Comparison of Modes of Administration and Response Options in the Assessment of Subjective Health Using the First Question of SF-36

To compare two modes of administration (self-administered; by interviewer) and two response options format (using words; images of “facial-expressions”) of the first question of SF-36 (Q1SF-36), and to test its validity. We included 825 participants (20–90 years). Q1SF-36, using words or images, was included in a global questionnaire interview and at the end participants filled the SF-36. The agreement was tested by weighted kappa coefficients (WKappa). Classification Trees were used in the calibration of Q1SF-36 responses, with the physical (PDSF36) and mental dimensions of SF-36. Polyserial correlation coefficients and areas under the ROC curves (AUC) were used for validation. After categorization, using PDSF36 classification trees, the WKappa were 0.770 (self-administered vs. interviewer), 0.569 (self-administered vs. facial-expressions) and 0.566 (interviewer vs. facial-expressions). The WKappa between the PDSF36 and the modes (self-administered, interviewer and facial-expressions) were 0.784, 0.713 and 0.579 and the corresponding polyserial correlation coefficients were 0.784, 0.713 and 0.579. A good discriminatory power was found comparing the modes with the PDSF36 (AUC = 0.907, 0.923 and 0.827), but not with mental dimension (AUC = 0.538, 0.501 and 0.629). The Q1SF-36, by self-administration or interviewer, may be a valid alternative for assessment of subjective physical health, but not mental health.     

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.     

Body Image and Quality of Life in a Group of African American Women

African American (AA) women’s preference for a larger body size and underestimation of their body weight may affect the relationship between their body weight and weight-related quality of life (QOL). We wanted to examine the relationship between weight-related QOL and body mass index (BMI) in a sample of overweight AA women. Thirty-three overweight AA women completed a clinic visit to measure height, weight, and complete surveys including the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and the Stunkard Figure Rating Scale. BMI was calculated using measured height and weight. Correlations and linear regression models were estimated using SAS v 9.1. In this sample, the mean total quality of life score was 78.00 ± 17.68 on a 100 point scale. There was a modest correlation between BMI and total weight-related QOL (r = −0.034, p = 0.053). Body image dissatisfaction was the strongest predictor of total quality of life score (p = 0.04). African American women’s unique cultural perception of body image may play a key role in weight-related QOL.     

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.     

Family Structure and Self-Rated Health in Adolescence and Young Adulthood

While the relationship between family structure and child well-being is well-established, little is known about the specific impact of family structure on health in adolescence and young adulthood. Using data on 12,737 respondents from Waves I and III of Add Health, we examine the association between family structure (two biological/adoptive, stepfather, and single mother families at Wave I) and self-rated health in adolescence (Wave I) and young adulthood (Wave III). We build on previous literature by investigating whether the relationship between family structure and self-rated health is mediated by demographic background, socioeconomic status, parent–child relationships, external social support, and health characteristics and behaviors, and whether the influence of these factors endures into adulthood. Overall, we find that self-rated health is reduced for respondents who lived in stepfather or single mother families during adolescence, although this effect is attenuated in young adulthood. Family structure effects at both waves are explained by socioeconomic status, social support and competence, and health characteristics and behaviors. We find little evidence that demographic background or mother–child relationships mediate the relationship between family structure and self-rated health. By young adulthood, effects of most adolescent predictors are attenuated, but health assessments are largely influenced by changes in health characteristics and behaviors, and in family type.

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.     

Life Satisfaction of Older Adults in Hong Kong: The Role of Social Support from Grandchildren

This study explores the relationship between the life satisfaction of older adults and the social support from grandchildren in Hong Kong. Two hundred and fifteen older people (from the ages of 64 to 101, mean age 79.3), whose youngest grandchild was aged 12 or older, were recruited from elderly service agencies to participate in the study. Face-to-face interviews were conducted by trained interviewers using a standardized questionnaire, which included the Life Satisfaction Scale for Chinese, the Lubben Social Network Scale, the Chinese Tradition Scale, grandchildren social support measures, self-rated health, self-rated financial adequacy, and demographic variables. Hierarchical regression showed that the life satisfaction of older adults benefitted significantly from the social support from grandchildren (R ² change = .05, F _change = 7.15, p < .001); while controlling demographic characteristics, general social support, attitude towards Chinese tradition, self-rated health, and self-rated financial adequacy. The total explained variance was 51%. Emotional support and appraisal support from grandchildren were identified as significant contributing factors. The policy and practice implications for active aging policies are discussed in a Chinese context.     

