Health-related Quality of Life, Marital Satisfaction, and Social Support in Medical Staff in Iran

Quality of life is a subjective and multidimensional concept that includes all aspects of an individual’s life. Many investigations indicate that marital satisfaction is an important determinant of quality of life and social support affects both marital satisfaction and quality of life. Since medical staff face job stressors in their everyday life, in the present cross-sectional study, the relationships between quality of life, marital satisfaction, and social support in medical staff in Tehran were analyzed. Data collection was performed in 653 medical staff using socio-demographic questions, the SF-36 questionnaire, the ENRICH Marital Satisfaction Inventory, and the Social Support Questionnaire. The results revealed that men reported significantly higher quality of life and marital satisfaction than women, but there was no gender difference in social support. The quality of life and marital satisfaction domains were found to be differentially correlated among male and female participants. All domains of marital satisfaction were found to be significantly associated with the “vitality” and “mental health” domains among females and “physical functioning” domain in the male. Also, social support was associated with almost all quality of life domains in both sexes. The multiple regression analyses indicated that all the study variables combined with socio-demographic factors can explain between 12 % and 28 % of the variance in quality of life domains. Therefore, focusing on these factors could be an effective approach to improve quality of life in medical staff as a group with a stressful job.     

Quality of Life in Old Age: Problematic Issues

Quality of Life (QoL) is a concept widely used in gerontology, as well as in other fields such as anthropology, health sciences, psychology, sociology and political sciences. Historically, although Aristotle is considered as an antecedent, the term QoL emerged in about the sixties in scientific literature. In the field of ageing, it is considered as an outcome of projects, programmes, services or policies and is used for describing populations, contexts and individuals. QoL is considered by most experts as a multidimensional concept involving multiple domains (health, psychological, social and environmental), containing objective and subjective components. Nevertheless, in recent years, QoL has been reduced to the subjective appraisal, to health or to subjective psychological attributes such as well-being, happiness or life satisfaction. Moreover, conceptual confusions can be found between QoL and other concepts related to positive ageing. In this conceptually-driven paper, after reviewing a set of expert and lay conceptualizations of QoL and identifying the diversity of its components, three critical issues will be discussed: its reduction to health or to the subjective appraisal of a set of domains, the confusion of QoL with other subjective or positive concepts and, finally, its methodological reductionism to self-reports as an exclusive procedure for QoL data collection. From these criticisms some conceptual and methodological suggestions are proposed.     

Correlates and predictors of positive mental health for school going children

The relationship between positive mental health and well-being was examined in 604 North Indian high school and secondary high school going children aged 11–18 years. The study employed various scales such as Mental Health Continuum-Short Form (MHC-SF; Keyes, 2005), Scale of Positive and Negative Experiences (SPANE) and Flourishing Scale (FS; Diener et al., 2010), World Health Organization Quality of Life-BREF (WHOQOL-BREF, 1996) and Personal Well-being Index Scale-School Going Children (PWI-SC; Cummins & Lau, 2005). The MHC-SF predicted the positive mental health and the various predictors used in this study were SPANE, FS, WHOQOL-BREF and PWI-SC. Positive mental health was found positively correlated with SPANE P, life satisfaction, personal well-being, flourishing and all four domains of quality of life (physical health, psychological well-being, social relationships and environmental health) and negatively correlated with SPANE N. Well-being measures of flourishing, SPANE P, SPANE-N, all four domains of quality of life (physical health, psychological well-being, social relationships and environmental health) significantly predicted children’s positive mental health (49% of variance) and its dimensions like emotional well-being (41% of variance), social well-being (24% of variance) and psychological well-being (47% of variance).     

