Towards the Good Life: A Population Survey of Dimensions of Quality of Life

The aim of the analyses presented here was to explore subjective and objective components and predictors of self-rated quality of life (QoL). The vehicle for the study was a questionnaire module on perceptions of quality of life, which was commissioned by the authors for inclusion in the Office of National Statistics (ONS) Omnibus Survey in Great Britain. For the survey, 2033 randomly sampled adults aged 16 and over were interviewed in their own homes (77% response rate). Multiple regression analyses showed that relatively little of the variance in overall QoL ratings was explained by the objective, socio-demographic indicators (5%), and the addition of the health status indicator (reported longstanding illness) contributed nothing. The subjective ratings of life in self-nominated areas of importance explained the most, with those who did not prioritise the area at all as the referent (relationships, finances, own health, others' health, work and social life). These variables contributed over twice as much as the objective and health status variables, indicating the relative importance of self-nominated 'important areas of life' over theoretically important, objective variables and reported illness. However, the final model still only explained a modest amount of the variance in quality of life ratings (16%), confirming the amorphous nature of quality of life.     

Transition to motherhood: A longitudinal study

A prospective longitudinal study assessed the development of the mother-child relationship within the context of other important aspects of transition to parenthood. In the prenatal phase, 238 women who were 8 months pregnant with their first child completed a set of questionnaires. At 1 month post-partum, 165 of these women completed a second set of questionnaires, and a subset of 86 were observed for 1 hour at home with their infants. When their child was 2 years old, 62 of the 86 mothers completed questionnaires and were observed in interaction with their toddler in the laboratory. The several hundred individual variables were reduced to internally consistent composite variables, 5 in the prenatal phase, 7 postpartum, and 14 in the toddler phase. Preliminary analyses reported in this paper assessed the structure of relationships among the composite variables within each phase (Pearson correlations) and whether there was significant prediction from one dimension to another across the phases, beyond stability in the predicted dimension (multiple regressions). Causal modeling analyses are still in progress. The results indicate that the development of maternal attachment is a gradual process and that feelings of attachment are related to a number of other measures of women's psychological well-being. Parenting confidence was found to play a central role in adaptation to motherhood within each phase, as well as from the prenatal to postpartum and postpartum to toddler phases.     

“On the outside: Interventions with infants and families at risk”

Infants and families at high psychosocial risk may be considered “on the outside,” that is, outside of the mainstream for healthy development and for well-being because of many different factors. They may be lacking the crucial ingredients that are necessary for healthy physical and emotional development that include good nutrition and health care, predictable caregiving, and guidance to develop the intellectual and emotional skills to succeed in school and in life. Some of the risk factors that may keep infants and families “on the outside” include poverty, teenage pregnancy, and violence exposure. In this paper, I will discuss different types and levels of intervention for infants at risk taking place in different settings around the world carried out by WAIMH members including a naturalistic intervention an orphanage in St. Petersburg, Russia, a community-based intervention program in Puerto Allegre, Brazil, and a community-based violence prevention and intervention program in New Orleans, Louisiana. Variety and levels of evaluation and assessment are also discussed. Finally, as President of WAIMH, I consider different perspectives on the future for WAIMH. © 1998 Michigan Association for Infant Mental Health     

Enabling Action: Reflections upon Inclusive Participatory Research on Health with Women with Disabilities in the Philippines

People with disabilities experience health disparities arising from social, environmental, and system-level factors. Evidence from a range of settings suggests women with disabilities have reduced access to health information and experience barriers to screening, prevention, and care services. This results in greater unmet health needs, particularly in relation to sexual and reproductive health. Women with disabilities are also more likely to experience physical and sexual violence than women without disabilities, further undermining their health. Community-based participatory research (CBPR) can generate knowledge and underpin action to address such health disparities and promote health equity. However, the potential and challenges of disability inclusion in CBPR, particularly in contexts of poverty and structural inequality such as those found in low- and middle-income countries, are not well documented. In this paper, we reflect on our experience of implementing and evaluating W-DARE, a three-year program of disability-inclusive CBPR aiming to increase access to sexual and reproductive health and violence-response services for women with disabilities in the Philippines. We discuss strategies for increasing disability inclusion in research and use a framework of reflexive solidarity to consider the uneven distribution of the benefits, costs, and responsibilities for action arising from the W-DARE program.     

Speaking for the baby: A therapeutic intervention with adolescent mothers and their infants

Adolescent mothers frequently experience problems in mother-infant interaction. However, intervention can be very difficult, particularly when complicated by unresolved conflicts involving relationships in the young woman's past. This article describes a therapeutic intervention, based on the work of Fraiberg, which allows the young mother to learn to interpret her infant's cues while also encouraging her to express her own emotions in the context of the mother-infant relationship. Two case studies are discussed to illustrate the use of the technique as part of a program of mother-infant intervention.