with the overall quality of their lives than those who didn’t use insulin. Conclusion: Diabetics understand they have poorer health than others, but they do not have poorer global life satisfaction scores. This may explain why it is difficult to get diabetics to adopt behaviours which may lower their quality of life – e.g., diet plans, lose weight, engage in exercise programs, or take medications.     

The Performance of the World Health Organization’s WHOQOL-BREF in Assessing the Quality of Life of Thai College Students

The purpose of this study was to examine the performance of the Thai-version of WHOQOL-BREF in assessing the quality of life (QoL) among Thai college students. The psychometric properties of WHOQOL-BREF were assessed in this study. The self-administered WHOQOL-BREF questionnaire was applied. A total of 407 Thai college students (male age = 20.5 ± 1.2; female age = 20.5 ± 1.2) participated in this study. Item-response distributions, internal consistency reliability, discriminant validity, criterion-related validity and construct validity through confirmatory analysis were analyzed. The findings indicate that the WHOQOL-BREF had acceptable internal consistency (α = 0.73–0.83 across four domains), all items highly correlated with corresponding domain scores (r = 0.53–0.80), the indices of a two-order confirmatory factor analysis (CFA) demonstrate that the data fit the model well with allowing covary of error variances of some items, all items had good property of criterion-related validity and item discrimination and, all three domain scores except the social relationship domain had significant associations with overall QoL or general health. The results suggest that the WHOQOL-BREF was reliable and valid to health professionals in the assessment of the QoL of college-based Thai youth, but some unsuitable items may be deleted in future studies.     

Can We Weight Satisfaction Score with Importance Ranks Across Life Domains?

The main purpose of this study was to investigate the utility of importance weighting when importance ranks were considered as the weighting values by (1) examining the range-of-affect hypothesis in the within-subject context and (2) comparing performances of weighted and unweighted satisfaction scores in predicting overall judgment of subjective well-being. Participants were 167 undergraduates at National Taiwan University. The mean age was 19.80 years (SD = 1.98). They were first asked to complete the measurements for global life satisfaction and overall QOL and then completed a QOL questionnaire for rating satisfaction, perceived have–want discrepancy on 12 life domains and ranking importance on these domains. Hierarchical linear modeling with a random-coefficients regression model was applied to examine the range-of-affect hypothesis in the within-subject context. Correlation analysis was applied to evaluate performances of weighted and unweighted satisfaction scores in predicting overall judgment of subjective well-being. Results of this study supported the range-of-affect hypothesis, showing that the relationship between item have–want discrepancy and item satisfaction is stronger for high importance items than low importance items for a given individual. Correlation analysis found that the four weighted satisfaction scores computed from the algorithms proposed by Hsieh (Social Indicators Research 61:227–240, 2003) were not superior to unweighted satisfaction score in predicting overall QOL and global life satisfaction. All these findings suggested that weighting satisfaction scores with importance ranks may not have theoretical basis and empirical contribution.     

A Mixed Method Approach to Quality of Life Research: A Case Study Approach

Increased use of qualitative and quantitative methods in quality of life projects necessitates an examination of how to effectively work within a mixed method framework. The research objectives of this paper are to (1) operationalize the two goals of mixed method research (confirmation and comprehension) and (2) develop a strategy for using mixed methods in quality of life research. Face-to-face interview (qualitative) and telephone survey (quantitative) data from the Community–University Institute for Social Research Quality of Life (CUISR QoL) project in Saskatoon, Saskatchewan were used for operationalization. Overall, confirmation and comprehension were challenging concepts to operationalize. Seven benefits and four guidelines were developed and are presented as dynamic, rather than definitive, structures.     

Are the Real Time Costs of Children Equally Shared by Mothers and Fathers?