Comparing Quality of Life Instruments in a Population of Abused Women

The SF-36 Health Survey and the WHO Quality of Life Index—BREF (WHOQOL-BREF) were used to study quality of life among women who had experienced intimate partner violence (IPV). The aim was to determine how these instruments correlated with each other and with physical and psychological IPV, in order to find the best instrument to use. IPV was measured using the Severity of Violence against Women Scale (SVAWS) and the Psychological Maltreatment of Women Index (PMWI). A self-administrated questionnaire was given to women able to understand Norwegian who were staying at a women’s shelter in Norway for more than 1 week. 87 of 212 women asked to participate completed the questionnaire. The physical acts of violence in SVAWS correlated significantly (P<0.001) with both the general health and bodily pain dimensions in SF-36 and global overall health (OH) in WHOQOL-BREF. Most correlations between WHOQOL-BREF and SF-36 were moderate. The WHOQOL-BREF domains explained 46% of the variance in OH and 40% of the variance in the global overall quality of life (OQOL). The SF-36 domains explained 66% of the variance in OH and 27% of OQOL. The mean WHOQOL-BREF and SF-36 scores were all low. The SF-36 correlated better with physical and psychological IPV in this population than the WHOQOL-BREF. The significant correlations between the OH, general health and bodily pain domains and acts of violence show the importance of including questions concerning bodily symptoms in determining the quality of life in a population of abused women.     

Life Satisfaction and Self-Assessed Health Among Adolescents in Hong Kong

Self-assessed health in four items of the Health Related Quality of Life Scale, overall health, physical health, mental health, and activity limitation, and perceived life satisfaction in six domains of the Brief Multidimensional Students’ Life Satisfaction Scale, overall life, family life, friendships, school experience, myself, and where I live were examined among 4,502 Chinese adolescent secondary school students in Hong Kong. Relative to the US adolescents in Youth Risk Behavior Survey the Hong Kong adolescents had very low levels of self-assessed health and life satisfaction. Among the different domains, family and school life were associated with the lowest satisfaction level. There were strong male advantages in self-assessed health and migrant disadvantages in life satisfaction. Age was negatively related to both health and life satisfaction. Two-parent family was a positive factor for adolescents’ quality of life but economic well-being was not a relevant factor.     

The World Health Organization WHOQOL-100: tests of the universality of Quality of Life in 15 different cultural groups worldwide.

The World Health Organization Quality of Life assessment (WHOQOL-100) was developed simultaneously across 15 international field centers and includes 24 facets relating to quality of life, which are grouped into 4 larger domains: physical, psychological, social relationships, and environment. It also includes 1 facet examining overall quality of life and general health perceptions. This article examines the extent to which the WHOQOL-100 assesses quality of life perceptions in different cultures and whether it is structurally comparable in these cultures. Regression analysis showed all 4 domains to be important in assessing quality of life in each of the 15 centers. Structural equation modeling suggested further support for the proposal that there are universal facets and domains that are cross-culturally important in determining quality of life and suggested that the ordering of facets within domains is comparable across cultures.     

Psychological distress and quality of life of people living with HIV/AIDS in a Nigerian teaching hospital

Presence of psychological distress and poor quality of life (QoL) may affect the outcome of HIV/AIDS. One hundred and seventeen consecutive and consenting participants were interviewed using a Socio-demographic questionnaire, Kessler Psychological Distress Scale (K10) and World Health Organization Quality of Life-HIV Bref. Fifty-six (47.9%) participants scored 20 and above on K10 Scale. QoL was significantly higher in married participants, those who perceived their state of health as being good, asymptomatic participants and those who scored well–mild on K10. The older age group scored higher on QoL Scale than the younger age group in the physical health domain while the married participants scored higher in the domains of physical health, psychological health, environment and spiritual/religion. The participants who perceived their state of health as being good scored higher than those who perceived their health as poor in all domains. There is a high level of psychological distress and poor QoL in people living with HIV/AIDS.     

Personality traits,coping strategies and quality of life in patients of hepatitis C

IntroductionIn recent decades, hepatitis has become a community health issue. A severe, asymptomatic and unobserved acute disease could be resulted by HCV and it could be treated completely in few cases or could result in chronic hepatitis.ObjectiveThe current research investigated the relationship among personality traits, coping strategies and quality of life in patients of hepatitis C in Pakistan.MethodTotal 102 patients of HCV were selected from government, semi-government and private hospitals. Mental Health Screening Questionnaire (Mirza & Kausar, 2008) was used to screen the patients. The Urdu versions of Big Five Inventory (John & Srivastava, 1999), Coping Strategies Questionnaire (Kausar & Munir, 2004) and Quality of Life-BREF (1997) were used to measure the study variables.ResultsThe results showed that extraversion had positive relationship with the subscales of quality of life except physical health. Conscientiousness had positive relationship with physical and psychological health. Neuroticism had negative relationship with all the domains of quality of life. Openness to experience had positive relationship with psychological health and environment. religious coping and conscientiousness positively predicted physical health, whereas, agreeableness was the negative predictor of physical health. Psychological health and social relationships were positively predicted by active focused coping, whereas, neuroticism negatively predicted psychological health.ConclusionThe results of present research indicated significant contribution of personality traits and coping strategies in maintaining quality of life of HCV patients. The clinical implications to improve quality of life of HCV patients are discussed in light of results.     

