Precariousness and Quality of Life—a Qualitative Perspective on Quality of Life of Households in Precarious Prosperity in Switzerland and Spain

Households’ resources and constraints are key components of quality of life (QOL). QOL also depends on how these are evaluated. In times of crisis one expects subjective wellbeing and quality of life to decline. We argue that the quality of life depends on objective living conditions, their subjective evaluation and the ability to maintain or improve the situation of “embedded individuals”. This ability, in turn, depends on the opportunities provided by the state, labour markets, families and communities. We analyse qualitative interviews (2008–2010) with around 25 households in precarious prosperity in two cities (Pamplona, Spain and Lausanne, Switzerland) to elaborate their QOL. Few sampled Swiss households witnessed a decline in socio-economic status, contrary to the Spanish. Domains important to these households for QOL varied according to the opportunity structures: in the Spanish sample QOL was related to the opportunities for income, work, and security to plan ahead; in the Swiss sample to health, work-life balance and loneliness. In both samples, QOL varied according to scope of agency, people’s position within the life course, the households’ past experiences, current situation and future perspectives. Lack of future perspectives and opportunities lowered QOL; reframing, adaption and accepting the situation sometimes moderated QOL. We conclude that apart from living conditions and/or subjective wellbeing, households’ agency within opportunity structures is a promising direction for further research in QOL.     

Caregiving Burden and Parent–Child Quality of Life Outcomes in Neurodevelopmental Conditions: The Mediating Role of Behavioral Disengagement

The aim of this study was to analyze the direct and indirect effects, via parents’ behavioral disengagement coping, of caregiving burden on the quality of life (QL) of parents and their children with neurodevelopmental conditions. Self-completion questionnaires on the target variables were administered to a sample of 156 parents who had a child with a neurodevelopmental condition, namely epilepsy (n = 65) and cerebral palsy (n = 91). Structural equation modeling was used to test a mediation model and ascertain direct and indirect effects among study variables. Significant direct effects of caregiving burden on parents’ and their children’s QL were found. Additionally, caregiving burden had a significant indirect effect on parents’ QL, via behavioral disengagement, but not on their children’s QL. Finally, this model was found to be invariant across conditions and patients’ age groups. Caregiving burden may be elected as a strategic intervention target to improve parent–child QL outcomes in neuropediatric settings. Parents should be encouraged to avoid or reduce behavioral disengagement coping in relation to their caregiving stress, and alternatively adopt active coping strategies that may positively affect their children’s QL and impede or attenuate the deleterious effects of caregiving burden on their own QL.     

Coronary Intervention Improves Disease Specific Health-Related Quality of Life but Not Individualised Quality of Life: A Potential Response Shift Effect?

To explore potential response shift effects with different quality of life (QoL) instruments in cardiac patients undergoing coronary intervention. Study Design and Setting: Recalibration was assessed with the disease specific health-related quality of life (HRQL) instrument MacNew in combination with a then-test approach. Reconceptualisation and reprioritisation were assessed with the individualised QoL instrument SEIQoL-DW. Significant treatment effects were seen on the MacNew (global Δ: 0.6 ± 1.1, p = 0.004) but not on the SEIQoL-DW (Δ: 3.3 ± 16, p = 0.37) 6 months after coronary intervention. No recalibration effect was found on the MacNew then-test, while with the SEIQOL-DW potential response shift effects of reconceptualisation and reprioritisation were seen. For the first time response shift effects were explored in cardiac patients undergoing coronary intervention. This study confirmed that there is a clinically significant improvement in disease specific HRQL over time following successful coronary interventions. However, no treatment effect was seen for individualised QoL with the SEIQoL-DW. This might be due to reconceptualisation and reprioritisation response effects. Future studies need to focus on exploring response shift effects, and the interrelationship between its different components, captured by different patient reported outcome instruments in larger patient groups undergoing coronary interventions.     

Free Time Management Makes Better Retirement: A Case Study of Retirees’ Quality of Life in Taiwan

The purpose of this study was to identify the relationships between free time management and quality of life for retirees. Data were collected by convenience sampling from the four main districts of Taiwan. Overall, 454 usable questionnaires were received. The data showed a positive relationship between free time management and quality of life (r?=?0.72, p?<?.05). However, contrary to this, the relationships between time allocation and quality of life were not significant or even negative. These results indicate that retirees who effectively manage their free time can enjoy a better quality of life. Suggestions are made based on the observed relationship and some directions for future research are discussed.     

