what do women want from a good quality of life? women in stem suzanne skevington phd, cpsychol,...
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What do women want from a good quality of life?Women in STEM
Suzanne Skevington PhD, CPsychol, ARCM, FBPsS
Manchester Centre for Health Psychology
‘(Quality of) life… is rather like opening a tin
of sardines.
We’re all looking for the key’
Alan Bennett (1961)
What is quality of life?
WHO Definition of Quality of life
• An individual’s perception of their position in life, in the context of the culture and values in which they live and in relation to their goals, expectations, standards and concerns.
• The WHOQOL Group (1993)
Who needs Quality of Life assessment?
• Chronic diseases e.g. heart disease, cancer, depression
• Caregivers of ill &/or disabled adults, children
• Those living in potentially high stress situations
e.g. migrants, refugees, trauma victims
• Communication problems e.g. stroke, dementia
• Well people e.g. worksites, pregnant women…
Languages of the world (7,300+)
ShonaEnglish
Hindi
Sequential Translation process
Simultaneous Translation procedure:‘spoke-wheel’
W.H.O.
JapanIndia
Panama
Zimbabwe UK
Focus group participants(Appleby in Cormie &Warren, 2001)
Asking questions about Quality of Life (QoL)
Example of Sleep
• An objective measure of QoL
e.g. Examine EEG readings of sleep depth & patterns
• Perceived Objective QoL
How many hours do you sleep?
• Self-report Subjective QoL
How refreshing is your sleep?
Properties of ‘good’ scales(Fitzpatrick et al,1998)
Appropriateness Reliability Validity Responsive to change Precision Interpretability Acceptability Feasibility
Overall Quality of Life and Health (General)
Physical Independence SocialRelationships
EnvironmentDomains
Pain & discomfort
Sleep &rest
Energy &fatigue
Dependenceon medication
Mobility
Activities ofdaily living
Workingcapacity
Positivefeelings
Self-esteem
Negativefeelings
Thinking, Learning,
Memory & Concentration
Body image & appearance
Financialresources
Recreation& leisure
Information& skills
Homeenvironment
Health &social care
Physical safety& security
Physicalenvironment
Personalrelationships
Practicalsocial support
Sex lifeFacets
WHOQOL-100
Transport
SRPB
Spiritual,religious &personalbeliefs
Psychological
Development of WHOQOL instruments
Year 1992 1994 1998 2004 2009 2014
Centres 10 15 15 30 67 87
Methods Qualitative Quantitative……………..
Versions - Pilot 100 BREF
Domains - 6 6 4
Facets 134 33 25 25
Items 2,000+ 235 100 26
Participants 4,800 11,800 40,000 +
Using the WHOQOL-BREF in UK (Skevington & McCrate, 2011) (N = 4628)
• Well people
• Students
• Nurses
• Carers
• Dental patients
• Prisoners
• Chronic fatigue syndrome
• Cocaine dependency
• Sleep disorder
• Disfigurement
• Cosmetic surgery
• Polycystic ovarian syndrome
• Depression
• Chronic schizophrenia
• Mild dementia
• Neurodegenerative disease
• Arthroplasty surgery
• Arthritis
• Chronic pain
• Skin disorder
• Heart transplant
• Stroke
• Diabetes
• IBS/IBD/Crohn’s disease
Arabic: Saudi, Egypt, KuwaitAmharic: EthiopiaBangla: Bangladesh BulgarianCantonese: S. China, Hong Kong,
AustraliaCatalan: SpainChichewa: MalawiCroatianCzechDanishDutchEmirati: SharjahEnglish: Australia, Canada, USA, NZ,
Fiji, MaltaEstonianFarsi: Iran, OmanFrench: Canada, Switzerland Burkina
Faso, VanuatuGerman: Austria Greek: CyprusHebrew: IsraelHindi:: India
HungarianBahasa: IndonesiaItalian JapaneseKannada: S. IndiaKhmer: Cambodia Korean Krio: Sierra LeoneLatvianLiberianLithuanianMalayalam: S.IndiaMarathi: India MalayMandarin: China NorwegianPortuguese: Brazil, PortugalPolishPreeti: NepalRomanianRussian: Kyrgyzstan
Serbian Shessana: South AfricaShona: ZimbabweSinhala: Sri LankaSlovak Slovenian Solomon IslandsSomaliSpanish: Argentina, Panama, Uruguay,
Mexico, Chile, Cuba Swahili: Kenya, UgandaSwedish TaiwaneseTamil: S. India ThaiTurkishUkrainianUrdu: Pakistan VietnameseYoruba: NigeriaZambian
WHOQOL Cultural adaptations and Translations (2015)
WHOQOL Modules
1. International Modules for specific diseases & conditions
• WHOQOL-HIV Group (HIV/AIDS)(2003,2004,2010,2012)
• WHOQOL-SRPB Group (Spiritual, Religious & Personal Beliefs)(2005,2006, 2007,2010,2013)
