Importance is Not Unimportant: The Role of Importance Weighting in QOL Measures

The effect of relative domain importance as a weighting mechanism in quality of life (QoL) measures has been a topic of debate for decades. Studies investigating the role of domain importance in QoL measures have produced mixed results. The mixed results may very well be the consequences of a limited choice of global satisfaction or QoL measures, measurements of domain satisfaction, measurements of domain importance and weighting approaches applied to date. This study investigated the effect of importance weighting without assigning any arbitrary weighting function of domain importance. A cluster analysis was first used to classify individuals into groups, based on their perceived importance of various life domains, and then the relationship between global life satisfaction measure and the composite of domain satisfaction scores between these groups was compared. Results of this study showed that the relationship between global life satisfaction and composite of satisfaction scores did not remain consistent for respondents with different importance rankings of major life domains, which suggested an important effect of domain importance in QoL measures.     

Should We Give Up Domain Importance Weighting in QoL Measures?

The purpose of this article is to examine the recent claims calling for abolishing domain importance weighting in quality of life (QoL) measures by considering the evidence conceptually and empirically. Based on a close review of evidence presented to date, it is suggested that using the range-of-affect hypothesis as a possible explanation of the poor performance of weighted satisfaction composite in predicting or correlating with global satisfaction or QoL measures can be beneficial to our understanding of the life satisfaction literature. However, given the conceptual focus and the empirical approach of the range-of-affect hypothesis presented in the life satisfaction context, using the range-of-affect hypothesis to argue against domain importance weighting raised more questions than answers. Calling for abolishing domain importance weighting in QoL measures, based on the evidence of range-of-affect hypothesis, is premature.     

Throwing the Baby Out with the Bathwater: Evaluation of Domain Importance Weighting in Quality of Life Measurements

This paper examined major inconsistencies between claims made and the evidence presented in recent studies on evaluating the role of domain importance weighting in quality of life (QoL) measures. Three inconsistencies were discussed and they were: (1) treating the failure to support a particular importance weighting function as the evidence of uncovering no importance weighting necessary at all, (2) considering domain importance weighting and multiplicative scores synonymous, and (3) extending findings with a within-domain focus to an across-domain focus. Overlooking these inconsistencies may lead to an overgeneralization of study findings, which would likely result in premature or even erroneous conclusions. Caution must be given in interpreting study results in order to avoid overgeneralization which limits our understanding of the true role that domain importance weighting may play in QoL measures.     

The Relative Importance of Health

This article seeks to extend Michalos’ [Social indicators research and health-related quality of life (QoL) research. Social Indicators Research, 65, 27–72, 2004] discussion on bridging social indicators research and health-related QoL (HRQoL) research through an examination of (1) the relative importance of satisfaction with one’s own health to another common measure of QoL—Life satisfaction, and (2) the relative importance of health in relation to other major life domains. Using data from two surveys, this article found that individuals may perceive health as most important in relation to other major life domains but satisfaction with one’s own health may not necessarily be the most important determining factor (in relation to satisfaction with other major life domains) of QoL as measured by life satisfaction. These findings support Michalos’ (Social indicators research and HRQoL research. Social Indicators Research, 65, 27–72, 2004) call for caution regarding the interpretation of research results on HRQoL since many HRQoL measures are measures of satisfaction with one’s own health and should not be considered as measures of QoL.     

To Weight or not to Weight: The Role of Domain Importance in Quality of Life Measurement

Although there are problems associated with thepractice of deriving weighted satisfactionscores by multiplying importance ratings andsatisfaction ratings of life domains, theseproblems do not seem sufficient to justify theabandonment of incorporating domain importanceweighting into quality of life (QoL)instruments. This paper shows that domainimportance as a weighting mechanism in QoLinstruments can be conceptually,psychometrically and empirically reasonable. Given the lack of conceptual or theoreticaldevelopment regarding the role of domainimportance in QoL instruments, it is importantto focus our attention on how to weight.     

