The concept of well-being: relevance to nutrition research

The aim of this paper is to discuss issues that fall within the general concept of well-being, with special emphasis on approaches that have been used in studies of nutrition and behaviour. Following this, two specific studies are described in detail, the first examining high-fibre breakfast cereals and the second investigating effects of inulin. Studies of nutrition and well-being can be categorised in a number of ways. One method involves examining acute effects of nutrition on mood and cognitive functioning. Another method has been to examine cross-sectional associations between dietary habits and questionnaire measures of reported health. Examples are given showing that regular consumption of a high-fibre diet is associated with better-reported physical and mental health. The problem with such correlational studies is that it is impossible to infer causality. Intervention studies are necessary to achieve this and some examples of this approach are given. In the first study reported here, we examined whether consumption of high-fibre breakfast cereal led to an increase in energy. Such an effect was observed and plausible biological mechanisms underlying such results are described. A similar methodology has recently been used to examine the effects of inulin. In this case the results showed no negative side-effects of taking inulin but there were no beneficial effects of inulin on measures of well-being (both subjective reports and objective measures). Possible reasons for these effects are discussed.     

The role of psychological well-being in retaining rural general practitioners

OBJECTIVE: Retention of rural GPs is an increasing area of concern and is receiving considerable attention from the government, medical authorities and the media. This study aimed to examine the potential for psychological interventions to assist in the retention of rural GPs through targeting their psychological well-being. DESIGN: GPs completed a questionnaire, including questions about their level of support in rural practice, psychological health (work-related morale and distress, distress related specifically to working in rural general practice, quality of work life) and intentions to leave rural practice. SETTING: Rural general practices in South Australia. PARTICIPANTS: One hundred and eighty-seven rural GPs. RESULTS: Results indicated that rural GPs who were seriously considering leaving rural practice had higher work-related distress, higher distress related specifically to working in a rural general practice and lower quality of work life. GPs who considered leaving rural practice also reported having fewer colleagues with whom to discuss professional issues. CONCLUSION: Results indicated that psychological interventions (such as cognitive behavioural training), assistance with stress reduction and coping mechanisms (such as more interaction with colleagues) may be of benefit to GPs who are considering leaving rural practice. Such training may increase the number of GPs who ultimately stay in rural practice.     

Measuring women's psychological well-being in Indonesia

This paper describes the development of a set of measures of women's psychological well-being in Indonesia, identifies meaningful clusters of women based on the well-being measures, and explores the sociodemographic factors associated with these well-being clusters. This is the first published study to measure psychological well-being among a large sample of Indonesians and the first to focus on women in that country. Rather than use standard measures of psychological well-being developed in Western nations and untested among Asian women, focus groups were conducted to develop an understanding of Indonesian women's perceptions of their own well-being. The focus group findings were used to develop 41 questionnaire items to measure psychological well-being, and the questionnaire was administered to 796 women in Sumatra and Lampung. Factor analysis reduced the well-being variables into five factors accounting for 45% of the total variance: (1) general negative feelings; (2) satisfaction with relationships and ability to control fertility; (3) satisfaction with economic, family and personal conditions; (4) negative feelings regarding marital and domestic issues; and (5) ability to pursue activities outside the home. We constructed five scales based on these factors. Based on their scores on these scales, women grouped into three clusters differentiated by their scores on four of the five scales. Low levels of psychological well-being were associated in bivariate analyses with: (1) rural residence; (2) young age (under age 30); (3) marriage before age 20; (4) low socioeconomic status; and (5) lower educational attainment.     

The effect of adolescent virginity status on psychological well-being

Although previous research has found that sexually active teens are more likely to suffer from depression, it is not clear whether this association is causal or spurious in nature. This study uses data from the National Longitudinal Study of Adolescent Health to examine whether virginity status affects self-esteem and depression. For males, fixed effects and instrumental variables (IV) estimates provide little evidence that sex is causally related to psychological well-being. In contrast, IV estimates indicate that sexually active female adolescents are at increased risk of exhibiting the symptoms of depression relative to their counterparts who are not sexually active. Comparing the psychological well-being of females who used contraception at last intercourse with that of virgins suggests that these effects may be ameliorated, but not eliminated, by contraceptive use.     

