Self-Efficacy,Pulmonary Function,Perceived Health and Global Quality of Life of Cystic Fibrosis Patients

This study examined the extent that pulmonary function is related to perceived health status and global quality of life in adults suffering from cystic fibrosis, and the extent that self-efficacy modifies these relationships. Our sample comprised 86 adults (48% female; mean age, 29 years; age range, 18–54 years) with cystic fibrosis, recruited from the Norwegian Competence Centre for Cystic Fibrosis (83% response rate). Both subjective data on psychosocial aspects of living with cystic fibrosis, and objective data on pulmonary function (FEV1%) were assessed. Psychosocial aspects were assessed by a questionnaire that included St George’s Respiratory Questionnaire (perceived health status), the Generalized Self-Efficacy Scale (perceived self-efficacy), and the Quality of Life Scale (global quality of life). We found that self-efficacy is an additional factor explaining health status and global quality of life. Pulmonary function is important for health status, but not for global quality of life, for which perceived self-efficacy and health status are the most significant variables. These results show that self-efficacy is as important as pulmonary function for the perceived health status and global quality of life of patients. These valuable findings should be considered in the treatment and care of adult patients suffering from cystic fibrosis.     

Perceived Quality of Life and Self-Rated Health among First-Year University Students

This study compares health status and qualityof life assessments of first-year universitystudents with those of their same-age workingcounterparts. Subjects and materials for eachgroup were gathered in 1999 from twocross-sectional data sets from the Swedishregion of Östergötland, covering malesand females aged 20–34 years. Subjects'perceived quality of life (QoL) and self-ratedhealth (SRH) were assessed on a 10-point scale(Ladder scale) and a five-point scale,respectively. Gender-based comparison revealedthat, for both males and females, first-yearuniversity students' average perceived QoL waslower than that of their working counterparts(p < 0.0001 in all instances). A higherproportion of students than expected ratedtheir health as ``average' or as ``low'(p < 0.0001). Perceived QoL was significantlycorrelated with SRH in both groups. Differencesin perceived QoL and SRH exist between studentsand their full-time working peers, and thedeterminants of these differences deservesgreater attention. Knowledge of thedeterminants of SRH and perceived QoL amonguniversity students might then be translatedinto sound and effective public-health practiceand intervention programs.     

Health and the Quality of Life

The aim of this investigation was to explain theimpact of peoples self-reported health on theirlevels of satisfaction with their health, and theimpact of these things plus satisfaction with otherspecific domains of their lives on the perceivedquality of their lives. The latter was operationalized as general happiness, satisfactionwith life as a whole and overall satisfaction with thequality of life. Seven hundred and twenty-three (723)usable questionnaires returned from a mailout randomsample of 2500 households of Prince George, BritishColumbia in November 1998 formed the working data-setfor our analyses. Among other things, mean respondentscores on the SF-36 health profile were found to belower than published norms from the UK, USA,Netherlands and Sweden, but higher than scores fromAberdeen, Scotland. Mean scores on the CES-Ddepression scale also indicated that our respondentstended to have more depressive symptoms thancomparison groups in Winnipeg and the USA. A review oftrends in mean scores on 17 quality of life items(e.g., satisfaction with family life, financialsecurity, recreation, etc.) from 1994, 1997 and 1998revealed that there were only 7 statisticallysignificant changes across the four year period andthey were all negative. Multivariate regressionanalysis showed that health status measured with avariety of indicators could explain 56% of thevariation in respondents reported satisfaction withtheir health. A combination of health status plusdomain satisfaction indicators could explain 53% ofthe variation in respondents reported happiness, 68%of reported life satisfaction and 63% of reportedsatisfaction with the overall quality of life. Sixtypercent of the explained variation in happiness scoreswas attributable to self-reported health scores, whileonly 18% of the explained variation in satisfactionwith life and with the overall quality of life scoreswas attributable self-reported health scores.     

