Specific Life Domains Research Articles

The Quality of Life of Persons with Severe and Persistent Mental Illness: A Typology Based on Cluster Analysis

Recently rehabilitation and mental health professionals have placed increased emphasis on quality of life as a service outcome for individuals with severe and persistent mental illness. Research has indicated that when services are based on quality of life improvement, consumers are able to achieve higher levels of independence, satisfaction, production, and community integration. Individuals with severe and persistent mental illness completed Lehman's Quality of Life Index. Respondents were grouped based on their subjective assessment of quality of life in specific life domains. Although cluster analysis revealed that most respondents viewed quality of life as satisfactory, the heterogeneous nature of the groups suggested that it is important to view quality of life from a multifaceted perspective. The multifaceted nature of quality of life is discussed in terms of implications for rehabilitation counselors, administrators, and policy makers.

Psychosocial adjustment in patients after a first acute myocardial infarction: The contribution of salutogenic and pathogenic variables

Objective: To ascertain the differential and independent impact of sociodemographic, medical, and psychologic variables assessed at patients' hospital discharge on these patients' psychosocial adjustment in several domains of life 3 to 6 months later. Design: Two-hundred ninety Israeli male patients, aged 30 to 65 years, with a documented first acute myocardial infarction (AMI) were interviewed once before discharge and again 3 to 6 months postinfarct. Sociodemographic, medical, and psychologic data were elicited at the first interview and completed from medical information in the hospital files. Psychosocial adjustment in seven significant life domains was evaluated by the Psychosocial Adjustment to Illness Scale-Self-Report Version (PAIS-SR) at the second interview. Hierarchical regression analysis was used to examine the relation between the sociodemographic, medical, and psychologic variables at discharge to psychosocial adjustment in the different life domains 3 to 6 months later. Results: Psychologic variables, such as depression, sense of coherence, and social support, and the sociodemographic variable of educational level at discharge predicted a relatively substantial amount of variance in psychosocial adjustment in most PAIS-SR-measured life domains. Low to moderate relations were found between such medical variables as Killip class, heart disease before AMI, other medical conditions, and perceived health before first AMI and psychosocial adjustment in specific life domains. The results also raised the possibility that part of the impact of the medical variables at discharge on psychosocial adjustment 3 to 6 months later may have been mediated by the psychologic variables. The centrality of the psychologic and domestic life domains to psychosocial adjustment in post-AMI patients was also suggested by the results. Conclusions: Both external and internal pathogenic (depression) and health proneness variables (sense of coherence and social support) at discharge predict psychosocial adjustment in most life domains 3 to 6 months after AMI.

Subjective quality of life in out-patients with schizophrenia: clinical and utilization correlates.

The relationship between subjective quality of life (QOL), clinical measures, and service utilization was measured in out-patients with schizophrenia. A total of 72 subjects completed the Quality of Life Interview and were also assessed by means of the Positive and Negative Syndrome Scale, a battery of neuropsychological tests, and two measures of social functioning. Use of psychiatric services over a 2-year period was ascertained from comprehensive records. Global subjective QOL was lower than patients' satisfaction with specific life domains. There were few significant correlations between satisfaction with, and objective measures of, specific life areas. In a multiple regression, patients' global subjective QOL was inversely related to their scores on the PANSS depression factor, and to the number of psychiatrist out-patient visits.

Does quality of life differ in schizophrenic women and men? An empirical study.

In our study of 617 schizophrenic patients, we tested the hypothesis that women have a better objective and subjective quality of life than men. Better social integration of women was confirmed. Objective conditions had a significant but quantitatively small impact on satisfaction with specific life domains. Better social integration did not, however, lead to more satisfaction among schizophrenic women. Satisfaction with life in general was better predicted by satisfaction in different life domains than by objective circumstances. Predictors of satisfaction with life were not equal for both sexes. Rather than confirming quantitative differences in subjective quality of life, our data support the existence of gender-specific processes and contexts of subjective valuation.

General life satisfaction and domain-specific quality of life in chronic schizophrenic patients.

Subjective quality of life (QOL) has often been assessed through questionnaires or structured interviews focusing on the person's satisfaction with various life domains. In particular, most QOL instruments for psychiatric patients are based on this concept. We report on a study casting some doubts on the rationale of this approach. We investigated the QOL of 48 chronic schizophrenic outpatients with a long-term disease history (at least 20 years) using a German version of the Lancashire QOL Profile. The interrelations between general life satisfaction, satisfaction with specific life domains, psychological well-being and psychopathology were studied using correlation analysis and multiple linear regression. Of the life domains assessed, only two, namely social relations and health, contributed significantly to the patients' general life satisfaction, while the others (including work, leisure, family relations and housing) did not. The subscales on psychological well-being (self-esteem, affective state) as well as psychopathology were found to be more closely associated with general life satisfaction than almost all life domains considered. The findings are discussed with regard to the specific situation of the group of patients investigated. They give indications that the life domain approach to measuring QOL has its limitations, in particular when applied to patients having adapted to a very restricted everyday life.

