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.     

Do We Need to Weight Item Satisfaction by Item Importance? A Perspective from Locke’s Range-Of-Affect Hypothesis

Importance weighting is a common idea in quality of life (QOL) measurement. Based on the common idea that important domains should have more contributions to individuals’ QOL total score, the weighting procedure of multiplying item satisfaction by item importance was adopted in many QOL instruments. However, in Locke’s [1969, Organizational Behavior and Human Performance 4, pp. 309–336; 1976, in: M.D. Dunnette (eds.), Handbook of Industrial and Organizational Psychology (Rand McNally, Chicago), pp. 1297–1343] range-of-affect hypothesis, he indicated that the satisfaction evaluation of an item was determined by the have–want discrepancy, importance and their interaction (discrepancy × importance), implying that item satisfaction has incorporated the judgment of item importance, therefore, weighting an item satisfaction score with an item importance score is unnecessary. The purpose of this study was to examine the range-of-affect hypothesis in the context of QOL research. Three hundred and thirty two undergraduate students at National Taiwan University (NTU) participated in the study. Item satisfaction, importance and perceived have–want discrepancy were measured for 12 different life-area items. Global life satisfaction was measured as well. Regression analysis results showed that item importance and perceived have–want discrepancy have a significant interaction effect on item satisfaction, supporting Locke’s range-of-affect hypothesis. In addition, regression analysis results also showed that item importance and item satisfaction did not have a significant interaction effect on global satisfaction, suggesting that weighting item satisfaction score by item importance value does not have advantages in predicting global satisfaction. In a summary, the findings revealed that item satisfaction has incorporated the judgment of item importance, and, thus, the procedure of importance weighting on item satisfaction is unnecessary.     

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

Social Indicators Research - Objective: To explain the global quality of life (QOL) from 2000 indicators representing all aspects of life. Design and setting: Two cross sectional population...     

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.     

The systemic life quality model: A basis for urban renewal evaluation

This paper develops, on the basis of explicit assumptions and axioms, a conceptual framework for observing the effectiveness of functioning of action systems, and, in particular of the human individual. The framework is used to construct a facet definition of human quality of life (QOL) which is claimed to be exclusive and exhaustive: The contents of the observational items it produces do not overlap and cover the entire QOL universe. A specification of two facets: the subsystem facet (personality, physical, social, cultural-value) and the functioning mode facet (expressive, adaptive, integrative, conservative) results in 16 content areas, each of which can be represented or covered by an observational item. The systemic QOL measuring represented or covered by an observational item. The systemic QOL measuring instrument is examined with respect to its reliability and validity. Structural hypotheses whose rationale is grounded in the elementary considerations that led to the systemic model of QOL are formulated, tested and are largely confirmed. Finally, the systemic QOL model is applied to the evaluation of life quality and environmental conditions in a neighborhood designated as “distress neighborhood” within national urban renewal project.     

Satisfaction Ratings of QOLPAV: Psychometric Properties Based on the Graded Response Model

A scale measuring quality of life (QOL) is important in adolescent research. Using the graded response model (GRM), this study evaluates the psychometric properties of the satisfaction ratings of the Quality of Life Profile Adolescent Version (QOLPAV). Data for 1,392 adolescents were used to check IRT assumptions such as unidimensionality and local item dependence (LID). The goodness of fit of the GRM to the data and the item characteristic curves were evaluated. The reliability and validity analyses included item/test information, Cronbach’s α, and convergent and discriminant validity. Differential item functioning (DIF) procedures were also performed to detect item bias. The results provide evidence that the items sufficiently measured one single dimension. Few pairs of questions were flagged as LID due to content or wording similarity. Five items did not fit the GRM, and 4 were low in item discrimination. The findings also suggest that the assessment had appropriate reliability and validity. The DIF impact on the assessment score was considered minor. Because QOLPAV includes a respondent’s perceived importance of various life aspects, a short form that only considers important life aspects in the overall QOL estimation for each respondent becomes feasible within the framework of IRT. Future studies focusing on the development of a QOL overall index using the items from QOLPAV are recommended.     