Health Related Quality of Life in Children with Congenital Heart Disease

Health-related quality of life in children with congenital heart disease (CHD) was compared to that of healthy children. Furthermore, agreement between child and parent reports was examined. In addition, differences in quality of life related to the severity of CHD were evaluated. One hundred children with CHD aged between 8-18 years and their parents answered a health-related quality of life-questionnaire during their visit to the paediatric cardiology outpatient department. CHD children reported reduced motor functioning and autonomy compared to healthy children. Parents of children with CHD reported their children to have a reduced quality of life in the domains of: motor functioning, autonomy and cognitive functioning. Agreement between child and parent reports was moderate. Children systematically reported lower health related quality of life on the domain of positive emotions than did parents. Health related quality of life in children with CHD appeared not to be influenced by severity of the disease. In conclusion, regardless of the severity of the disease, children with CHD reported their health related quality of life on several domains to be lower than that of healthy children. This means that on several domains, the emotional impact of problems in health status is greater for children with CHD than for healthy children. When CHD patients visit the clinic, it is important that physicians actively ask patients as well as parents about the child's motor functioning, autonomy and cognitive functioning. Children with problems in these domains can then be identified, and psychological interventions can take place at an early stage.     

Predictors of Satisfaction Among College-Educated African American Women in Midlife

There has been little theorizing or empirical research on satisfaction among African American women at midlife. This study addresses this gap by examining predictors of satisfaction in 3 cohorts (N = 202) of midlife college-educated African American women. Specifically, 3 domains of satisfaction were examined: overall life satisfaction, personal satisfaction, and work satisfaction. Results revealed that the women were highly satisfied with their work situation, their personal life, and generally with how their life had turned out so far. Overall life satisfaction was predicted by the women's perceptions of personal control, role quality, household burden, and their cohort status. Work satisfaction was best predicted by the women's sense of personal control and role quality. Lastly, household burden and physical well-being emerged as significant predictors of personal satisfaction. Implications of the findings and recommendations for future research are offered.     

Perceptions of stressful life events as turning points are associated with self-rated health and psychological distress

Abstract

We test the hypothesis that changes in physical and psychological health are associated with construals of stressful life events. At two points in time, approximately 10 years apart, participants (n=1038) rated their physical health and psychological distress. At the second assessment, participants also reported their most stressful life event since the first assessment and indicated whether they considered the event a turning point and/or lesson learned. Lower self-ratings of health and higher ratings of psychological distress, controlling for baseline health and distress, and relevant demographic factors, were associated with perceiving the stressful life event as a turning point, particularly a negative turning point. The two health measures were primarily unrelated to lessons learned. How individuals construe the most stressful events in their lives are associated with changes in self-rated health and distress.     

Relation of life goals at age 70 to activity participation and health and psychological well-being among Terman's gifted men and women

In this study I investigated the relation of life goals to activity participation and health and psychological well-being for men and women in Terman's Study of the Gifted. The subjects were between the ages of 65 and 75 years (M = 70.2 years) when they responded to a mail-out survey in 1982. The study included three goals scales-Autonomy, Involvement, and Achievement Motivation-as well as measures of activity participation and health and psychological well-being. Multiple regression analyses in which the three goals scales were used to predict health and psychological well-being were both significant. Path analyses demonstrated both a direct and an indirect contribution, through activity participation, of life goals to health and well-being. In most cases, the indirect effect of life goals on health and well-being accounted for more than one half of the total effect. Implications of the results for life satisfaction in aging are discussed.     