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.     

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.     

Region of Birth and Disability Among Recent U.S. Immigrants: Evidence from the 2000 Census

This study aimed to test the “healthy immigrant” hypothesis and assess health heterogeneity among newly arrived working-age immigrants (18–64 years) from various regions of origin. Using the 5% sample of the 2000 U.S. Census (PUMS), we found that, compared with their native-born counterparts, immigrants from all regions of the world were less likely to report mental disability and physical disability. Immigrants from selected regions of origin were, however, more likely to report work disability. Significant heterogeneity in disabilities exists among immigrants: Those from Eastern Europe and Southeast Asia reported the highest risk of mental and physical disability, and those from East Asia reported the lowest risk of physical disability. Furthermore, Mexican immigrants reported the lowest risk of mental disability, and Canadian immigrants reported the lowest risk of work disability. Socioeconomic status and English proficiency partially explained these differences. The health advantage of immigrants decreased with longer U.S. residence.     

Young Adult Dating Relationships and the Management of Sexual Risk

Young adult involvement in sexual behavior typically occurs within a relationship context, but we know little about the ways in which specific features of romantic relationships influence sexual decision-making. Prior work on sexual risk taking focuses attention on health issues rather than relationship dynamics. We draw on data from the Toledo Adolescent Relationships Study (n = 475) to examine the association between qualities and dynamics of current/most recent romantic relationships such as communication and emotional processes, conflict, demographic asymmetries, and duration and the management of sexual risk. We conceptualize ‘risk management’ as encompassing multiple domains, including (1) questioning the partner about previous sexual behaviors/risks, (2) using condoms consistently, and (3) maintaining sexual exclusivity within the relationship. We identify distinct patterns of risk management among dating young adults and find that specific qualities and dynamics of these relationships are linked to variations in risk management. Results from this paper suggest the need to consider relational dynamics in efforts to target and influence young adult sexual risk-taking and reduce STIs, including HIV.     

Validation of the WeDQoL-Goals-Thailand Measure: Culture-Specific Individualised Quality of Life

The aim of this study was to validate an individualised measure of quality of life (WeDQoL-Goals-Thailand). Three hundred and sixty-nine Thai people completed the WeDQoL by interview. Respondents rated (0–2) the perceived necessity for wellbeing of 51 goals (goal necessity), then rated (0–3) their satisfaction with the same goals (goal satisfaction). Weighted goal attainment (possible range 0–6) was computed (necessity x satisfaction). Psychometric validation used frequency distributions, Principal Components Analysis (PCA), and Cronbach’s alpha. Analysis of variance, t-tests, Kruskal–Wallis, Mann–Whitney U, Spearman’s correlation and multiple regression explored socio-demographic, geographic and economic differences. Respondents were aged 15–89 (mean 45.7, SD 18.0); 169 men, 200 women. For weighted goal attainment scores, PCA found a 44-item scale (α = 0.91) and three subscales (community/social/health, α = 0.90; house and home, α = 0.80; nuclear family, α = 0.81). Thai Individualised Goal Attainment (TIGA) scale and the three subscales were computed as the mean of contributing weighted goal attainment scores, after excluding goals considered ‘not necessary’ to each individual. Unweighted and individualised scores differed significantly with socio-demographic, geographic and economic indicators. In multiple regression, both Thai Unweighted Goal Satisfaction (TUGS) and TIGA scale scores were predicted by being married, living in the South and in a non-urban location. TIGA scores were also predicted by being over 25 years old. WeDQoL-Goals-Thailand has excellent psychometric properties. Individualised scores reflect each person’s perspective on wellbeing and are sensitive to subgroup differences. However, unweighted satisfaction scores give a broadly similar picture and involve less complex computation.     