Does Weighting Capture What’s Important? Revisiting Subjective Importance Weighting with a Quality of Life Measure

The present study evaluated subjective importance weighting using data collected with the Injection Drug User Quality of Life Scale (IDUQOL). Weighted and unweighted IDUQOL scores from 241 adults were correlated with convergent, discriminant, and criterion measures. Regression analysis was used to examine the contribution of importance ratings to scores on a global measure of life satisfaction and the corrected weighted IDUQOL total scores. Overall, the results showed that weighted scores did not perform better than unweighted scores in measuring quality of life. However, the mean satisfaction ratings for important domains correlated significantly higher with convergent measures than did the mean satisfaction ratings for unimportant domains. This finding suggests further attention needs to be paid to the meaning and measurement of subjective importance and how it may be incorporated more effectively into measures of quality of life.     

Employment and Earnings Expectations of Jobless Young Skilled: Evidence from Italy

Quality of Life (QoL) is a multi-dimensional idea that includes various distinctive dimensions and its estimation is considered as an essential factor for policy assessment. The study estimates the inter-district variation in QoL in Pakistan by using a data set of Household Integrated Economic Survey of 2010–2011. Objective and subjective indices are constructed to measure QoL with 7 domains and 31 indicators within 89 districts of Pakistan by employing the principal component analysis. The leading result of the study reveals that top ranked district is Jhelum in term of QoL and Tharparkar is at the bottom. The analysis also reveals that the most of the top ranked districts are located in Punjab province. This reflects the better performance of the province in term objective and QoL indices. Whereas, the districts of Balochistan emerge at the lower end in terms of objective and QoL indices. Majority districts of Punjab shows a modest level of satisfaction regarding the facilities provided by the government and the least satisfied districts belong to KPK and Sindh. It is interesting to identify that disparity in the objective index and subjective perceptions are representing QoL differences.

     

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.     

Ranking and Prioritization of Emergency Departments Based on Multi-indicator Systems

In this work we discuss how Emergency Departments (EDs) can be ranked on the basis of multiple indicators. This problem is of absolute relevance due to the increasing importance of EDs in regional healthcare systems and it is also complex as the number of indicators that have been proposed in the literature to measure ED performance is very high. Current literature faces this problem using synthetic (or numerically aggregated) indicators of a set of performance measures but, although simple, this solution has a number of drawbacks that make this choice inefficient: a compensation effect among the indicators; a high degree of subjectivism in the indicators weighting; opacity in the decision making; all the EDs are considered to be comparable. Indeed, the situations in which EDs are comparable (i.e. when all the performance of one ED are not lower than the performance indicators of the other) are a minority and incomparability is by itself a source of information that should be used to identify situations for which different policy actions should be designed. In this work we propose to use non compensatory composite indicators and partial ordering theory to rank and compare EDs giving value to the reasons of such an incomparability. These methods are applied on a case study of 19 EDs in an administrative region in Italy.     

A Comparison of Normalized and Non-Normalized Multiplicative Subjective Importance Weighting in Quality of Life Measurement

Social Indicators Research - In quality of life (QOL) studies, importance weighting generally refers to the incorporation of perceived importance as a weighting factor into measures of QOL....     

Examining the Influence of the Wine Festival Experience on Tourists’ Quality of Life

Hosting events and festivals is the best way of providing the wine tourism experience. Wine festivals offer a wide range of experiences that are different from day-to-day living, offer a lifestyle package and are an indicator of lifestyle tourism experience. Tourists travel to wine festivals for wine and other leisure-related experiences, including opportunities for social and/or cultural experiences, interactivity and personal development. Therefore, wine festivals should provide an experience that can influence the quality of life (QoL) of the attending tourist. QoL is influenced by various life domains, which include social, leisure and recreational, intellectual, culinary, and travel life. By its nature, a wine festival is able to influence life domains, thereby decreasing or increasing the level of satisfaction with QoL, according to the level of satisfactory experience. The purpose of this article is to examine the influence of the wine festival experience on the QoL of attending tourists. The structural relationship between the wine festival experience on tourists’ QoL is shown in a structural equation model (SEM), which is based on the notion that the QoL of attending tourists will be influenced by their level of satisfaction in various life domains. A self-administrated questionnaire was distributed during the Wacky Wine Festival in Robertson South Africa. The data from 329 (N) eligible questionnaires was cleaned, captured and analysed using SPSS. Furthermore, Amos was used to test the structural model providing statistical support. From the study’s findings, managerial recommendations were made with the aim of maximising attending wine tourists’ QoL. The research contributes to the literature related to QoL.     