正念训练对某校医学生主观幸福感和心理幸福感的影响

探讨正念训练对某医科院校学生主观幸福感及心理幸福感的影响,为大学生心理健康教育提供实证参考.方法 招募山西医科大学本科生90名,随机分为实验组和对照组(各45名).最终得到有效数据的实验组38人参加为期9周的正念训练,对照组36人不进行任何干预.训练前后进行正性负性情感量表(PANAS)、青少年学生生活满意度量表(CASLSS)、心理幸福感量表(PWBS)、脑电α波、肌电和心率的测量.结果 两组被试所有指标训练前差异均无统计学意义(P值均>0.05).训练后与训练前比较,实验组正性情感(3.00±4.84 vs-0.64±4.66)、生活满意度总分(10.53±19.04 vs-1.83±24.47)、心理幸福感总分(15.05±23.90 vs-2.64±28.92)的增值高于对照组(t值分别为3.292,2.433,2.875,P值均<0.05),负性情感(-3.08±4.49 vs 0.53±3.46)的差值低于对照组(t=-3.857,P<0.01),脑电α波的增值高于对照组(t=5.912,P<0.01),肌电和心率的差值低于对照组(t值分别为-5.878,-2.134,P值均<0.05).结论 正念训练能够有效提升个体的主观幸福感和心理幸福感,改善心理和生理状态.     

Predictors of psychological well-being among assisted-living residents

Assisted-living facilities are a rapidly growing source of supportive housing for frail elderly people. This study examined the psychological well-being of elderly assisted-living residents and factors associated with well-being. Participants were nondemented elderly residents of an assisted-living community in the urban southeast. Depression, life satisfaction, and demographic, health, and social support variables were measured through face-to-face interviews. A sizeable minority of the residents reported high levels of depressive symptoms and low life satisfaction. Female gender, self-reported health, functional impairment, perceived social support, and participation in activities were significantly associated with well-being. The predictive value of gender and health variables were reduced when social support was introduced. Implications for policy and social work practice are discussed.     

Reported disease and psychological well-being in Swiss adults

Summary In Switzerland, and in many other countries as well, the distribution of morbidity and perceived health in the general population and their determining factors have not been systematically studied so far. This article reports an exploratory study of prevalence of two complex health indicators, longstanding disease (Disease) and psychological well-being (Well-being) and of their environmental, person-specific and behavioural determinants. Data from a health survey conducted in five cantons and three language regions as part of the Swiss Intercantonal Health Indicators Project were used. Whereas distributions of prevalence of Disease according to gender, age, level of education and place of living confirm results of other studies, unexpected prevalence patterns were found for Well-being, especially with regard to gender differences. Multivariate analyses by general linear models (independent sub-samples of the study population were used to develop and validate models) showed different sets of environmental, person-specific and behavioural factors to explain inter-individual differences of Disease and Well-being, both in the total validation sample and in sub-samples of women and men. The results are discussed with regard to implications for socioepidemiological health research.