Optimally Scaled Quality-of-Life Indicators

When studying quality of life, researchers have to rely on the subjective evaluations, which are typically categorized, collected in surveys. When statistical analysis are applied to these data, they used to apply the simplistic approach including (i) direct quantification, which assigns discrete numerical values to ordinal response scale, and (ii) complete-case analysis, which discards all observations selecting any of the off-scales choices like Dont Know No Answer from the analysis. The present paper examines the disadvantages of this approach and introduces the optimal scaling method as a remedy. The new scheme attempts to restore the continuity property of the measurements as well as provide estimates for most of the missing responses. Application of the new scheme to the Hong Kong QOL data illustrates how the scheme works, demonstrates its advantages and shows how the QOL indicators, the global QOL indicator as well as its inherited indicators, can be constructed from series of principal component analyses. Factor analysis of the 20 life domain indicators verifies Wan's opinion (1992) that the global sense of well-being can best be captured by two dimensions, namely the personal well-being and the societal well-being. Although previous QOL studies had seldom included perceptions towards various societal conditions to identify life satisfaction in general, our data analysis shows that satisfaction on these conditions do constitute an important component of the global QOL.     

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.     

Basic Minimum Needs,Quality of Life and Selected Correlates: Explorations in Villages in Northern India

For those involved in international development, one of the major goals is an improvement in the quality of life of the poor. Bhargava and Chakrabati (1992: 133) see the “primary objective of development at any given time is to improve the quality of life”. Indeed, the mission statement for an international development organization explicitly commits itself to the improvement of the quality of life for the “poorest of the poor” (DID, 1994). Social indicators, as “transeconomic” measures of quality of life, have “become an integral part of 'development indicators”' (Kao and Liu, 1984: 400; see, also Kahn, 1991). The connection between quality of life and development extends beyond the Third World. For example, in the U.S. Myers (1987) found quality of life influenced inmigration to Austin, Texas, thus affecting its economic development. Undoubtedly the majority of the connections between social indicators and development has been examined at the macro, or national levels using economic, health, education and other objective, comparative indices. Recognizing that such measures as GNP are oftentimes inadequate, assorted indices have been derived to gauge the changes in social development over time, e.g., the well-known Physical Quality of Life Index (PQLI) constructed by the Overseas Development Council (Morris, 1976). Many of these tend to focus on objective, material indicators (commodity possessions) as opposed to the more subjective ones (Anand and Ravallion, 1993). It is not the purpose of this paper to examine the various critics' arguments about the strengths and weaknesses of extant macro versus micro indices, but rather to lend support for the general need to assess development and social change through social indicators, whether macro or micro, objective or subjective. Ultimately, the purpose of the assessment should guide which social indicators are selected. The purpose of this paper is to examine several issues arising from the linkages between development efforts and quality of life (QOL). Using empirical data which were gathered to evaluate a community development project in the Garhwal region of Northern India, several issues, germane to both social indicators and development, will be investigated. These include: (1) the relationship between “Basic Minimum Needs” (BMNs) and QOL, (2) some methodological innovations for measuring both BMNs and QOL, and (3) selected correlates of BMNs and social indicators of QOL for Garhwali villagers. Before describing the project and its findings, we will first place it in the overall development context.     

Ideology and social indicators of the quality of life

This paper explores the possibility that social-psychological, evaluative measures of social well-being/quality of life (QOL) perceptions may embody unintended ideological elements. We argue that individual QOL satisfactions are likely caused, in part, by ‘satisfactions’, or conservative orientations, vis-à-vis societal institutions. Four dependent measures of QOL attitudes-overall life satisfaction, service satisfaction, community satisfaction, and powerlessness-are derived from factor analyses and established measurement procedures. Each of these QOL indicators is found to exhibit significant bivariate associations with measures of political-economic ideology. These relationships are somewhat reduced, but persist at statistically significant levels, when socio-demographic background variables are held constant. We then discuss the implications of our results for theory and method in the social indicators field.     

A DEA Approach to Measure the Quality-of-Life in the Municipalities of the Canary Islands

The notion of the quality of life has always intrigued economists, sociologists and other researchers in the area of social science. Since the genesis of the definition of Gross Domestic Product (GDP) as a truthful measure of well-being and economic development, other sophisticated methodologies have been proposed in the literature to measure the quality-of-life (QOL) that extend in a multidimensional way this complex concept. Measuring QOL in municipalities consists in finding a set of comparable attributes that can be weighted by some metric in order to construct a synthetic index. Thus, the narrow vision obtained by a single measure as the GDP, in which differences in the QOL cannot be fully analyzed, is overcome. Based upon a refinement of data envelopment analysis (DEA)—the cross-efficiency method, the current paper develops a synthetic QOL index that is based in 19 partial indicators which present the tradeoffs of different dimension for the 87 municipalities of the Canary Islands in Spain. Marginal rates of substitution are calculated to evaluate the tradeoffs on QOL dimensions. A method is also proposed to determine the scores chart of each municipality which can be used as a tool to policy makers in order to establish a program of improving the ranking position of the municipality identifying the critical QOL factors.     

