Subjective QOL Research Articles

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.

Actual conditions of postoperative dyschezia recognized by rectal cancer patients and self-care

The purpose of this study is to reveal the actual conditions of dyschezia as recognized by postoperative rectal cancer patients and their self-care, as well as the subjective QOL (Schedule for the Evaluation of Individual Quality of Life-Direct Weighting: SEIQoL-DW), and to obtain suggestions for the nursing intervention for improving the self-care of dyschezia and QOL. The subjects were 88 patients (age: 62.2 ± 9.3 years), consisting of 33 and 55 patients that received intersphincteric resection (ISR) and low anterior resection (LAR), respectively. The mean of the SEIQoL-DW index was 66.7 ± 15.3 for ISR and 63.8 ± 14.8 for LAR, showing no significant difference. The dyschezia was grouped into seven categories such as [frequent defecation], [irregular number of defecations], [defecation on oral drug administration], [frequent nocturnal defecation], [fecal incontinence], and [anal pain]. The proportions of [irregular number of defecations], [frequent nocturnal defecation], and [fecal incontinence] were significantly higher for ISR than LAR. The self-care of dyschezia can be summarized into eleven categories such as [washing anus], [applying diapers and pads], [controlling dietary intake], and [controlling defecation]. In conclusion, it is important to understand in detail the fecal control, local anal care, food content, and intake method as nursing interventions using a checklist, and to instruct the patients individually in cooperation with physicians and physical therapists. Hirosaki Med.J. 62:186―198,2011

Depression and quality of life in first-episode psychosis

AimQuality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL. MethodsWe assessed 208 individuals with first-episode non-affective psychosis using measures of diagnosis (Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), symptoms (Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning), insight (Birchwood Scale), duration of untreated psychosis (Beiser Scale), and QOL World Health Organisation Quality of Life Instrument (WHOQOL-Bref). We used multiple regression to determine the contribution of depressive symptoms to QOL domains while controlling for socio-demographic and other clinical characteristics. ResultsThere were complete data for 146 individuals with FEP. Quality-of-life domains were consistently predicted by depressive symptoms including depressive mood and hopelessness rather than biological symptoms of depression with those experiencing more depressive symptoms reporting worse QOL. Those who were treated as in-patients reported improved QOL, and hospitalization was an independent predictor of most QOL domains. In-patients displayed greater levels of positive symptoms with those involuntarily detained displaying greater levels of bizarre behavior, thought disorder, and delusions. ConclusionsThese findings suggest that QOL is heavily influenced by depressive symptoms at initial presentation; however, as QOL domains are also influenced by admission status with in-patients being more symptomatic in terms of positive symptoms, subjective QOL assessment may be compromised during the acute phase of illness by both positive and depressive symptom severity.

Emotional adjustment in amyotrophic lateral sclerosis (ALS)

Despite the devastating motor impairment, a significant number of patients with amyotrophic lateral sclerosis (ALS) maintain a good psychosocial adjustment. Here we investigated whether this is specific for ALS or a more general characteristic of terminal disease. Psychosocial adjustment was investigated in 30 ALS patients, 29 cancer patients in palliative treatment and 29 age-, gender- and level of education-matched healthy controls. Subjective quality of life (sQoL), degree of depressive symptoms and coping were evaluated as measures of psychosocial adjustment. Personality factors were described. ALS and cancer patients showed a good psychosocial adjustment. Subjective QoL and depression did not differ significantly. Both patient groups presented a good sQoL. The level of mild depressive symptoms in both patient groups was similar and none showed clinically relevant depression. ALS patients expressed fewer active coping strategies than cancer patients which were explained by gender differences. Both patient groups showed comparable psychosocial adjustment to their disease. Overall, in terminally ill patients the psychological response to the prognosis is not associated with neurobiological changes (e.g., associated with subclinical deficits in ALS) or with physical decline.