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Zusammenfassung Wie in zahlreichen anderen Ländern so sind bisher in der Schweiz die Verteilung und die Determinanten von Morbidität und wahrgenommener Gesundheit in der Gesamtbevölkerung nicht systematisch untersucht worden. Die vorliegende Arbeit berichtet über eine explorative Studie über die Prävalenz zweier komplexer Gesundheitsindikatoren, länger andauernde Krankheit (Disease) und psychisches Wohlbefinden (Well-being), und über deren jeweilige umweltbedingte, personale und verhaltensbezogene Einflußfaktoren. Grundlage dafür waren Daten, die in einer Bevölkerungsbefragung in 5 Kantonen und 3 Sprachregionen im Rahmen des Interkantonalen Gesundheitsindikatorenprojekts (IGIPPROMES) erhoben wurden. Während die Verteilung der Prävalenz von Krankheit nach Geschlecht, Alter, Bildungsstatus und Wohnortgrösse den Ergebnissen anderer Studien entspricht, ergaben sich bei der Prävalenz von Wohlbefinden unerwartete Verteilungsmuster, insbesondere Unterschiede zwischen Frauen und Männern. Eine Analyse interindividueller Unterschiede von Krankheit und Wohlbefinden mit Hilfe eines allgemeinen linearen Modells (Modellentwicklung und Validierung an unabhängigen Teilstichproben) zeigte, dass diese durch jeweils spezifische Konstellationen von Umwelt-, Personen- und Verhaltensfaktoren erklärt werden können, sowohl in der gesamten Validierungsstichprobe als auch in den Teilstichproben für Frauen und Männer. Die Ergebnisse der Studie werden in Hinblick auf die Weiterentwicklung der sozialepidemiologischen Gesundheitsforschung diskutiert.

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Résumé En Suisse, comme dans beaucoup d'autres pays, la morbidité et le bien-être psychologique de la population générale n'ont presque pas été étudiés jusqu'à présent. Dans ce rapport, les résultats d'une étude exploratoire sur deux indicateurs complexes de santé, maladie chronique (Disease) et bien-être psychologique (Well-being) et sur les facteurs de l'environnement, de la personnalité et du comportement qui influencent ces deux indicateurs sont présentés. Cette étude faisait part du projet intercantonal sur les indicateurs de santé (IGIP-PROMES) et se base sur les données tirées d'une enquête auprès des populations de cinq cantons et trois régions linguistique de la Suisse. Tandis que la prévalence de l'indicateur «maladie» par sexe, age, degré de formation et dimension du lieu de résidence était conforme aux résultats d'autres études, des distributions inattendues de la prévalence de «bien-être psychologique», notamment des différences entre hommes et femmes ont été trouvées. Une analyse des différences entre individue de «maladie» et «bien-être» au moyen d'un modèle linéaire généralisi — le développement et l'évaluation duquel ont été faits à l'aide de deux échantillons d'occasion indépendents — a montré que des constellations spécifiques constituées de facteurs de l'environnement, de la personnalité et du comportement, peuvent expliquer ces différences, soit dans l'échantillon d'évaluation totale, soit dans les échantillons partiels de femmes et d'hommes. Ces résultats sont discutés par rapport à l'évolution de la recherche socio-épidémiologique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Social relationships and psychological well-being in rheumatoid arthritis

This study examines the social relationships of a sample of 158 patients attending a hospital rheumatology clinic with rheumatoid arthritis (RA). Scores of the sample were compared with those of other samples on the Interview Schedule for Social Interaction (ISSI). In addition the effects of severity of disease activity and of disability upon social relationships were examined. Diffuse social relationships such as with friends and acquaintances, rather than more intimate ones appear to be more affected in individuals with RA. Psychological well-being was assessed by means of two measures. The more favourably patients scored for social relationships, the more favourable were their scores for psychological well-being using both scores. More diffuse social relationships were more strongly correlated with psychological well-being than were the scores for more intimate relationships. Despite the strong effects of social relationships upon well-being, no buffering action on the effects of disability upon well-being were found.     

The psychological impact of video display terminals on employees' well-being.

A survey was administered to two large groups of employees, one a group of health care employees and the other a group of employees from a large insurance firm. The survey was used to determine whether video display terminal (VDT) operators experience greater psychosomatic distress, job tension, job dissatisfaction, and strain than nonoperators or employees who operate VDTs infrequently. After controlling for demographic factors, tenure, and role strain variables, findings suggest that hours of VDT use has an impact on employee well-being, though role strain was more consistently related to outcome measures.     