Therapist attitudes and countertransference as predictors of professional quality of life and burnout among psychotherapists

This study aimed to examine the role of attitudes towards psychotherapy and countertransference dimensions as predictors of professional quality of life and burnout among psychotherapists in Iran. Participants were 259 psychotherapists who worked in mental health centres in Tehran (Iran), and they completed the Professional Quality of Life questionnaire, the Therapist Response Questionnaire and the Therapist Attitudes Scale. Professional quality of life was associated with countertransference dimensions and attitude towards psychotherapy. This study concludes that psychotherapists can benefit from working on their specific countertransference issues and re-evaluating their basic attitudes towards psychotherapy to achieve the highest levels of professional satisfaction. Culture may play a role in a specific therapist's attitude and difficulties in addressing certain aspects of countertransference.     

Significance,structure, and gender differences in life domains of college students

The purpose of this study was to assess the significance and structure of life domains of college students and to explore the patterns of gender differences on different indices of significance. Four hundred fifty-seven college students rated 21 life domains in terms of degree of importance, frequency of involvement, and level of impact. They also responded to a measure of global life satisfaction. Gender differences on significance indices were investigated by means of three types of analyses. First, gender mean ratings on 21 life domains were compared via one-way multivariate analyses of variance. Second, the underlying dimensions of the 21 domains for each gender were compared via exploratory factor analyses. Third, the correlation patterns between perceived positive impact of each life domain and life satisfaction were calculated separately for men and women. Within-group comparisons revealed that men and women shared the same nine most significant domains: education, friends, biological needs, leisure, family, health, couple, esthetics, and physical activities. However, several gender differences were consistently found in the three types of analyses. The results indicated that although traditionally feminine domains are rated as more significant to women than men, traditional masculine domains were rated as equally significant by men and women. Domains considered sex role neutral (e.g., personal planning) were rated as more significant by women than men. In general, women appear to experience greater cognitive, affective, and behavioral aspects of significance in a wider spectrum of activities and as well perceive their general life satisfaction as deriving from a broader range of sources. Results also highlight the importance of assessing the degree of significance of life domains as an initial step in the development of multidimensional self-related constructs.Preparation of this paper was made possible through grants from the Social Sciences and Humanities Research Council of Canada, the Fonds pour la Formation des Chercheurs et l'Aide à la Recherche (FCAR-Québec) and the Université du Québec à Montréal. We would like to thank Richard Koestner and Richard Bourhis for their valuable comments on an earlier version of this paper.     

Depression and appearance-related distress in functioning with lipedema

Lipedema is a chronic, progressive adipose tissue disorder that may impact the quality of life of women who suffer from it. The main aim of this study was to asses the role of perceived symptom severity, physical and psychological functioning with the disease in predicting quality of life in patients with lipedema. We conducted an online study with 329 participants who responded to five questionnaires measuring quality of life (World Health Organization Quality of Life BREF), lipedema symptom severity, mobility (Lower Extremity Functional Scale), depression (Patients Health Questionnaire-9), and appearance-related distress (Derriford Appearance Scale 24). Multiple hierarchical regression analyses showed that appearance-related distress and depression explained significantly more variance in quality of life when added to the symptom severity and mobility. Lower quality of life was predicted by higher symptom severity, lower mobility, higher appearance-related distress and higher depression severity. Appearance-related distress and depression constitute important aspects of psychological functioning in women with lipedema. Considering their relationship with quality of life, their assessment should be included in lipedema treatment with appropriate interventions aimed at decreasing appearance-related distress, as well as preventing and addressing depression.     