Impact of Arts-Related Activities on the Perceived Quality of Life

The aim of this investigation was to measure the impact of arts-related activities on the perceived or experienced quality of life. In the fall of 2006 a questionnaire was mailed out to a random selection of 2000 households in each of five British Columbia communities, and 1027 were returned completed. The total and individual community samples should be regarded as merely representative of some British Columbian residents who had some interest in the arts. Sixty-six kinds of arts-related activities were identified in the questionnaire, and five indexes were created to help explain people’s motives for engaging in such activities. Seven different scales were used to measure respondents’ overall assessment of their lives, (1) self-reported general health (5-point scale), (2) satisfaction with life as a whole (7-point scale), (3) satisfaction with the overall quality of life (7-points), (4) happiness with life as a whole (7-points), (5) satisfaction with life as a whole (5-item index), (6) contentment with life (5-item index), (7) subjective wellbeing (4-item index). In the context of all our predictors, based on the relative impact of all the arts-related activities and the satisfaction obtained from those activities on our seven overall life assessment variables, it is fair to say that such activities and their corresponding satisfaction contributed relatively little. While this may seem incredible (especially to arts enthusiasts), it is important to keep in mind the initial condition “in the context of all our predictors” and the qualifier “relatively”. Our inability to discover greater marginal or total impacts of arts-related activities on the perceived quality of life may be the result of our use of the wrong search instruments for the great variety of values involved. It is an open question whether we used the best tools and found as much as there was to find or whether better tools would have found more.     

Arts and the Perceived Quality of Life in British Columbia

The aims of this investigation were (1) to measure the impact of arts-related activities on the perceived quality of life of a representative sample of British Columbians aged 18 years or more in the spring of 2007, and (2) to compare the findings of this study with those of a sample of 1,027 adults drawn from five B.C. communities (Comox Valley, Kamloops, Nanaimo, Port Moody and Prince George) in the fall of 2006. Seven hundred and eight British Columbians responded to a mailed out questionnaire, and the working data set was weighted by age and education to match the 2006 census statistics for the province, yielding a fairly representative sample. Speaking quite generally, about 62.0% of the results for the two samples are very similar. In particular, in both surveys we found that (a) among arts-related activities in which people participate relatively infrequently (i.e., participation is counted in times per year rather than in hours per week), live theatre is supreme in the strength of its positive correlation with respondents’ perceived quality of life measured in 7 different ways, and (b) compared to 4 demographic variables (age, education, household income and body mass index), household income had the highest average, positive correlation with 7 different measures of respondents’ overall life assessments, namely, self-assessed general health, satisfaction with life as a whole (single item), happiness, satisfaction with the quality of life, satisfaction with life as a whole (5-item index), contentment with life (5-item index) and subjective wellbeing (4-item index). Different results were found in the province-wide versus the five-communities survey for the following, among other things, (a) compared to all 7 life assessment measures, for the province, satisfaction with the quality of life and happiness had the largest number of significant correlations with arts-related activities measured in hours per week engaged, while for the five communities, the single measure of satisfaction with the quality of life had the largest number of significant correlations, and (b) For the province, compared to all 7 life assessment measures, satisfaction with the quality of life had the largest number of significant correlations with arts-related activities measured in times per year engaged; for the five communities, compared to all 7 life assessment measures, self-assessed general health had the largest number of significant correlations with arts-related activities measured in times per year engaged.     

Assessing the Psychometric Properties of Both a Global and a Domain-Specific Perceived Quality of Life Measure When Used with Youth Who Have Chronic Conditions

The purpose of this paper was to assess the psychometric properties of the Students’ Life Satisfaction Scale (SLSS) and the Brief Multidimensional Students’ Life Satisfaction Scale (BMSLSS) when used with youth who have chronic conditions. Baseline data from a longitudinal study examining predictors of changes in perceived quality of life (PQOL) for youth with chronic conditions were used. SLSS and BMSLSS data were collected on over 400 youth aged 11–17 using youth self-report and parent proxy-report versions. Internal consistency, convergent validity, and factor structure were examined for both versions. Extent of agreement and magnitude of differences between youth and parent report were evaluated. Finally, gender, age, and condition group differences in youth report scores were examined for the SLSS and BMSLSS. Strong internal consistency was demonstrated for the youth and parent reports of both measures. As with normative samples, a single factor structure was found for youth and parent reports of the BMSLSS. However, both youth and parent reports of the SLSS had a two-factor structure: one consisting of five positively worded items, and the other, two negatively worded items. Youth reported their PQOL to be significantly higher than did their parents. Significant differences in PQOL scores for the youth report were not found by age, gender, or conditions. Findings show that, from a psychometric standpoint, the BMSLSS (both youth and parent report) is a promising measure of PQOL for use in population-based research with youth who have chronic conditions. The SLSS may need to be revised to exclude negative items when used with this population of youth.     

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.     