The role of spirituality in sustaining the psychological well-being of HIV-positive black women

Historically, spirituality has been an instrumental component to the survival of Black women. In an era when the HIV epidemic disproportionately compromises their health, it is imperative to explore spirituality's role in sustaining the psychological health of Black women living with HIV. This study examined the relationship between spirituality and self-reported depression among Black women living with HIV. A sample of 308 HIV-positive Black women were recruited from HIV/ AIDS clinics in the Southeastern United States. Participants completed an interview assessing demographics, quality of life, depression, coping, and spirituality. A hierarchical multiple regression was used to determine the association between spirituality and depression. The results suggest that in our sample, spirituality accounted for a small, yet significant proportion of variance in reducing depressive symptoms, above and beyond variance accounted for by demographic variables and other theoretically important psychosocial factors. In light of these findings, future studies with HIV-positive Black women should assess spirituality as a salient factor affecting psychological health. Developing interventions that address spirituality may serve to enhance women's psychological adjustment to living with HIV.     

Assessing psychological well-being: self-report instruments for the NIH Toolbox

Objective

Psychological well-being (PWB) has a significant relationship with physical and mental health. As a part of the NIH Toolbox for the Assessment of Neurological and Behavioral Function, we developed self-report item banks and short forms to assess PWB.

Study design and setting

Expert feedback and literature review informed the selection of PWB concepts and the development of item pools for positive affect, life satisfaction, and meaning and purpose. Items were tested with a community-dwelling US Internet panel sample of adults aged 18 and above (N = 552). Classical and item response theory (IRT) approaches were used to evaluate unidimensionality, fit of items to the overall measure, and calibrations of those items, including differential item function (DIF).

Results

IRT-calibrated item banks were produced for positive affect (34 items), life satisfaction (16 items), and meaning and purpose (18 items). Their psychometric properties were supported based on the results of factor analysis, fit statistics, and DIF evaluation. All banks measured the concepts precisely (reliability ≥0.90) for more than 98 % of participants.

Conclusion

These adult scales and item banks for PWB provide the flexibility, efficiency, and precision necessary to promote future epidemiological, observational, and intervention research on the relationship of PWB with physical and mental health.     

The psychological impact of aging on sexuality and relationships

Aging has a powerful impact on the quality of relationships and sexual functioning. The psychological impact of aging after midlife is a particularly timely topic given improved medical and psychological understanding of sexuality in both women and men, as well as more effective treatment for age-related sexual dysfunctions. It is time to dispel the stereotype of the midlife relationship as the continuation of a traditional heterosexual marriage with grown or almost grown children in order to more effectively address emotional and sexual issues arising in relationships. Regardless of the length or nature of the relationship, however, its quality is enhanced by emotional intimacy, autonomy without too much distance, an ability to manage stress and distractions by external factors, and achieving a satisfying sexual equilibrium. Perception of the quality of the primary relationship and sexuality is influenced by the other factors in a person's life. Thus, the relationship must be examined and issues must be addressed taking these external factors into consideration. Among the most powerful external factors is one's occupation or avocation, as it tends to strongly influence one's sense of identity, self-esteem, and self-worth in all areas of life. To understand and treat effects of aging on sexuality, it is important to address the three components of sexual desire: drive, beliefs/values, and motivation, as well as the sexual equilibrium within the primary relationship. It is also essential to understand how the physiological changes in male and female sexual functioning affect desire and equilibrium. Other health-related changes that occur with aging must be recognized and addressed, including the fact that the oldest of old women will outlive their corresponding male cohort. Treatment implications for these issues are discussed.     

Social support and psychological well-being in breast cancer patients

many aspects of the role of social support in psychological adaptation to illness have been investigated using different definitions of the construct. The present study focused on the role of instrumental social support and one aspect of emotional social support, namely supportive communication. In addition, the differential role of support provided in these areas by the spouse and significant others (SO) was examined. Subjects were 76 post-mastectomy breast cancer patients treated at a University Hospital in Istanbul. Patients were administered Spielberger's State-Trait Anxiety Inventory and the Beck Depression Inventory, and were interviewed using a structured interview developed by the authors. Results showed that supportive communication with the spouse, positive reaction of the spouse to mastectomy, marital satisfaction and open discussion of emotions concerning cancer were positively associated with psychological well-being. Instrumental support from the spouse or SO was not related to depression or anxiety.     