Reconstruction of Pelvic-Organ Prolapse Using a Self-Fashioned Gynemesh

Objective: This study was conducted to evaluate the effectiveness of self-fashioned Gynemesh for the concomitant treatment of pelvic-organ prolapse (POP) and the factors involved in mesh erosion and disease recurrence. Design: This was a retrospective analysis of the results of surgery using Gynemesh for surgical management of POP. Population: The study population consisted of 81 women with stage 2 or higher POP, according to International Continence Society POP (ICS POP-Q) criteria, who underwent vaginal surgery in which Gynemesh was used. Methods: This was a retrospective study of surgeries conducted over a period of 16 months. Surgery involved a vaginal approach with mesh reinforcement. At 12 or more months postsurgery, women were examined for prolapse recurrence and were given visual analogue scale testing for satisfaction with the surgical outcome. Women completed quality-of-life (QOL) questionnaires preoperatively and at 12 months postsurgery. Objective success of surgery was assessed at 12 months postsurgery. Secondary outcomes were subjective success, complications, QoL outcomes, and patients' satisfaction. Results: Objective and subjective success rates were 91.4 and 92.6% at 12 months, respectively. Seven women developed further objective (ICS POP-Q stage 2 or more) POP. New prolapse in nonrepaired compartments accounted for 5 of 7 (71.4%) failures at 12 months. Five mesh exposures required further surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 24% at 12 months. QoL scores were significantly improved at 12 months, compared with baseline (p < 0.001). Conclusions: Modified pelvic-floor reconstruction using self-fashioned Gynemesh is a practical procedure for various kinds of POP. However, the long-term effect remains unknown. (J GYNECOL SURG 27:71)

Comparison of the Subjective QOL and the Objective QOL in Elderly Nursing Home Resident with Dementia

Comparison of the Subjective QOL and the Objective QOL in Elderly Nursing Home Resident with Dementia

1002 EARLY EFFICACY OF SILODOSIN ON STORAGE AND VOIDING FUNCTION IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA, BASED ON PRESSURE-FLOW STUDY

RESULTS: Mean age of the patients and mean prostate volume were 67.8 years and 43.9 mL, respectively. Mean I-PSS and QOL scores dropped from 17.8 to 9.8 points (p <0.001) and from 5.1 to 3.2 points (p < 0.001), respectively, indicating a significant improvement of subjective symptoms and QOL. On free uroflowmetry, mean Qmax significantly increased from 7.5 to 11.3 mL/sec (p = 0.005), while the residual urine volume significantly decreased from 69.8 to 32.1 mL (p = 0.002), showing an improvement in the voiding function. Although not statistically significant, improvement was observed in the parameters of the storage function on PFS, with mean FDV rising from 127 to 159 mL (p = 0.168), MCC from 262 to 298 mL (p = 0.135). While uninhibited detrusor contraction was observed in 21 patients before silodosin administration, it disappeared in 14 patients after administration. Qmax significantly improved from 5.8 to 9.7 mL/sec (p = 0.01). Mean Pdet Qmax declined significantly from 73.9 to 52.4 cmH 2 0 (p <0.001), demonstrating that silodosin relieved bladder outlet obstruction CONCLUSIONS: Silodosin may be considered improving not only subjective symptoms but also voiding function and bladder outlet obstruction in BPH patients with lower urinary tract symptoms. Q2: Week 0.5 −0.5 (1.08) −0.3 (0.96) 0.0002 Last observation −0.9 (1.34) −0.5 (1.16) <0.0001 Q4: Week 0.5 −0.4 (1.21) −0.3 (1.14) 0.0075 Last observation −0.8 (1.36) −0.4 (1.27) <0.0001 Q7: Week 0.5 −0.4 (1.06) −0.3 (1.03) 0.0968 Last observation −0.6 (1.14) −0.4 (1.15) 0.0037 Obstructive symptoms Q1: Week 0.5 −0.6 (1.14) −0.3 (0.97) <0.0001 Last observation −0.9 (1.42) −0.6 (1.22) <0.0001 Q3: Week 0.5 −0.7 (1.19) −0.4 (1.10) 0.0002 Last observation −1.1 (1.41) −0.6 (1.33) <0.0001 Q5: Week 0.5 −0.8 (1.29) −0.4 (1.03) <0.0001 Last observation −1.1 (1.41) −0.5 (1.21) <0.0001 Q6: Week 0.5 −0.7 (1.16) −0.3 (1.21) <0.0001 Last observation −0.9 (1.32) −0.5 (1.24) <0.0001