Using Quality of Life Criteria to Define Urban Areas in Catalonia

The purpose of this paper is to develop the concept and definition of multidimensional urban areas, thereby providing insights into our understanding of the sub-regional structures of household spatial systems. Hence, we propose a framework for strategic planning that considers several areas of household needs. In order to achieve this goal, we develop a multicriteria methodology to define the territorialisation of the region of Catalonia (Spain). We first analyse the different methodologies used to define territorial areas based on economic criteria, for example, those used to construct travel-to-work areas (TTWA), among other methods. Thus, in practice several criteria and techniques are used to organize a territory, including administrative areas, commuting-based algorithms, and gravitational techniques. Finally, these points help us build a system of multicriteria urban areas that is consistent with the overall use of time by individuals.

A Par Approach to Quality of Life: Modeling Health through Participation

Social Indicators Research -     

Perceived Family Life Quality in Junior Secondary School Students in Hong Kong

The present longitudinal study examined perceived family functioning and related socio-demographic correlates from the perspective of adolescents in Hong Kong. Results showed that adolescent perceptions of family functioning based on different indicators gradually deteriorated over time. Regarding the socio-demographic correlates, (a) boys had more favourable perceived family functioning than did girls; (b) adolescents from non-intact families had poorer perceived family functioning than those from intact families; and (c) economically disadvantaged adolescents had poorer perceived family functioning than non-economically disadvantaged adolescents. Results also revealed that adolescents’ perceived family functioning was positively related to positive youth development. Analyses further indicated that perceived family functioning and positive youth development were concurrently and longitudinally related.     

The Perceived Role of ICTs in Quality of Life in Three Chinese Cities

This study assesses the perceived role of information and communication technologies (ICTs) including the Internet, mobile telephone, CD/MD/MP3, television and VCR/VCD/DVD in raising quality of life (QoL). A comparison is made between three Chinese cities, namely, Beijing, Taipei and Hong Kong, to see if differences exist in the perceived value of various forms of ICTs in the three cities, which share Chinese culture but different levels of development. Household interviews with probability samples were conducted in the three cities in 2002–2003. The findings show that the Internet and mobile phone are considered as the most and second most important medium respectively in raising quality of life in all three cities, while television ranks third and other ICTs trail behind. Based on the findings, the authors advance four propositions for the perceived role of ICTs in QoL. First, there are four basic needs related to ICT’s role in QoL. These “ICT-QoL” needs are the need for interaction, need for being in touch, need for instantaneous communication, and need for entertainment. Second, people’s assessment of an ICT’s value in raising their QoL varies with the penetration rate of that ICT—the higher the penetration, the more positive is the assessment of that ICT’s role in QoL. Third, the perceived value of an ICT in QoL declines with time—the longer the ICT has been around after reaching full penetration rate, the lower the value is attached to its contribution to QoL. Finally, education has strong influences on the assessment of the Internet’s role in QoL. Highly educated people tend to value the Internet most as a QoL raiser irrespective of the city they reside in. As a QoL raiser, the Internet is favored more by highly educated while mobile and fixed phone are favored more by lowly educated people.     

Stability and Sensitivity in Perceived Quality of Life Measures: Some Panel Results

The aim of this study was to test a fundamental assumption concerning 27 of the most frequently used measures to assess aspects of the quality of people’s lives, e.g., measures concerning happiness, satisfaction with life as a whole, with the quality of one’s life, with domains of life (job, marriage, friendships), and with perceived gaps between what one has compared to what one wants, what one’s neighbor has and so on. The assumption is that such measures are sensitive to changes in the circumstances of one’s life measured by self-perceptions of change and by self-assessments of the net balance of salient positive and negative events one has experienced in some specified period of time. A total of 462 residents of British Columbia distributed across 3 different panels completed mailed-out questionnaires at 3 points in time in 2005, 06 and 07. Among other things, we found that measuring year-by-year changes in respondents’ life circumstances by reports of their own perception and experienced life events, on average the values of the 27 variables changed in ways that were consistent with respondents’ reported changes in 49.7% of the cases examined. The success rate of the assumption using self-perceptions of change (61.7%) was much higher than the success rate using a net balance of experienced events (37.3%).     