Domain Compensation in Quality of Life of Individuals with Vasovagal Syncope: a Test of Homeostasis Theory

Although health-related quality of life is often diminished in populations characterised by physical illness, this does not necessarily imply lower overall assessments of general life satisfaction (GLS) and greater incidence of mental illness. According to Homeostasis Theory, this limited impact of health on these more global wellbeing indices may be due to internal and external buffers that serve to maintain one’s overall sense of wellbeing and GLS in the face of adversity. Thus, the present study tested in a sample of 212 individuals (48 with vasovagal syncope, 62 cardiac patients, and 102 healthy control participants) the possibility that poor health-related quality of life (as expected for the cardiac and vasovagal syncope groups) may be offset by relatively higher satisfaction with other aspects of one’s life (the domain compensation hypothesis). Consistent with this view, present findings showed that although individuals in the two health-risk groups reported lower health satisfaction (HSat) than the control group, they had comparable levels of mental health, GLS satisfaction, and subjective wellbeing (minus health; PWI-H). Moreover, moderation analyses confirmed that the relationship between HSat and GLS reduced to non-significance for individuals with PWI-H higher than nationally representative, normative levels. Collectively, these findings suggest that a broader context is necessary to understand the impact that illness may have on one’s sense of GLS and mental health. In particular, the provision of support and satisfaction with other life domains may serve to buffer concerns about one’s health.     

An Investigation of the Relationships Between Spirituality, Health Status and Quality of Life in Adolescents

This study examines the relationships between six spirituality-related attributes and quality of life (QOL) in adolescents, and the extent to which these relationships are mediated by perceived physical and mental health status and five important life domains (family, friends, living environment, school experiences, and perception of self). The data were obtained via a cross-sectional health survey of 8,225 adolescents in British Columbia, Canada. Structural equation modeling was used to test the hypothesized relationships. All spiritual attributes are significantly associated with three or more of the life domains, and four of the attributes significantly explain global QOL after controlling for the other variables in the multivariate model. The attributes indicative of adolescents’ feelings about their future and other existential matters were found to be relatively most explanatory with respect to global QOL. The predominant mediators include adolescents’ satisfaction with their family, their perceived self, and their perceived mental health status. Spirituality is important with respect to adolescents’ QOL. The multivariate model provides preliminary insights into the relevance of several attributes of spirituality and the possible mechanisms by which these attributes may contribute to adolescents’ QOL.     

Between adolescents and aging grandparents: Midlife concerns of adults in the “Sandwich generation”

This study examined whether the midlife transition of men and women in the “sandwich generation” was related to their 15- to 19-year-old adolescent's psychosocial development and their relationships with their own aging parents (i.e., the grandparents). One hundred eighty-six (186) respondents representing adolescents, mothers, and fathers from 62 families completed questionnaires that assessed adolescents' psychological autonomy and involvement in adult-type roles, adults' midlife transition and marital quality, and adults' relationships with their aging parents. Analyses conducted by domain revealed that women reported greater concerns with midlife issues when their adolescents demonstrated fewer signs of psychological autonomy and involvement in adult-type roles whereas men reported more intense midlife concerns when they experienced more strain in their relations with their own parents. When adolescent, grandparent, and marital factors were considered conjointly, the results indicated that women's level of midlife concerns was still related to their adolescents' development, but men's level of concerns was most strongly related to their satisfaction with the quality of their marriages. The discussion focuses on adult women's and men's experience of the midlife transition in relation to adolescents' development, parents' relationships with aging grandparents, and marital quality.     

Gender Differences in Psychological Well-Being in Emerging Adulthood

Gender is recognized as an important social determinant of health, but past research on gender differences in psychological well-being have not produced conclusive results. This study investigated gender differences in eudaimonic well-being and life satisfaction in emerging adulthood. A cross-sectional study with a sample of 1990 emerging adults (50% males) from the Spanish general population was conducted. Participants were assessed through five questionnaires. Results showed that women scored higher than men in purpose in life and personal growth. Hierarchical multiple regression analysis revealed that the most important predictors of emerging adult men’s and women’s eudaimonic well-being and life satisfaction were higher self-confidence and lower negative self-evaluation. Other significant variables in the eudaimonic well-being of both women and men were higher score in the masculine/instrumental trait, higher emotional social support, higher educational level, and higher score in the feminine/expressive trait. Furthermore, higher instrumental social support was associated with eudaimonic well-being in females. Other predictors of women’s and men’s life satisfaction were higher score in the feminine/expressive trait, less age, higher educational level and higher instrumental social support. In addition, higher emotional social support was associated with life satisfaction in males. The results suggest that gender is important in the psychological well-being of people in emerging adulthood, although self-esteem and instrumental social support are, in both emerging adult women and men, the most important predictors of psychological well-being.