Boldogító utazás: A turizmus hatása a magyar lakosság szubjektív életminőségére

A szubjektív életminőséggel kapcsolatban felmerülő kérdések tisztázása napjainkra már nem csak a tudományos műhelyek közötti párbeszédben, hanem a társadalom közérzetéért felelős politikai berkekben is prioritást élvező témának számít. A kutatók, legyenek azok a filozófia, a pszichológia, a szociológia, a geográfia vagy éppen a közgazdaságtudomány képviselői, leginkább a boldogság forrását, a szubjektív jólét eléréséhez vezető utat, a politikusok pedig annak a hatalom általi befolyásolhatóságának mikéntjét kívánják feltárni, illetve feltáratni. A Nemzeti turizmusfejlesztési stratégia (2005-2013) – nemzetközi összehasonlításban is egyedülálló módon – rendkívüli fontosságot tulajdonít a magyar lakosság utazásainak életminőség-növelő szerepére. Ahhoz, hogy a dokumentumban megfogalmazottak valóban a társadalom javára válhassanak, az önkormányzati és Területfejlesztési Minisztérium Turisztikai Szakállamtitkársága a Magyar Turizmus Zrt.-vel és az MTA Földrajztudományi Kutatóintézettel együttműködve felkérte a Központi Statisztikai Hivatalt a lakosság utazási magatartásával összefüggő boldogságfaktor feltárására. A 2007- ben, mintegy 11,5 ezer háztartásban folytatott kérdőíves felmérés eredménye felszínre hozta a turizmus és az életminőség kapcsolatának eddig alig ismert vetületeit. A tanulmány az életminőséggel kapcsolatos hazai és nemzetközi szakirodalom kontextusába helyezve tárgyalja a felnőtt magyar lakosságra reprezentatív vizsgálat eredményeit, értékeli az egyes változók mentén létrehozott adattáblákat. A szerzők különös hangsúlyt helyeznek az utazás és az élettel való elégedettség közötti általános kapcsolatok bemutatására, valamint az utazásokban rejlő boldogság összetevőinek feltárására.

Factors associated with work outcome among individuals with schizophrenia: Investigating work support in Japan

As the mental health care system in Japan is putting an increased emphasis on community rehabilitation, an effective working-support program is needed for patients with schizophrenia. In order to examine personal factors associated with competitive employment, a retrospective, cross-sectional study was conducted with patients involved in an integrated program that provides both psychiatric care and a working-support service for patients with schizophrenia. Thirty six schizophrenic outpatients who were employed in the working support program participated. Patients were divided into a working group and a non-working group, depending on whether they worked more or less than 20 hours a week. The working group significantly differed from the non-working group in that they were more likely to have completed high school (p<0.05, Fisher's exact probability test), disclosed their disability to their employers (p<0.05, Fisher's exact probability test) and worked less than 20 hours in their initial employment (p<0.001, Fisher's exact probability test). Logistic regression analysis revealed that the disclosure of disabilities (odds ratio=6.00, p=0.02), shorter initial working-time (odds ratio=27.6, p<0.001), or higher educational level (odds ratio=6.42, p=0.02) increased the probability of success of competitive employment. For the other outcomes (severity of psychotic symptoms, disability of daily life or subjective QOL), there was no difference between the two groups (p>0.05, respectively, Mann-Whitney's U-test). In this program, participation in competitive employment may not be associated with the severity of psychotic symptoms, disability of daily life or subjective QOL but may be promoted by the disclosure of disabilities, shorter initial working-time and higher education.

CS11-02 Interepisode functioning of bipolar disorder

Even though bipolar disorder is suggested to have a benign course with episodes and remissions, it has been shown that interepisode functioning of bipolar disorder is not so good. Subclinical residual mood symptoms are found to be in 24% of bipolar patients during remission. Furthermore, it appears that 30-60% of individuals with bipolar disorder fail to regain full functioning in occupational and social domains. In cognitive domain, euthymic bipolar patients demonstrate relatively marked impairment in aspects of executive function such as processing speed and verbal fluency, sustained attention, and verbal memory.It is estimated that 30-50% of largely remitted patients fail to attain premorbid levels of psychosocial functioning due to their cognitive impairment. It is also suggested that the subsyndromal residual depressive symptoms have substantial effect on the persistence of cognitive and psychosocial impairment after remission. Thus, residual symptoms play an important role in the inter-episode functioning of the bipolar patients.In the assessment of interepisode functioning, subjective QOL in bipolar patients may not accurately reflect objective functional outcome status. Especially, in the subjective assessment of cognitive functions, bipolar patients tend to over-estimate themselves. There is only weak to moderate correlation between subjective cognitive complains and objective cognitive tests. Therefore, it would be more accurate to assess the inter-episode functioning of the bipolar patients via objective tests and ratings.