Exploring the Quality of Life of People in North Eastern and Southern Thailand

The assumption that development brings not only material prosperity but also a better overall quality of life lies at the heart of the development project. Against this, critics assert that development can undermine social cohesion and threaten cultural integrity. Rarely, however, is the impact of development on well-being rigourously analysed using empirical data. This is what the Wellbeing in Developing Countries Group at the University of Bath aims to do drawing on fieldwork carried out in four developing countries, which addresses the themes of resources, needs, agency and structure, and subjective Quality of life (QoL). The first phase of the QoL research in Thailand aimed to explore the categories and components of quality of life for people from different backgrounds and locations with the aim of developing methods for QoL assessment in the third phase of the WeD QoL research. The study presents data obtained from rural and peri-urban sites in Southern and Northeastern Thailand (two villages in Songkhla and three in Khon Kaen, Mukdaharn, and Roi-et). Participants were divided into six groups by gender and age, and were divided again by religion (Buddhist and Muslim) and wealth status in the South. Data collection was conducted between October and December 2004 using focus group discussions, semi-structured interviews, and the Person Generated Index. Content analysis was used for data analysis. The use of a qualitative approach enabled the gathering of empirical data that reflects the sources of difficulty and happiness in the lives of participants. Respondents identified 26 aspects to their quality of life, including family relations, health and longevity, income and having money, jobs, housing, education, debt, and so on. The results reveal clear similarities and differences in the role of traditions, religious beliefs, and values in the lives of people living in remote rural or peri-urban areas in Northeastern and Southern Thailand. These results, together with the findings from Peru, Ethiopia, and Bangladesh, will inform the rest of the WeD research and be used to develop measures to assess the quality of life of people living in developing countries.     

The Influence of the Human Rights to Water and Sanitation Normative Content in Measuring the Level of Service

Human Rights to Water and Sanitation (HRWS) have been consolidated as relevant frameworks to measure different levels of services. It is essential to move forward with specific initiatives that interpret the content of these human rights and operationalize them through specific metrics. However, some critical issues emerge in attempting this. Different approaches are proposed in this article to tackle this challenge: (1) utilizing a participatory technique to discuss the relative importance of the normative criteria to define water and sanitation services, (2) defining a short list of key indicators to measure the different dimensions of HRWS, and (3) assessing the impact of different weighting systems in the constructing an aggregated index, which has been proposed as a useful tool to monitor water, sanitation, and hygiene (WASH) from a rights perspective. Two municipalities (in Mozambique and Nicaragua) were selected as initial case studies. The results suggest that there is a common understanding among the experts about prioritization of the HRWS criteria. Differences in the relative importance given to the HRWS criteria can be explained due to the particularities of the local context. Further, the research suggests that expert opinions may be partially conditioned by targets and indicators proposed at the international level. Although the influence of weighting techniques on aggregated measures and their utilization in the decision-making process are limited, this methodology has a great potential for adapting specific WASH metrics to different regional, national, and/or local contexts taking into account the HRWS normative content.     

The Relative Contribution of Health Status and Quality of Life Domains in Subjective Health in Old Age

To analyze the influence of different health status dimensions and quality of life (QoL) domains on older adults’ subjective health, and to assess the role that residential satisfaction plays in these relationships. A QoL survey was conducted on a representative sample of the community-dwelling older adult population in Madrid province (Spain). Logistic regression models were applied to studying: the health status dimensions associated with satisfaction with health; the relationship between satisfaction with health and other QoL domains; and, the influence of these domains on satisfaction with life. Sociodemographic and residential characteristics were included in all the models. The determinants of satisfaction with health in the first model were: mobility, usual activities, morbidity, and satisfaction with neighborhood. QoL domains associated with health were: leisure activities, neighborhood, and finances. Satisfaction with life was explained by these three domains, along with age, family and health. In sum, leisure, neighborhood, and finances showed a positive effect on satisfaction with health and with life.     