Quality of Life and Quality of Living Conditions in Rural Areas: Distinctively Perceived and Quantitatively Distinguished

In the last decades, large amount of effort and resources have been spent in projects and programs aiming to develop rural communities. The ultimate goal of such projects is supposed to be the improvement of the Quality of Life (QOL) of these communities. Although improving the Quality of the Living Conditions (QLC) is an acceptable strategy to reach that goal, all too often there is significant confusion between the two concepts. In this paper we argue that QLC and QOL can not be dissociated, but they are distinct. Our hypothesis is that we can make this distinction objectively. For that purpose, we develop an Index of the Quality of Living Conditions (IQLC) and an Index of the Quality of Life (IQOL). Each index is obtained by combining partial indicators of the conditions of several aspects in several dimensions (e.g., social, environmental, and economic). While the assessment of living conditions to obtain the IQLC is done by project staff, the IQOL is based on the manifestation of the farmers about their satisfaction in living those conditions. The IQLC and the IQOL result, then, from different views of the same aspects of life in a given context. Therefore, their objective measurement can be a useful instrument to evaluate the effectiveness of improvements on living conditions proposed by institutions and their professionals to improve the quality of life of rural communities.     

Models of the Joint Structure of Domain-Related and Global Distress: Implications for the Reconciliation of Quality of Life and Mental Health Perspectives

Research on subjective wellbeing includes studies of both domain-related and global distress. The mental health literature, though, focuses almost exclusively on global distress. This seems to be partly due to a common belief that psychological distress, and the moods that comprise distress, necessarily lack referential content. However, if that were the case it would make little sense for any study to ever focus on domain-related distress. The research presented in this report clarifies the relation between global and domain-related distress. We compare confirmatory factor analytic models of the joint relationship among symptoms of global distress with affective symptoms of distress about work, home, and physical appearance. Data are from a general population telephone survey. In the best-fitting models domain-related distress and global psychological distress are related but distinct latent variables. We discuss the theoretical and methodological implications of the models, and model choice.     

Reliability and Validity of the World Health Organization Quality of Life: Brief Version (WHOQOL-BREF) in a Homeless Substance Dependent Veteran Population

With the high number of homeless, there is a critical need for rapid and accurate assessment of quality of life to assess program outcomes. The World Health Organization’s WHOQOL-100 has demonstrated promise in accurately assessing quality-of-life in this population. However, its length may make large scale use impractical for working with a homeless population. The World Health Organization Quality of Life—Brief version (WHOQOL-BREF), though providing a shorter instrument and being, theoretically, more manageable has not been evaluated for use with homeless individuals. This study evaluated the psychometric properties of the WHOQOL-BREF in 389 homeless veterans. Adequate internal consistency for all domains was found and validity for each domain was supported using the Personality Assessment Inventory. The WHOQOL-BREF provides a reliable, valid, and brief assessment of quality-of-life. Due to the length of the instrument and the domains covered, it could have great utility in the assessment of homeless populations with multiple problem domains.     

A Gender Lens on Quality of Life: The Role of Sense of Community,Perceived Social Support,Self-Reported Health and Income

Quality of life (QoL) refers to a subjective evaluation that is embedded in a cultural, social and environmental context. It is a multidimensional concept and its assessment covers four domains: physical health, psychological health, social relationships, and environment. Although many studies report on QoL, literature rarely addressed the question of the QoL predictors from a gender perspective. Present study aimed at investigating gender differences in the determinants of QoL. Specifically, gender was considered as a moderator in the relationship between predictors of QoL (i.e. socio-demographic characteristics, perceived health, income, social support and sense of community) and each dimension of QoL. 654 Italian adults participated in the study. Results show that men outscore women on the physical, the psychological and the environmental domains of QoL. Considering determinants of QoL, sense of community and self-reported health operate in a similar fashion for both genders. On the contrary, social support is more predictive for women’s QoL, whereas the income level is more significant for men’s QoL. Implications are discussed.     