Prenatal stress,health, and health behaviours during the COVID-19 pandemic: An international survey

BackgroundPregnant women’s stress, mental and physical health, and health behaviours can have important implications for maternal and child health outcomes.AimTo examine pregnant women’s levels of stress, mental and physical health, and health behaviours during the COVID-19 pandemic.MethodsA cross-sectional survey was conducted online, with recruitment and data collection occurring between 16/6/20 and 17/7/20. Participants were pregnant women recruited via online pregnancy/parenting communities. Participants self-reported their levels of general stress, pregnancy-specific stress and COVID-19 related stress, mental and physical health, general health behaviours, and COVID-19 related health behaviours.Findings573 pregnant women participated in the survey. Participants were most commonly resident in the United States (42.6%, n = 243), Ireland (41.2%, n = 235) or the United Kingdom (10%, n = 57). The majority (80.0%, n = 457) were married and educated to degree level or above (79.3, n = 453). Pregnant women reported high levels of pregnancy-specific and COVID-19-related stress, and low levels of mental and physical health, during the pandemic. Encouragingly, pregnant women in this study generally reported high levels of adherence to public health advice and pregnancy health behaviours. Stress and general mental health outcomes were best predicted by well-being factors (including stress and social support). Health impairing behaviours (e.g. poor diet) were predicted by both well-being and demographic factors.DiscussionInterventions targeting pregnancy- and pandemic-specific stress at the population level will be essential to support mental health and minimise adverse outcomes for women and children during the pandemic.     

Gratitude and Adolescent Athletes’ Well-Being

Two cross-sectional studies were conducted to examine the relationships between gratitude and athletes’ well-being. Study 1 examines the relationship between dispositional gratitude and well-being, while Study 2 investigates the relationship between sport-domain gratitude and well-being. In Study 1, 169 Taiwanese senior high school athletes (M = 16.43, SD = 0.7 years) were administered the Gratitude Questionnaire (GQ; McCullough et al. 2002, Journal of Personality and Social Psychology, 82(1), 112–127), Team Satisfaction Scale (Walling et al. 1993, Journal of Sport & Exercise Psychology, 15, 172–183), Satisfaction with Life Scale (SWLS; Diener et al. 1985, Journal of Personality Assessment, 49, 71–75), and the Athlete Burnout Questionnaire (ABQ; Raedeke and Smith, 2001, Journal of Sport & Exercise Psychology, 23(4), 281–306). In Study 2, a separate sample of 265 adolescent athletes (M = 16.47 years, SD = 0.7) were administered the modified Sport-domain GQ, Team Satisfaction Scale, and ABQ. Study 1 results showed that dispositional gratitude positively predicts team satisfaction and life satisfaction, and negatively predicts athlete burnout. Findings from Study 2 revealed that sport-domain gratitude positively predicts team satisfaction and negatively predicts athlete burnout. A stronger gratitude and well-being relationship was observed in Study 2. This research provides the initial verification that gratitude and adolescent athletes’ well-being are related. Possible mechanism of this relation, limitations, and practical implications are discussed.     

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.     

Implementing innovative evidence-based perinatal mental health screening for women of refugee background

ProblemNational guidelines recommend repeated screening for depression and anxiety for all women in the perinatal period. Routine screening in pregnancy is limited due to service, community and individual barriers.BackgroundPerinatal depression and perinatal anxiety affect up to 20% of all women. Women of refugee background are at even greater risk for perinatal mental health conditions due to refugee experiences and resettlement stressors.AimTo evaluate the acceptability and feasibility of a perinatal mental health screening program for women of refugee background from the perspective of health professionals.MethodsA mixed methods design guided by the Normalization Process Theory was used. Data were collected at a dedicated refugee antenatal clinic in the south-eastern suburbs of Melbourne, Australia. An online survey (n = 38), focus groups (n = 2; 13 participants) and semi-structured interviews (n = 8; 11 participants) with health professionals were conducted.FindingsUnder the four constructs of the Normalization Process Theory, health professionals reported improvements in identifying and referring women with mental health issues, more open and in-depth conversations with women about mental health and valued using an evidenced-based measure. Key issues included professional development, language barriers and time constraints.DiscussionImplementing a perinatal mental health screening program has been positively received. Strategies for sustainability include professional development and the addition of audio versions of the measures.ConclusionThis perinatal mental health screening program is acceptable and a feasible option for health professionals. Health professionals value providing more holistic care and have more open discussion with women about mental health.     