Measuring Subjective Quality of Life: A Survey to Porto’s Residents

The evaluation of the urban quality of life has been an important aspect of the research concerning the contemporary city and an increasingly support to urban planning and management. As part of a project to monitor the quality of life in the city of Porto, a survey of the resident population was conducted in order to study the citizens’ perceptions of their local quality of life and its evolution in recent years. The opinions of individuals on their level of satisfaction with various fields of the urban quality of life are systematised, as well as their integrated assessment. This analysis is complemented by a multivariate analysis that allows the grouping of the interviewees in large homogenous groups and their social and economic characterisation. Based on the results achieved, we try to highlight the usefulness of the qualitative analysis of the quality of life to support the definition of urban policies.

Fatigue and Quality of Life in Hepatitis C: Fact or Fiction?

The chronic hepatitis C virus (HCV) has traditionally been impossible to treat. Recently there has been increased attention in the treatment of HCV due to the development of drug treatments (i.e., Interferon and Ribavirin). As clinical attention to the assessment and treatment of HCV has increased, the issue of fatigue has become a central concern. Fatigue is one of the major symptoms reported by those suffering from HCV but it is not clear whether fatigue should be treated as a major symptom that is an important focus on attention or if it is a minor and irrelevant concern. In this paper, we examine the issues of fatigue in HCV in light of the importance of health-related quality of life in HCV. We present evidence to suggest that fatigue is a major issue that warrants clinical attention. We also propose that fatigue be reconceptualized as lassitude and provide an operationalized definition of dysfunctional lassitude, a new clinical construct that may have value as a psychological diagnosis. The purpose of this paper is to provide those interested in psychological issues in HCV, and chronic illnesses for which fatigue is a major symptom, guidelines for future clinical and research efforts.     

QALYs—A Threat to our Quality of Life?

ABSTRACT QALY calcuations are currently being considered in the UK as a way of showing how the National Health Service (NHS) can do the most good with its resources. After providing a brief summary of how QALY calculations work and the most common arguments for and against using them to set NHS priorities, I suggest that they are an inadequate measure of the good done by the NHS because they refer only to its effects on what will be defined as the 'patient community'. The benefit of the NHS to the wider community is best regarded as a public good—everyone benefits from the general belief that the NHS is there to provide care for those who fall into a state of medical need. QALY ideology threatens this belief because it gives efficiency a higher priority than caring in response to need. It is a fallacy that a QALY maximising health service will be a greater good to society, because this sort of quest for efficiency threatens the caring basis of the Welfare State as such.     

Can Life Be Evaluated? The Jewish Halachic Approach vs. The Quality of Life Approach in Medical Ethics: A Critical View

In recent years there has been an increase in the number of requests formercy killings by patients and their relatives. Under certain conditions,the patient may prefer death to a life devoid of quality. In contrast to thosewho uphold this quality of life approach, those who hold the sanctity oflife approach claim that life has intrinsic value and must be preservedregardless of its quality. This essay describes these two approaches,examines their flaws, and offers a golden path between the two extremepositions.We discuss the halachic and the secular views, arguing for a balancebetween the sanctity of life and the quality of life. We argue that, indeed,such a balance exists in practice, and that life is important, but it is not sacred. Life can be evaluated, but quality of life is not the solecriterion.     

Thomas E. Jordan, A Review of “The Quality of Life in Seventeenth-Century Ireland”

In “The Quality of Life in Seventeenth-Century Ireland,” Thomas Jordan brings a historian’s perspective to quality-of-life studies. The book raises questions about the determinants of quality-of-life, tangible outcomes and appropriate measures to assess societal well-being.     

A Descriptive Study of Pain and Quality of Life following Guillain-Barré Syndrome: One Year Later

Guillain-Barré syndrome (GBS) is a debilitating immunopathy that afflicts approximately 5,000 patients annually in the United States, a number that represents roughly half of the incidence of spinal cord injuries (J. M., Meythaler, 1997). Of these 5,000 new cases per year, 4–15% will die, 20% will possess deficits in ambulation or require ventilator assistance more than one year later, and more than two-thirds will have persistent fatigue (J. M., Meythaler, 1997; Hughes et al., 2003). These figures suggest that GBS is currently a legitimate cause of long-term disability.Many secondary complications may follow GBS that include dysautonomia, deep vein thrombosis, anemia, immobilization, and pain and sensory involvement (J. M., Meythaler, 1997; J. M. Meythaler, M. J. De Vivo, and W. C. Braswell, 1997). These medical complications have not been studied systematically, and the psychosocial complication of pain following GBS has certainly been overlooked in the literature. The present paper utilized a limited sample of 18 patients (N = 18) with persistent motor deficits at least one year after onset of GBS. We examined their pain and perceived quality of life as part of an ongoing federally funded study which will ultimately attempt to determine if 4-aminopyridine (4-AP) significantly improves motor function in patients with residual weakness from GBS. Findings suggest that while most persons do not rate themselves as depressed one year after GBS onset, 22% of respondents did exceed the cutoff for clinical depression on the CES-D. Age and gender do not appear to be related to any component of pain in GBS; however, self-ratings of physical and mental health do appear to be significantly related to pain experience. The nature of this relationship was not determined, and merits further investigation in future studies.     