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     

A Comparison of Alternative Models of Individual Quality of Life for Social Service Recipients

There is considerable debate in the area of individual quality of life research regarding the factor structure of the QOL construct that is focused on the number and composition of QOL factors and domains, and its hierarchical nature. The main goal of this study involve testing by means of confirmatory factor analyses five models that have been pointed out by recent scientific literature: firstly, an unidimensional model; secondly, a QOL model that consisted of eight inter-correlated domains proposed by Schalock and Verdugo (2002); thirdly, a model composed of these eight 1st-order factors and one 2nd- order factor; the forth and five are model with the eight 1st-order factors and three 2nd-order factor that has been denominated in other studies ‘Salamanca model’ and ‘Schalock model’. Data were collected from 3.029 social service recipients from Catalonia (Spain) who completed the GENCAT Scale, an objective QOL questionnaire. The best fit of the eight inter-correlated and 1st order domains was empirically demonstrated. Implications for future research are also discussed.     

Yea-saying and mood-of-the-day effects in self-reported quality of life

This paper focuses on some of the complications that may arise from errors of measurement in quality of life (QOL) scales based on self-report. It is argued that systematic errors as well as random errors (specifically in the shape of mood-of-the-day effects) will tend to suppress, mask or “wash out” statistical associations between “objective”, sociologically relevant, indicators of well-being and self-reported quality of life. Results from a Norwegian sample of middle-aged and old participants in a health screening operation (N=610) are reported. The findings indicate that response acquiescence (“yea-saying”) may be a source of systematic error even in balanced QOL-scales, and that this bias may lead one to underestimate QOL among the well-educated and overestimate it among older respondents. Utilizing over-time data we are able to show that self-reported QOL appears particularly vulnerable to mood-of-the-day effects among younger females. Implications for sociological research on subjective well-being are pointed out.     

Further Validation of the Sirgy et al.'s Measure of Community Quality of Life

Sirgy et al. (2000) have developed a measure ofcommunity quality of life (QOL). This measurecaptures residents' satisfaction withcommunity-based services in the way that theseservices contribute to global satisfaction withthe community and overall life satisfaction. The measure was validated nomologically bytesting hypotheses directly deduced from atheoretical model that relates residents'satisfaction with community-based services withglobal community satisfaction and global lifesatisfaction. The study reported in this paperreplicates and extends Sirgy et al.'s (2000)study. Specifically, the conceptual model thatwas used to test the nomological (predictive)validity of the community QOL measure wasfurther expanded and refined. The modifiedmeasure is based on the theoretical notion thatsatisfaction with the community at large(global community satisfaction) is mostlydetermined by satisfaction with governmentservices (police, fire/rescue, library, etc.),business services (banking/savings, insurance,department stores, etc.), nonprofit services(alcohol/drug abuse services, crisisintervention, religious services, etc.), aswell as satisfaction with other aspects of thecommunity such as quality of the environment,rate of change to the natural landscape, racerelations, cost of living, crime, ties withpeople, neighborhood, and housing. In turn,global community satisfaction together withsatisfaction with other overall life domains(work, family, leisure, etc.) affect globallife satisfaction. Survey data from a varietyof communities located in southwest Virginiawere collected to further test the nomologicalvalidity of the measure. The results providedadditional nomological validation support tothe community QOL measure.     

A human ecological approach to quality of life: Conceptual framework and results of a preliminary study