Health and Other Aspects of the Quality of Life of Older People

Celebrating the United Nations' International Year of Older Persons, in September 1999 a survey research project was undertaken throughout the Northern Interior Health Region (NIHR) of British Columbia. A total of 875 people completed 23-page questionnaires, the average age of the respondents was 69 and the range ran from 55 to 95 years. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 74.4. This mean was practically identical to that of the United States norm for such people (74.5) and lower than that for the United Kingdom (77.4). For male respondents aged 65 and older, the mean was 68.3. This was numerically higher but again practically the same as that of the norm for the United States (68.1). For females aged 55–64, the mean score for 8 dimensions was 73. This was superior to that of the United States norm of (70.6) for such people and lower than that for the United Kingdom (74.6). For female respondents aged 65 and older, the mean score was 65.4. This was practically identical to that of the United States (65.5).Comparing 18 average figures for our respondents on satisfaction with specific domains of life (e.g., financial security, health, friendships) and life as a whole with those of average adults in Prince George in November 1999, we found that in all but two cases the older people's scores were higher. Only in the cases of satisfaction with health and overall happiness were older people's scores lower, and the differences were not statistically significant.Eleven percent of our respondents reported that they had been a victim of a crime in the last year, compared to 38% in our 1997 adult victimization survey. Older people had a more benign view than ordinary adults of the growth of crime in their neighbourhood and city, although exactly 64% of both groups thought that crime had increased in Canada. Although older people had a more optimistic view than other adults of the increase in crime in their neighbourhoods, fewer of the former than the latter felt safe out at night. Nevertheless, compared to adults surveyed in 1997, the behaviour of respondents in our survey of older people was not as constrained by concerns of criminal victimization.Two or three of the 8 SF-36 health dimensions explained 37% of the variation in life satisfaction scores, 34% of variation in happiness scores, 34% in satisfaction with the overall quality of life scores and 22% in satisfaction with one's overall standard of living. In every case, Mental Health was the dimension that had the greatest impact on our four dependent variables.When all of our potential predictors were entered into a regression equation simultaneously, we found that they could explain 60% of the variance in life satisfaction scores, 44% in happiness scores, 58% in satisfaction with the overall quality of life scores and 59% in satisfaction with one's overall standard of living scores.     

Determinants of Health and the Quality of Life in the Bella Coola Valley

The aim of this investigation is to obtain some baseline self-reported data on the health status and overall quality of life of all residents of the Bella Coola Valley of British Columbia aged 17 years or older, and to measure the impact of a set of designated health determinants on their health and quality of life. In the period from August to November 2001, a variety of procedures were used to ensure that all eligible residents of the Valley received a copy of our questionnaire, and 687 useable questionnaires were obtained for our working dataset. Health status was measured by SF-36 and the U.S. Centers for Disease Control healthy days items. Thirty-one items were used to measure the Provincial Health Officer’s designated determinants of health in four clusters, namely, biological, social and economic, health behaviours and health services determinants. Quality of life was measured by satisfaction levels in 13 specific domains of life (e.g., family, financial security), four global items (e.g., happiness, life satisfaction) and one global Subjective Well-Being Index. Besides obtaining baseline figures on all our measures for the Valley, we made some comparisons among our figures and those from other areas, e.g., Prince George, BC. Most of the measures indicated that the health status and quality of life of Bella Coola Valley residents were lower than those of Prince George residents. For the sample as a whole, SF-36 scores on the eight dimensions ran from 82.3 (physical functioning) to 50.0 (social functioning), with a mean of 62.7. Residents in the Valley averaged 6.5 days in the past 30 in which their health was physically not good, 5.5 days when it was mentally not good and 4.1 days when their health limited their usual daily activities. Eleven percent of respondents described their general health as “excellent” and another 27% said it was “very good”. On a 7-point scale from 1=very dissatisfied to 7=very satisfied, respondents had average life satisfaction and satisfaction with the overall quality of life scores of 5.5. For specific domains of life, the lowest mean level of satisfaction was reported for federal and provincial government officials (3.3) and the highest was reported for living partners and personal safety around home (5.8). Regarding bivariate relations, each of the eight dimensions of SF-36 was significantly correlated with a single item measure of general health, and five of the eight were significantly correlated with the number of good health days. Happiness and the Subjective Well-Being Index were positively but moderately correlated with six of the eight dimensions, and life satisfaction was positively correlated with five. 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 the Subjective Well-Being Index. Education was positively related to the four global health measures but not to the three global quality of life measures. The Social Support and Good Family Indexes were positively related to all seven global measures. There was a positive correlation between six of the seven global measures and the frequency with which respondents participated in activities sponsored by voluntary organizations. Frequency of smoking was negatively associated with every global dependent variable except the Physical Health Index. Frequency of skipping meals was negatively associated and average hours of sleep per night was positively associated with all seven global measures. Turning to multivariate relationships, the four clusters of health determinants explained from 12% (SF-36 Mental Health Index) to 24% (general health) of the variance in the dependent global health variables, and from 20% (happiness) to 26% (Subjective Well-Being Index) of the variance in the dependent global quality of life variables. Adding domain satisfaction scores to the total set of predictors allowed us to explain from 20% (SF-36 Mental health Index) to 29% (general health) of the variance in the dependent global health variables, and from 39% (happiness) to 62% (life satisfaction) in the dependent global quality of life variables. By including measures of social support and good family relationships in our set of health determinants, we practically guaranteed that the latter would be relatively strongly predictive of global quality of life.