A Framework for Developing Family Life Education Programs

Family life education is becoming an increasingly important part of the work of human service providers. Although there have been many important advancements in family life education in the last decade, there is still limited articulation of the criteria needed develop and implement effective family life programs, especially those designed for community-based prevention efforts. This paper begins outline the relevant methodological issues that need be considered for the creation of effective family life education programs. Family life education is becoming an increasingly important part of the prevention efforts of human service providers. In recent years, family life education has been championed as an important factor in dealing with such issues as adolescent pregnancy (Roosa, 1991), substance abuse (Alvy, 1988) and family violence (Lloyd & Emery, 1993). Although there is a growing body of data demonstrating that some programs are effective, there continues be the need improve the performance of family life programs (Guerney & Maxson, 1990). During the past decade, there have been a number of important advancements in the practice of family life education. A significant step has been the development of standards by the National Council of Family Relations in regards the minimum qualifications needed for family life educators (NCFR, 1984). This has resulted in greater specification of the knowledge base for family life education. Coupled with this is a growing literature on the theoretical basis for family life education. Thomas and Arcus (1992) analyzed the definition of family life education clarify the purpose and content. To this end they concluded that the general purpose of family life education is to strengthen and enrich individual and family well-being (Thomas & Arcus, 1992, p. 4). Through the work of several authors, there has also been increased clarification of the content of family life education over the life-span (Arcus, 1987; Cassidy, 1993; Hennon & Arcus, 1993). There have also been important commentaries on alternative perspectives on family life issues. Morgaine (1992) analyzed the philosophical roots of family life education and explored a critical on the way in which family life education is conducted. Allen and Baber (1992) critiqued family life education from a feminist perspective and developed ideas for how feminist theory can influence work with families. In more specific domains of family life, there have been theoretical discussions of how work with divorced families from an empowerment perspective (Hughes, 1992) and how work with ethnic families (Alvy, 1988). These discussions further clarify the work of family life education. At a more practical level, there have also been important developments in strategies for teaching family life education and in evaluating the effects of programs. Two especially innovative approaches teaching family relations are a simulation approach learning for divorced and remarried families (Crosbie-Burnett & Eisen, 1992) and an ethnographic approach studying human development issues developed by Quinn (1992). In regards evaluation of family life education, Small (1990) provides clear guidelines consider when conducting evaluations. He makes an important distinction between established, model programs that are likely be widely replicated, thus requiring substantial evaluative work, and more general local programs that are in need of ongoing monitoring through evaluation. Additionally, Guerney and Maxson (1990) provide some suggestions for the use of no-treatment control groups and outcome measures evaluating family life programs. Despite these advancements, there are still major issues that need attention further develop the practice of family life education. One of the major difficulties with the development of family life education programs is that there has been limited discussion of the methodology of family life education. …

Research note victimization in the workplace: A test of routine activities theory

To advance and test fully routine activities theory, it is necessary to examine the relationship between routines and victimization in specific domains of social life, such as work, school, home, and leisure. Domain-specific studies, however, are limited in number and in rigor. In this light, using a sample of faculty members, the present study attempts to assess the impact of routines on victimization at work. The results support the utility of routine activities theory as an explanation of differences in workplace vitimization of faculty members. We discuss the implication of these findings, as well as the implications of domain-specific models for empirical tests of routine activities theory.

Stressful Events and Life Satisfaction Among Elderly Men and Women

The purpose of this study was to examine the interrelationships among stressful events, domain-specific assessments of life satisfaction, and global evaluations of life satisfaction. This research was guided by two competing theoretical formulations. According to bottom-up theory, older adults first assess feelings of satisfaction within specific life domains that are based in part on the experiences (i.e., stressors) they encounter in these areas. The domain-specific views are subsequently synthesized to form an overall sense of satisfaction with life as a whole. In contrast, the top-down theory suggests that a person's ongoing sense of satisfaction with life as a whole predisposes him or her to assess satisfaction with specific domains in ways that are congruent with his or her initial sense of global life satisfaction. Analysis of data provided by older participants in a nationwide survey tends to support the bottom-up perspective.

Stressful life circumstances: Concepts and measures

AbstractConceptualizations of the role of life stressors in health and well‐being typically emphasize stressful events and tend to neglect the ongoing context in which events occur. We suggest that stress and coping theory will contribute more to research and clinical practice when stressful circumstances are conceptualized in terms of a person's life context, and assessed by examining chronic stressors and life events in specific life domains. We exemplify this broader perspective by presenting a new way to measure ongoing stressors, discrete life events, and social resources in multiple life domains, and by some relevant research on alcoholism and depression. Finally, we describe some applications of this approach to diagnosis and treatment, and to program planning and evaluation.

Time‐use in later life

This paper seeks to demonstrate the significance of the time budget methodology for nursing as a means of exploring the use of time in later life and its relation to health and well-being. With increasing concern for quality of life issues, the use of time and the proportion of time that is allocated to specific domains of life become important life-style decisions that merit both personal concern and professional inquiry. The paper begins with a review of the time budget methodology and the research employing the time budget methodology dating back to the 1960s. It continues with a description of how people allocate and use their time in later life as revealed by these studies, and concludes with the significance of this method of inquiry for nursing.