Positivsymptome und Lebensqualität aus der Sicht schizophrener Patienten

The aim of the study was the investigation of positive symptoms and quality of life from the subjective perspective of patients with schizophrenia. We assessed self- and expert-rated positive symptoms (semi-structured interview), standardized psychopathology (PANSS), subjective well-being (SWN) and QOL (MSLQ) in n=59 patients. Patients reported that ideas of grandiosity and hallucinations of dialogue voices were less distressing compared with command voices, malevolent voices and delusional ideas of persecution. Patients with high levels of distress reported significant lower subjective well-being (SWN: t=2.27; p<0.05) and QOL (MSLQ: t=2.01; p<0.05), but showed no differences in symptom severity (PANSS: t=-0,98; p=n. s.) compared with patients with low subjective distress. Distress caused by positive symptoms reflected the individual meaning of the symptoms and was associated with lower quality of life.

Life-lines of relapsed breast cancer patients : A study of post-recurrence distress and coping strategies

This study investigated latent distress and coping mechanisms existing in the experiences of relapsed breast cancer patients in order to identify strategies for improving support structures for this population. Semi-structured interviews were performed with 26 subjects receiving care from two medical facilities in the Tokyo Metropolitan area. In this study, the life-line methodology was selected as a tool to express the subjective QOL of subjects. Specifically, we used life-lines to examine the changing processes of the subjective QOL and to explore latent distress and coping mechanisms.We found that 1) the life-lines of approximately half of the subjects regained a pre-initial diagnosis level of psychosocial equanimity after both the initial diagnosis of cancer and the first episode of recurrence ; however, the life-lines of some subjects remained depressed as they suffered multiple recurrences and a concomitant loss of hope, 2) relapsed patients faced an awareness of death and a sense of uncertainty, a decline in pleasures, and a declining ability to find meaning in life, 3) the recovery of the level of the life-line accompanied changes corresponding to a scale recalibration, a change in values, and a reconceptualization as described in response shift theory. These changes were confirmed in two areas : those related to sickness, treatment and survival, and those related to finding a significance in life itself and asserting one's reasons for living. Furthermore, as a result of cognitive coping strategies, the maintenance of life-line levels after recovery were attained in the same two areas as stated above, 4) when compared with a SF-8 survey methodology measuring a health-related QOL, the life-line methodology was more consistent with the mental health rather than the physical health domains, especially as related to identifying a personal meaning in one's life, and 5) relapsed patients combined characteristics of patients in both treatment and terminal stages of the disease.Study results reinforce the recognition that relapsed breast cancer patients have an unmet need for support systems tailored to respond to their individual psychological characteristics.

Confirmatory factor analytical study of the WHOQOL-Bref: experience with Sudanese general population and psychiatric samples

BackgroundThe widespread international use of the 26-item WHO Quality of Life Instrument (WHOQOL-Bref) necessitates the assessment of its factor structure across cultures. For, alternative factor models may provide a better explanation of the data than the WHO 4- and 6-domain models. The objectives of the study were: to assess the factor structure of the WHOQOL-Bref in a Sudanese general population sample; and use confirmatory factor analysis (CFA) and path analysis (PA) to see how well the model thus generated fits into the WHOQOL-Bref data of Sudanese psychiatric patients and their family caregivers.MethodIn exploratory factor analysis (FA) with all items, data from 623 general population subjects were used to generate a 5-domain model. In CFA and PA, the model was tested on the data of 300 psychiatric outpatients and their caregivers, using four goodness of fit (GOF) criteria in Analysis of Moment Structures (AMOS). In the path relationships for our model, the dependent variable was the item on overall QOL (OQOL). For the WHO 6-domain model, the general facet on health and QOL was the dependent variable.ResultsTwo of the five factors ("personal relations" and "environment") from our FA were similar to the WHO's. In CFA, the four GOF criteria were met by our 5-domain model and WHO's 4-domain model on the psychiatric data. In PA, these two models met the GOF criteria on the general population data. The direct predictors of OQOL were our factors: "life satisfaction" and "sense of enjoyment". For the general facet, predictors were WHO domains: "environment", "physical health" and "independence'.ConclusionThe findings support the credentials of WHO's 4-domain model as a universal QOL construct; and the impression that analysis of WHOQOL-Bref could benefit from including all the items in FA and using OQOL as a dependent variable. The clinical significance is that by more of such studies, a combination of domains from the WHO models and the local models would be generated and used to develop rigorous definitions of QOL, from which primary targets for subjective QOL interventions could be delineated that would have cross-cultural relevance.