Particip-active Musical Performance: Quality of Life at a Seniors’ Village in South Africa

Applied Research in Quality of Life - With increasing life expectancy around the globe, both developed and developing countries face greater ageing populations. South Africa is no different as...     

Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are they Comparable?

This study aimed to compare primary and secondary caregiver QOL within families of children with asthma and determine the potential importance of including secondary caregiver QOL in clinical and research settings. Participants included 118 families of children with asthma that had primary and secondary caregivers. Families completed measures in a single research session. Caregivers reported on QOL, psychological functioning, and family burden; children completed a measure of QOL. Child lung function was determined from objective spirometry. Adherence to prescribed controller medication was measured for 6 weeks following the research visit. Primary caregiver QOL was significantly lower than secondary caregiver QOL (Mean overall QOL of 5.85 versus 6.17, p < .05). Better medication adherence was associated with higher primary caregiver QOL (ρ = .22, p = .02); secondary caregiver QOL, not primary caregiver QOL, was positively associated with child QOL (ρ = .20, p = .03). Families with discrepant QOL scores between caregivers (difference in scores of at least .50) were characterized by more family burden and primary caregiver psychological symptoms. Differences in QOL scores between caregivers may be a reflection of primary caregivers’ greater investment in daily asthma management. In families reporting low burden and few psychological difficulties in the primary caregiver, QOL assessments from either caregiver may may be informative and representative of how parents are adapting to child asthma. In families experiencing high levels of burden or more primary caregiver psychological difficulties, QOL reports from secondary caregivers may not be as clinically meaningful.     

Quality of Life and Health State of Long – Term Unemployed in Older Production Age

The aim of the study was to evaluate the changes in the subjective quality of life (QoL) and health state of unemployed people at the age of 45 and older in the city environment. The study also aimed at evaluating some social and demographic factors on the quality of life and health of the unemployed. A group of 454 unemployed people aged 45 and older, registered in labour offices in the city of ?ód?, Poland were included in the study. Two groups were formed: short-term and long-term unemployed. QoL was measured with the WHOQOL-Bref questionnaire. The main problems formulated in the study were: Does QoL and health state decrease during the period of unemployment and in what aspects? What factors can modify the changes of QoL of the unemployed? The findings of the analysis indicate that unemployment entails many negative health consequences and the long-term stress connected with being out of work leads to the decline in the quality of life and worsening of mental state. The multidimensional effects of unemployment depend not only on the economic situation of the particular household, but also on perceived health status, personal relationships and the sense of ability to work.     

Does Economic Inequality Affect the Quality of Life of Older People in Rural Vietnam?

By combining data from the 2011 Vietnam National Aging Survey and the 2011 Rural, Agricultural and Fishery Census, this study examined whether expenditure inequality has any effect on the quality of life (life satisfaction or happiness) among the elderly in rural Vietnam. It was confirmed from our regression analysis that individuals who live in the communes with high inequality tend to self-report as being less happy, even after controlling for various individual and household attributes. The findings are robust to the choice of inequality measures and the specification of econometric models. We also find that older rural people who are farmers or poor are more sensitive to inequality. Given that these people tend to be less happy than others, the result shows the risk that inequality further lowers their subjective well-being. This finding, in part, supports the view that rural Vietnam is not a mobile society.     

An Exploration of Trainees’ Perception of Clinical Psychology Training in India: A Qualitative Analysis

This study explored trainees’ perception of clinical psychology training in India. A sample of 20 (18 females; 2 males; Mean age?=?25 years) clinical psychology trainees participated in the study following written informed consent. Participants were interviewed individually (40–50 min) using a semi-structured interview schedule developed for the study. Interviews were audio recorded and transcribed. Broader themes were identified using principles of content analysis. The findings indicated trainees’ great enthusiasm about practical training, supervisor supervision and hospital based training. Results also showed poor recognition of the role of research and theory in training, unilateral view of supervision, poor perception of secondary goals and components of training and limited awareness about variety of clinical material. The results are indicative of trainees’ preference of clinical component of training over theory and research components of training, the backbone of prevailing systems of training globally. The preliminary findings suggest the need for further research in this area.     

Edited by Daniel T. L. Shek and Robert M. Hollister: Book Review of “University Social Responsibility and Quality of Life: A Global Survey of Concepts and Experiences”. Quality of Life in Asia Series,Volume 8

Applied Research in Quality of Life -