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.     

Physical Self-Efficacy and Depressive Symptomatology in Older Women: A Group Treatment Approach

This article presents an outline of a practice model geared toward alleviating depressive symptomatology in older women. Based in Bandura's (1977) self-efficacy theory, and on empirical data reported in this article, the focus of the practice model is on physical self-efficacy as a cognitive mediator of depressive symptoms in older women. Through the use of a group treatment approach, an attempt is made to raise levels of physical self-efficacy, and to determine the concomitant changes in depressive symptoms. Finally, the importance of continued research, and the further refinement of practice methods based in theory is stressed.     

Evaluating Quality of Life in Urban Areas (Case Study: Noorabad City, Iran)

Quality of urban life (QOUL) has become an important field within urban studies. The increased level of attention to this topic is due to the increasing importance of QoL studies in monitoring public policies and in the role they can play as effective tools in urban management and planning. The main objective of this study is to measure the QOUL in the town of Noorabad in Iran, using subjective and objective indicators. In addition to secondary datasets, this study relies on a perception survey of households in the selected city. Based on an 11-point Likert scale, the mean of the overall life satisfaction of the respondents was found to be 6.06. At the same time, it has been found that satisfaction from employment opportunities is lowest among all other indicators. The comparison between the subjective and objective QoL in Noorabad indicated that 25 % of the households are in a state of well-being, 30.1 % are in a state of deprivation, while 24.4 % are in dissonance and 20.4 % are in a state of adaptation. Although correlation between objective and subjective dimensions of the QoL has not been found to be high, in general, the findings of this study reveal the importance of simultaneous studying of both objective and subjective dimensions of QoL. Results and findings of this study will be useful in designing and implementing future policies in the town of Noorabad.     

Quality of Life and Well-Being Ranking of Selected Districts of Khyber Pakhtunkhwa,Pakistan

Quality of life (QoL) is a multidimensional concept encompassing many aspects of an individual’s existence. It is not just a measure of material resources but of intangible environments which affect quality of life. The study concentrates on the province of Khyber Pakhtunkhwa, Pakistan, and looks at the QoL and well-being in thirteen districts representing the province’s major population. It followed an integrative approach to measuring quality of life. Principal component analysis was used to tackle with multidimensionality. Weighted factor scores were used as an index for ranking QoL and well-being on the basis of social indicators chosen in different life domains. The results show that districts having high urban disposition top the ranks in QoL in Khyber Pakhtunkhwa, like Peshawar, Mardan, Swat and Charsadda, while Bannu, Kohat and Lower Dir fall amongst the bottom districts in terms of QoL. The rural/urban ranking also follows similar patterns with a few exceptions.     

Mediating Effects Between Objective and Subjective Indicators of Urban Quality of Life: Testing Specific Models for Safety and Access

Enhancing the urban quality of life (QoL) is an explicit policy goal of many countries, yet it is rarely studied using models that relate objective measures of the urban environment to the subjective evaluations of residents. It thus often remains unclear how planning interventions in the urban environment may influence residents’ satisfaction with their living conditions. In particular, during periods of significant urban growth, such as those recently observed in Switzerland, which result in diverse, unwanted threats to the local QoL (e.g., loss of green spaces, traffic congestions, and fear of crime). This study uses data from a sample of 1,693 residents that participated in a postal survey about urban QoL. The responses were combined with objective attributes of residential conditions, using geographic information systems. Structural equation models were calibrated to examine the direct and indirect effects of important indicators of urban QoL, namely safety in public spaces and access to central urban facilities. The study sheds further light on the mediating effects between objective characteristics and subjective evaluations that influence the urban QoL. The results showed predominantly low correlations between objective characteristics and subjective evaluations of urban QoL, which confirmed the findings of the few previous studies on this topic. Surprisingly, this study also found a strong link between objective access and perceived accessibility. This relation was explained by the spatial scope of the study region and suggested that the scale discordance theory should be tested in future research. The findings implied that variations in objective measures do not reliably represent differences as evaluated by residents.