• WHOQOL-OLD Group (60+ years) (2005,2006,2007,2010,2011)
2. Culture-specific (national) modules in 10 centres (Skevington et al,1999)
3. Modules for diseases/conditions piloted in one centre
• Chronic Pain (UK) (Mason et al, 2004,2008,,2009, 2010,2013)
• Children 5-8 years (Thailand) (Jirojanakul et al, 2000,2003)
• Adolescents 13-18 years (UK) (Skevington et al,2014)
4. Developments for an international poverty module Peru, Ethiopia, Bangladesh &Thailand(Skevington et al, 2004, 2008,2009)
Quality of life at stages of HIV/AIDS (n=900) (WHOQOL-100)
Health Status
Well
HIV + symptoms
HIV+ no symptoms
AIDS
Me
an
17
16
15
14
13
12
11
10
Physical
Psychological
Independence
Social
Environment
Spiritual
Centres
Melbourne, Australia
Porto Alegre, Brazil Bangalore, India
New Delhi, India
Bangkok, Thailand
Rome, Italy
Dniepropetrovsk, Ukraine Harare, Zimbabwe
Phnom Pen, Cambodia
Sample11,241 women and men living in 35 cultures in 29 countries
Adults age 15 - 100 years; sick and well
Women n=5017 Age bands: 15-29 13%; 30-44 14%; 45-59 10%;
60-74 41%; 75+ 22% Marital status: Single 12%; Married 50%; Partnered/Living as
married 4%; Separated/Divorced 9%; Widowed 25% Educational level: None 0.3%; Primary 25%; Secondary 29%;
College/Univ 35%; Postgrad 4%; Other 5%
Overall Quality of Life and Health (General)
Physical Independence SocialRelationships
EnvironmentDomains
Pain & discomfort
Sleep &rest
Energy &fatigue
Dependenceon medication
Mobility
Activities ofdaily living
Workingcapacity
Positivefeelings
Self-esteem
Negativefeelings
Thinking, Learning,
Memory & Concentration
Body image & appearance
Financialresources
Recreation& leisure
Information& skills
Homeenvironment
Health &social care
Physical safety& security
Physicalenvironment
Personalrelationships
Practicalsocial support
Sex lifeFacets
Women have significantly better quality of life than men
Transport
Spiritual
Spiritual,religious &personalbeliefs
Psychological
Overall Quality of Life and Health (General)
Physical Health
Psychological SocialRelationships
EnvironmentDomains
Pain & discomfort
Sleep &rest
Energy &fatigue
Dependenceon medication
Mobility
Activities ofdaily living
Workingcapacity
Positivefeelings
Self-esteem
Negativefeelings
Thinking, learning
memory & concentration(Cognitions)
Body image & appearance
Financialresources
Recreation& leisure
Information& skills
Homeenvironment
Health &social care
Physical safety& security
Physicalenvironment
Personalrelationships
Practicalsocial support
Sex life
Meaning in Life
Facets
WHOQOL-SRPB
Transport
SRPB
Purpose
in Life
Faith
Hope
Strength
Awe
Peace
SpiritualConnection
Wholeness
Overall Quality of Life and Health (General)
Physical Independence SocialRelationships
EnvironmentDomains
Pain & discomfort
Sleep &rest
Energy &fatigue
Dependenceon medication
Mobility
Activities ofdaily living
Workingcapacity
Positivefeelings
Self-esteem
Negativefeelings
Thinking, Learning,
Memory & Concentration
Body image & appearance
Financialresources
Recreation& leisure
Information& skills
Homeenvironment
Health &social care
Physical safety& security
Physicalenvironment
Personalrelationships
Practicalsocial support
Sex lifeFacets
Men have better quality of life than women
Transport
SRPB
Spiritual,religious &personalbeliefs
Psychological
International sample of Women: WHOQOL-100 (n=5017)
What predicts good quality of life in women?All six domains contribute to a good overall QoL and
67.6% of total QoL is explained.
Environmental QoL 46.2% Psychological QoL 7.6% Social relationships 2.9% Independence 2.6% Physical health 0.3% Spiritual QoL 0.2%
Age, education and marital status account for 7.8%
What predicts good quality of life in women?72% of overall QoL and health is explained by 17 facets. Age, education & marital status account for 8.1% of total
Positive feelings 42% Activities of daily living 10.6% Personal relationships 3.9% Home environment 3.9% Energy 1.5% Financial resources 0.9% Recreation & leisure 0.7% Self-esteem 0.4% Mobility 0.3%
Health & social care 0.3% Sex life 0.2% Sleep 0.1% Social support 0.1% Medication (-) 0.1% Working capacity 0.1% Spiritual QoL 0.01% Physical environment 0.01%