This article attempts to estimate the time cost of children in France for couples who do not forgo any income, on the basis of the INSEE 1998–1999 time use survey. Having a child involves an increase in domestic work and/or the dedication of occupational income to pay for childcare. The reduction in “time for oneself”—leisure and personal care, i.e. 24 h less working hours paid or unpaid—is modelled for a dual-earner couple in full-time employment who do not use childcare services to increase his/her leisure time. Taking a couple in full-time employment avoids income endogeneity bias, since income is reduced by career interruption and part-time employment. These estimates account for this selection by full-time paid work. The article shows that time cost is roughly 1 h 30 min a day for a child aged 3–14, and is 4 h a day for each younger child. As this cost rises, the more fathers sacrifice some of their free time. The father and mother of two young children with a childminder thus each have only 11 hours of free time (including sleep) per day. The time cost of a large family (3 children) is equivalent to a full-time job on the labour market. In France, work-life balance policies and family pension entitlements only cover a small part of this cost.     

Multidimensional Quality of Life: A New Measure of Quality of Life in Adults

This paper presents a new measure for assessing quality of life (QOL) –the Multidimensional Quality of Life (MQOL)– and describes its derivation, characteristics, structure and several applications. Reasons for developing the MQOL include the restricted range of assessed domains and the heavy emphasis on health in many standard assessment tools. The MQOL was derived by meaning probes into QOL in different samples. It is a 60-item self-report tool of high reliability and validity covering various themes and forming, in line with factor and cluster analyses, 17 scales that constitute five factors according to confirmatory factor analysis. It has been applied with thousands of individuals, in English, Hebrew, Russian and Arabic, and is adequate for healthy and physically or mentally sick individuals, under regular or challenging circumstances. Described studies present findings in samples of sick or healthy individuals (e.g., unemployed, members of a collapsing Kibbutz); relations between the MQOL and coping strategies in partners of sick individuals; and interrelations of overall and scale scores in new and old immigrants. Conclusions focus on the structure of the MQOL, the specificity of coping effects, and the stabilizing mechanisms of QOL.     

The health expectancies of older Australians

Health expectancies of the states ‘Disability-free’ and ‘Disabled’ are estimated for Australian females and males aged 60 and over, both by cohort from 1980 and current for survey years 1981, 1988, 1993 and 1998. Modifications of recently developed logistic regression techniques are used rather than the standard 1971 method due to Sullivan. Results from the three later surveys are broadly similar and differ in important respects from those of the 1981 survey. Based on the last three surveys our estimates support the view that, depending on age, two-thirds or more of the increase in female life expectancy over the decade 1988–1998 is spent in the Disabled state. The situation is worse for elderly men, for whom all of the increased years of expected life are estimated to be spent in the Disabled state. The findings do not support rectangularization of the survival curve or Disability-free survival curve.     

Health Condition and Quality of Life in Older Adults: Adaptation of Qolie-89

This study aimed at adapting the Questionnaire Quality of Life in Epilepsy (QOLIE-89 version 1.0: Vickrey et al., 1993), Quality of Life in Epilepsy QoLIE-89 RAND (Santa Monica, CA)] so that it may be used to measure quality of life (QoL) of older adults, healthy or suffering from various chronic illnesses. The participants were 202 older adults recruited from the Pathology Clinic of a general hospital in Thessaloniki, Greece, and from Community Centers for Older adults. The mean age was 71 years. Of them, 51 suffered from diabetes, 50 from cardiovascular disease, 52 suffered from arthritis/myoskeletal diseases, and 49 were healthy. The QOLIE-89 inventory comprises 89 items that measure 17 topics. Exploratory factor analysis revealed 3 factors, namely, health (i.e., physical health and functioning), cognition, and social behavior. Cronbach’s α for the various topics in each group of participants ranged from 0.60 to 0.90 with a number of exceptions with very low α. Concurrent validity was tested through correlations with measures of subjective well being, affect, life satisfaction, and adaptation to old age. A series of ANOVAs showed differences between the healthy and the chronic illness groups of participants but no clearcut differences between the three chronic illness groups. Further study on the adaptation of QOLIE-89 is needed so that its potential as a general measure of QoL in older adults is determined.