Assessing the Use of the Family Affluence Scale as Socioeconomic Indicators for Researching Health Inequalities in Taiwan Adolescents

This study examined the reliability and validity of the Family Affluence Scale (FAS) and explored the relationship between FAS and health in a general adolescent population of Taiwan. Our data was obtained from a 2009 school-based survey. In total, 3,368 students (1,741 boys, 1,627 girls) in grades 6–10 in Kinmen County, Taiwan completed a modified WHO Health Behaviour in School-Aged Children (HBSC) questionnaire. Indicators of the family’s social position were their parents’ occupation and education. Indicators of material affluence were number of cars, number of holiday travel, whether the participant had his or her own room and number of computers (FAS items). A higher proportion of the participants completed the four family affluence items than their parents’ occupation and education items (≧98% vs. 90% and 88%; respectively). Analysis of the FAS showed a moderate internal reliability (Cronbach’s alpha = 0.35). The associations between the FAS scores and parental occupation and education were moderate (P < .001). Consistent gradients were found for the association between FAS and positive health and health promoting behaviours. In conclusion, the Taiwan version of the FAS had a high completion rate and moderate internal reliability and external validity. The clear associations between the FAS and health indicators confirm the findings of previous studies and suggest that the FAS can be used as an additional measure of socioeconomic status among Taiwan adolescents.     

Health-Related Quality of Life Among Abused Women One Year After Leaving a Violent Partner

This is the first follow up study measuring quality of life among abused women who have left their abusive partner. The women (n = 22) answered a questionnaire while staying at women’s shelter and one year later. The aim was to examine long-term effects of intimate partner violence against women on health-related quality of life. Health-related quality of life was measured using the SF-36 Health Survey and the WHOQOL-BREF. The meantime for living in a violent partnership was 11 years, most of the women had children under 10 years living with them, low income and were on sickness absence or disability pension. About half of the women had experienced threats of violence and 6 had experienced violent acts after leaving their partner. SF-36 scores after one year were significantly better in vitality (t-test, P < 0.001), mental health (t-test P < 0.001) and social domains (t-test, P < 0.04). WHOQOL-BREF scores did not change significantly from baseline, showing that the SF-36 showed more responsiveness in this population. Regression analysis showed that serious physical violence reported at baseline predicted significantly less improvement in physical and mental health and role-emotional in the SF-36 and in social relationships and environmental health in the WHOQOL-BREF. High psychological violence at baseline predicted significantly less improvement in mental health in the SF-36 and in social relationships and environmental health in the WHOQOL-BREF.     

An Examination of the Dual Model of Perfectionism and Adolescent Athlete Burnout: A Short-Term Longitudinal Research

The dual model of perfectionism (Slade and Owens, Behav Modificat 22(3):372–390, 1998) is adopted to examine the influence of adaptive and maladaptive perfectionism on adolescent athlete burnout in Taiwan. Participants were 188 high school adolescent student-athletes (M = 16.48, SD = .59). They were administered the Multidimensional Inventory of Perfectionism in Sport (Stoeber et al., Pers Individ Dif 43(1):131–141, 2007) and the Chinese Athlete Burnout Questionnaire (ABQ) (Lu et al., Phys Educ J 39(3):83–94, 2006). A field longitudinal design was used. In cross-sectional analyses, hierarchical multiple regressions indicated that adaptive perfectionism negatively predicted athlete burnout while maladaptive perfectionism had an inverse relationship with burnout. However, after controlling for the initial scores of burnout, neither adaptive nor maladaptive perfectionism significantly predicted athlete burnout after a three month interval. Possible mechanisms of this relation, limitations, and practical implications are discussed.