A human ecological framework for study of quality of life is proposed and used in the study of the QOL of a rural sample in northern Michigan. The framework is based on an ecosystem, i.e., the interaction of humans, the environed units, with their interrelated environments. These are conceptualized as: natural, human constructed and human behavioral. Quality of life indicators can measure aspects of the environed units, environments, and their interaction. Scales to measure perceived overall quality of life (POQL), community satisfaction (COMSAT), and the importance of and satisfaction with selected life concerns (SALI and SALS) were used. The life concerns represented human needs, attributes of the self, conditions and resources of the three environments, or implied interaction with or action upon the environment. Objectives were to study how these life concerns contributed to POQL; the relationship between SALI and SALS ratings and how this influenced POQL; the relationship between COMSAT and POQL; and whether or not satisfaction with these two variables varied by demographic characteristics. A relatively high POQL was found; those with higher incomes and children living at home had higher scores. COMSAT was also generally high, but did not vary by demographic characteristics. POQL and COMSAT were significantly related. Family life, health, safety, house, and financial security ranked highest in importance; clothing, spare time activities, and fun ranked lowest. Family life, religious faith, food work, and safety ranked highest in satisfaction; national government, financial security, developing oneself, health, and an interesting life ranked the lowest. The various life concerns appear) to behave differently in regard to how the discrepancy between importance of a concern and satisfaction with it influences overall quality of life. Satisfaction with accomplishments, family life, work and financial security accounted for over half the variance in POQL. These represent essential human needs which are satisfied with resources of the near environment, suggesting the salience of one's most proximate environment to evaluation of quality of life. Findings, while preliminary, illustrate the viability of a human ecological model as a unifying framework for conceptualization and measurement of quality of life. Further specification and elaboration of the model are indicated.     

Spiritual well-being: A neglected subject in quality of life research

The social indicators and quality of life (QOL) movements have given scant attention to religiosity, in spite of theoretical and empirical evidence that it is related to personal and social well-being. Reasons for this include the constitutional provisions pertinent to religion, problems of funding, the lack of measuring instruments, conceptual and theoretical difficulties, biases of researchers, and the lack of consensus regarding the definition of QOL. A partial solution to this neglec is to engage in conceptual, theoretical, qualitative, and empirical research on spiritual well-being (SWB). The authors indicate its potential and some initial steps toward bringing SWB into the QOL movement.     

Examining the appropriateness of importance weighting on satisfaction score from range-of-affect hypothesis: hierarchical linear modeling for within-subject data

This study examines the range-of-affect hypothesis in a within-subject context using the weighting situation faced in quality of life (QOL) measurement. Data collected in Wu and Yao’s (2006b) study were used (332 undergraduates at National Taiwan University). The mean age was 19.80 years (std = 1.98). They completed a QOL questionnaire and indicated satisfaction, importance, and perceived have–want discrepancy on 12 life domains. Hierarchical linear modeling with a random-coefficients regression model was applied. At the first level (within-individual level), the satisfaction scores for each item were regressed on the have-want discrepancy, importance, and the interaction between have-want discrepancy and importance (have-want discrepancy ×  importance) of the same item. At the second level (between-individual level), the intercept, coefficients of have-want discrepancy, importance and the interaction between have-want discrepancy and importance at the first level were regarded as varying randomly over all participants. 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. Implications for important weighting on item satisfaction scores were discussed.     

Leisure and quality of life in an international and multicultural context: what are major pathways linking leisure to quality of life?

This paper aims at advancing the conceptualization of leisure as a contributor to quality of life (QOL) in an international and multicultural context, based on an extensive and critical review of literature on leisure and QOL from a global, international perspective. Given the central role of culture in conceptualizing this notion, this paper gives attention to various cultural contexts world-wide. To illustrate the diversity of our societies, examples are introduced specifically from three culturally unique contexts in this paper – i.e., Asian, Middle-East, and Indigenous contexts. Also, some examples are drawn from other cultural groups in global and international contexts, particularly, in non-western contexts. Then, the final section of this paper aims at integrating and synthesizing the knowledge gained from this review to develop a tentative/working proposition about how leisure can contribute to QOL from international and cross-cultural perspectives. Specifically, based on such integration, this paper identifies and describes major pathways linking leisure to QOL. Overall, an overarching theme common to almost all cultural contexts examined appears to be the role of leisure-like activities as a context or space for creating meanings which then help to promote the quality of people’s lives. Major pathways or mechanisms that can facilitate meaning-making and life-quality-enhancement highlighted in this review include: (a) positive emotions and well-being experienced from leisure, (b) positive identities and self-esteem gained from leisure, (c) social and cultural connections and a harmony developed through leisure, and (d) leisure’s contribution to learning and human development across the life-span. Also, emphasized in this paper is the role of leisure as a context for realizing and utilizing human strengths and resilience. It is important, however, to stress that in people’s quest for a meaningful life, the benefits of meaning-making through leisure involve both “remedying the bad” and “enhancing the good,” as shown throughout this paper. Despite these benefits, we should not ignore that leisure experiences are socially and culturally constructed and shaped by the inequalities of society. Thus, the reality of power imbalance and inequalities should be acknowledged and appropriately addressed socially, culturally, and politically. Particularly, providing culturally relevant and meaningful leisure opportunities for less privileged population groups world-wide is clearly a top priority.