Factors associated with quality of life of outpatients with breast cancer and gynecologic cancers and their family caregivers: a controlled study.

BackgroundQuality of life (QOL) issues are of interest in cancer because effective methods of treatment and detection have led to an increase in the number of long-term survivors. The objectives of the study were: to assess the subjective QOL of stable Sudanese women cancer outpatients and their family caregivers, using the WHO 26-item QOL Instrument; compare with matched general population groups, as well as diabetic and psychiatric patient groups; examine patient-caregiver concordance in ratings; and assess the variables associated with their QOL, with a view to identifying factors that can enhance quality of care.MethodsResponses of oncology outpatients with breast cancer (117), cervical cancer (46) and ovarian cancer (18) (aged 44.6, SD 11.5) were compared with those of their family caregivers and matched general population groups. Data were analyzed by univariate and multivariate statistics.ResultsThe cancer groups had similar QOL domain scores, which were significantly lower than those of their caregivers, but higher than the control group as well as those of psychiatric and diabetic patients studied previously. Patients who were married, with higher education, better employment, and with longer duration of illness had higher QOL. Patients on radiotherapy and their caregivers had higher QOL scores. Correlations between patient's ratings and caregiver impression of patient's QOL were high. Caregiver impression was a significant predictor of patient's and caregiver's QOL. Other predictors for the patient were: currently feeling sick and duration of illness; for the caregiver: feeling sick, relationship to patient, and age.ConclusionCancer patients in stable condition and with psychosocial support can hope to enjoy good QOL with treatment. The findings constitute an evidence base for the country's cancer care program, to boost national health education about prognosis in cancer. Families living with women cancer patients are vulnerable and need support if the patient is recently diagnosed, less educated, single, not formally employed; and the caregiver is female, parent, younger, less educated, unemployed and feels sick. Clinicians need to invest in the education and support of family caregivers. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.

Gender-specific and gender-sensitive associations with psychological health and morbidity in older age. Baseline findings from a British population survey of ageing

Objective: To examine gender-specific and gender-sensitive factors associated with psychological health and morbidity. Design: Face-to-face home interview survey of random sample of 999 people aged 65 and over living in Britain. Results: A fifth of respondents had symptoms of psychological morbidity. Men with high self-efficacy had over six times the odds of men with lower levels, of scoring as a non-case with the 12-item General Health Questionnaire (GHQ-12). Women with excellent to good health status had over five times the odds of those in worse health of scoring as a non-case. Self-efficacy and mobility were the strongest independent predictive variables of GHQ score among men; health status and subjective QoL were the strongest, independent predictors among women. Discussion: This paper is unique in examining in detail the independent, gender-specific and gender-sensitive predictors of psychological morbidity in a national random sample of older adults. Optimism, self-efficacy, quality of life and mobility were gender-specific predictors, and health status was a gender-sensitive predictor of psychological morbidity. These differences suggest that interventions aiming to improve the mental health outcomes of older people need to be guided by evidence on risk factors by gender.

A prospective study of Quality of life in schizophrenia in three European countries

Only a small number of studies have tried to identify factors influencing the subjective QoL of patients suffering from schizophrenia in a longitudinal design. These studies suffer from small clinical samples or compare baseline data only with a single follow-up. The European Schizophrenia Cohort Study overcomes these shortcomings by providing data from five time points on 1208 patients in psychiatric treatment in three European countries over a period of 2 years. QoL was measured with the brief version of Lehman's Quality of Life Interview. Random effects, between-effects and within-effects regression models were computed in order to measure the influence on subjective QoL of patients' socio-demographic and clinical characteristics and objective QoL. Objective QoL scores were generally found to be related to the equivalent subjective QoL scores. People's financial situation, and depressive and positive symptoms had a general effect on almost all subjective domains. The significant effects of objective finances on subjective domains like health and social relations raise interesting possibilities for intervention. Sufficient financial resources appear to be a necessary condition for achieving satisfactory QoL in schizophrenia patients. However, changes in individual's characteristics and circumstances did not relate as strongly as expected to changes in QoL, suggesting effective intervention may be difficult.