Religious Involvement and Life Satisfaction in Canada

This paper examines the relationship between religious involvement and self-reported satisfaction with life in general, and with six specific domains of life. The sample consists of persons aged 25-59 (N = 6,621) surveyed in 1985 in the first Canadian General Social Survey. Overall, there appears to be a positive association between religious involvement and satisfaction for both men and women. However, in British Columbia, where levels of religious involvement are lower than the rest of Canada, the relationship is substantially weakened and, in some cases, actually reversed. Despite data limitations, which are discussed, it is concluded that a positive relationship between these two variables cannot be substantiated in all instances. It is suggested that more refined research is needed to assess and to explain the particular conditions under which a positive relationships will prevail.

A Comparison Between Bottom–Up, Top–Down, and Bidirectional Models of Relationships Between Global and Life Facet Satisfaction

ABSTRACT We compared “bottom‐up,”“top‐down,” and “bidirectional” models of relationships between global and life facet satisfactions in a sample of university professors A bottom‐up model proposed that specific life facet satisfactions determine satisfaction with life in general A top‐down model proposed that global life satisfaction determines satisfaction in specific life domains A bidirectional model proposed reciprocal influences between global and life facet satisfaction We used LISREL‐VI to contrast these models and, overall, the bidirectional model received strongest support However, direction of relations between global and life facet satisfaction varied across life domains We suggest that differences in domain scope, criticality, and centrality may determine the direction of the relationship between overall and life facet satisfaction

Exploring Individual Differences in Marital Change across the Transition to Parenthood: The Role of Violated Expectations

The major purpose of this investigation is to test the hypothesis that spouses whose prenatal expectations proved too positive or insufficiently negative relative to their actual postnatal experiences would experience the greatest decline in marital functioning across the transition to parenthood. A 2ndary goal involves the simple comparison of prenatal expectations and postnatal experiences to determine the general accuracy of prenatal expectations about how the transition to parenthood is likely to affect individual and family functioning. The 61 middle class families particiapting in the project provided information on themselves during the last trimester of pregnancy and at 3 and 9 months postpartum. Prenatal assessment questions asked how parents-to-be expected the baby to affect a number of aspects of their lives. At 3 and 9 months the questions requested that parents evaluate how the birth of the baby and the transition to parenthood actually affected these same domains in their lives. Respondents were queried about 6 specific domains of individual and family life: marital conflict and cooperation overall marital relationship personal opinion of self relations with extended family with friends and neighbors and shared caregiving arrangements. A measure of violated expectations was created on the basis of the discrepancy between parental expectations and postnatal reports. In general prenatal expectations and postnatal experiences were similar. The effects of having a baby on the marriage turned out to be significantly less positive than anticipated for the sample as a whole; and parents-to-be expected husbands to be more involved in child care than they turned out to be. As predicted it is found that parents whose postnatal experiences turned out less positive and more negative than anticipated experienced more negative change in marriage. This is especially the case for mothers and for marital change between the last trimester of pregnancy and 3 months postpartum. The analyses clearly indicate that violated expectations had a much less powerful effect on marital change from 3 to 9 months. That the impact of violated expectations was more evident in the case of women may be explained by the fact that it is mothers who invariably bear the major burden of the transition to parenthood. Because women experience the greatest lifestyle change following the arrival of a 1st baby it seems to be the case that failure to anticipate accurately the nature of the babys influence and especially the tendency to overestimate the positive effects of this event are associated with negative change in the marital relationship as evaluated by women.

The impact of life events and changes in domain satisfactions on well-being

Previous research has shown that QOL measures are reasonably reliable and valid for static analysis. This article is concerned with the validity of the measures for use in panel studies/dynamic analysis. Are they sensitive enough to register changes (i.e., enhanced satisfaction and well-being) of the kind one would expect to follow favourable life events, and also changes (i.e., reduced satisfaction and well-being) due to adverse life events? Also, do changes in satisfaction with specific domains of life produce concomitant changes in the general sense of well-being?

Age and Satisfaction

The authors studied the relationship between age and variables measuring satisfactions with specific domains of life as well as global satisfaction and happiness. Data from several large, mostly national, surveys of American adults were utilized. The results showed an increase in satisfaction with housing, community, work, and, somewhat less consistently, with finances/income, standard of living, and leisure/spare time. The increase was less clear for family, marriage, friends, and global well-being. Various explanations for the relationship were tested by multiple regression procedures, using two national surveys. Higher religiosity of the aged, increased desire to respond in a socially acceptable manner, and a lessening of change in life conditions appear to contribute to higher satisfaction. Although these factors individually represent only partial explanations, a combination of them accounts for a substantial part of the relationship. On the other hand, certain aspects of older people's lives are actually worse and, as such, suppress an even more substantial association between age and satisfactions.