Association of psychological well-being with oral conditions in Japanese workers

Although the effect of disorders on psychological well-being is well-known, there are few studies focusing on oral conditions at the worksite. The present study examined the association between psychological well-being and oral conditions of Japanese workers. A cross-sectional study was performed using data from 1381 Japanese civil service officers aged 20-59 yr old. Psychological well-being was measured with the 12-item version of the General Health Questionnaire (GHQ-12) in a comprehensive health questionnaire, while measures for oral condition included self-rated oral health, oral symptoms and clinical indicators: dental caries, periodontal status and number of missing teeth. The mean GHQ scores according to the levels of each oral condition were estimated by analysis of variance, separately for males and females. Higher scores corresponded to poorer psychological well-being. Age, gender, smoking and type of occupation were adjusted in a multivariate analysis. Psychological well-being was not associated significantly with dental caries, periodontal status or number of missing teeth. The adjusted means of the GHQ scores for ;conscious of appearance of mouth' were significantly different among the categories for both genders (male: p<0.001, female: p=0.018). For five of six oral symptoms, the adjusted means of GHQ scores were lowest for those respondents who rated their oral symptoms as ;never or hardly ever.' Our results did not show that psychological well-being was associated with oral conditions measured by clinical indicators. However, an association was found between some oral symptoms and psychological well-being. Absence of oral symptoms seems to be related to better psychological well-being.     

The effect of weight-loss dieting on cognitive performance and psychological well-being in overweight women

This study investigated the effect of a weight reduction diet on cognitive performance and psychological well-being among overweight women. A total of 42 women undertook a 12-week weight reduction diet while 21 women maintained their usual diet and exercise habits for 12 weeks. All women completed neuropsychologcial tests of speed of information processing, executive function, working memory, immediate and delayed recall and recognition, and verbal ability. They also completed measures of weight locus of control, dieting beliefs, self-esteem, mood and dysfunctional attitudes, before and after the 12-week interval. Being on the diet had a minimal impact on cognitive performance and a positive effect on emotional eating, feelings of depression and dysfunctional attitudes. A sense of control over weight and eating behaviour increased among the dieters, but an internal locus of control was negatively related to self-esteem.     

The impact of the physical environment on the psychological well-being of office workers

This paper examines the relationship between the physical office environment and the psychological well-being of office workers. The results indicate that adverse environmental conditions, especially poor air quality, noise, ergonomic conditions, and lack of privacy, may effect worker satisfaction and mental health. The data also provide substantial evidence that worker assessments of the physical environment are distinct from their assessments of general working conditions, such as work load, decision-making latitude and relationships with other people at work. Stated another way, people who reported problems with the physical environment could not simply be characterized as dissatisfied workers exhibiting a tendency to 'complain' about every aspect of their working conditions. Taken together, these findings lend support to the position that the stress people experience at work may be due to a combination of factors, including the physical conditions under which they labor. Both theoretical and practical considerations arise from these data, including the need for work site based health promotion and stress reduction programs to consider both the physical and psychological design of jobs.     

The effects of low-pay and unemployment on psychological well-being: a logistic regression approach

The paper explores the relationship between unemployment and mental distress. The analysis draws upon data from the 1992 British Household Panel Study (BHPS). Six different measures of mental distress are used. Controlling for a number of individual characteristics, unemployed individuals are found to suffer significantly higher odds of experiencing a marked rise in anxiety, depression and loss of confidence and a reduction in self-esteem and the level of general happiness even compared with individuals in low-paid employment. This finding highlights the involuntary nature of unemployment. The results also suggest that all six measures of psychological well-being are lower in middle age compared with younger and older age groups. In addition, women appear to be less affected by unemployment than men.