A comparative study of quality of life among adults with spina bifida

Method The Norwegian sample consisted of 57 adults registered with the Norwegian Association of SB and Hydrocephalus. Adults included 38 females and 19 males, mean age 31.8 years (17 – 54 years). The Oregon sample included 34 adults attending the Child Development Rehabilitation Center, at Oregon Health Science University. Adults included 15 females and 19 males, mean age of 29.5 (17 – 49 years.) By postal survey, information was obtained assessing subjective QoL (WHOQOL – BREF, psychological distress (Hopkins Symptom Checklist), disability cognitions (Harowitz Impact of Events Scale) coping efforts (Lazarus Revised Ways of Coping Checklist), and cognitive difficulties (1item and Broadbent Cognitive Failures Questionnaire).

Effect of antipsychotic replacement with quetiapine on the symptoms and quality of life of schizophrenic patients with extrapyramidal symptoms

Replacement of antipsychotic drugs with quetiapine (QTP) was tried in a naturalistic setting in chronic schizophrenic patients who still showed moderate psychiatric symptoms and either showed extrapyramidal symptoms (EPS) or took anti-parkinson drugs for the EPS. QTP was added on and gradually increased while the previous drugs were tapered and discontinued whenever possible. Clinical symptoms, objective and subjective QOL, and EPS were measured before and 6 months after QTP addition, using Brief Psychiatric Rating Scale (BPRS), Quality of Life Scale (QLS), Schizophrenia Quality of Life Scale (SQLS) and Drug-Induced Extrapyramidal Symptom Scale (DIEPSS), respectively. Twenty-one patients completed the trial and received the assessment. It was found that replacement with QTP-improved clinical symptoms, objective and subjective QOL and EPS. This improvement was equally observed in not only patients who switched to QTP monotherapy (n = 11) but also patients who took QTP together with reduced small doses (4.4 +/- 4.3 mg/day) of previous drugs (n = 11). The results suggest that replacement with QTP improves symptoms as well as objective and subjective QOL in a subgroup of schizophrenia.

Path Analytical Study of the Short Version of the WHO Quality of Life Instrument

Background: Using confirmatory factor analysis, we have shown that the 8 factors we derived from the responses of 118 Nigerian psychiatric patients to the short version of the WHO Quality of Life Instrument had greater structural integrity than the 4- and 6-domain models of the WHO. Objectives: Using path analysis to assess the structural integrity of the model we generated from the relationships among the 8 factors, we proposed a model of QOL from which targets for subjective QOL interventions could be delineated. Method: The model was generated by multiple regression analysis with the item on overall QOL (OQOL) as dependent variable and the 8 domains as predictors. Path analysis was done by Analysis of Moment Structures, with a maximum likelihood ratio as method of estimation. Results: Our model had high Cronbach’s alphas and met the criteria for the following fit indices: relative χ² (1.9), goodness of fit (0.92) and comparative fit index (0.91). Hence, we propose that subjective QOL is primarily mediated by satisfaction with life, informational need, opportunity for experience, and instrumental need. Conclusion: Subjective QOL encompasses satisfaction with life circumstances, fulfillment of needs, and opportunity for experience, which should be targets for QOL interventions.

What is the Strength of the Link Between Objective and Subjective Indicators of Urban Quality of Life?

Urban quality of life is usually measured by either subjective indicators using surveys of residents' perceptions, evaluations and satisfaction with urban living or by objective indicators using secondary data and relative weights for objective indicators of the urban environment. However, rarely are subjective and objective indicators of urban quality of life related to each other. In this paper, these two types of indicators were linked using Geographical Information Systems (GIS) to both locate respondents to the “2003 Survey of Quality of Life in South East Queensland” and also to gather objective indicators about their urban environment within the region with regard to services, facilities and overcrowding. Using Structural Equation Modelling (SEM), the strength of the relationships between these objective indicators and subjective indicators was examined. The results show that relationships between objective and subjective indicators of urban QOL can be weak, and suggests care should be taken when making inferences about improvements in subjective urban QOL based on improvements in objective urban QOL. However, further research is needed into the links between objective and subjective indicators of urban QOL including examining other aspects of the urban environment, non-linear relationships, and moderating effects for individual differences.