Meaning in life and perceived quality of life in Switzerland: results of a representative survey in the German, French and Italian regions

Predicting perceived quality of life through social trust, physical activity, and sense of happiness in Iran: Moderating role of gender

Background and Aims

In Iran, few studies have addressed the moderating effect of gender on determinants of quality of life. This study aimed to determine the effect of social trust, physical activity, and sense of happiness on the perceived quality of life, considering the moderating role of gender.

Methods

This was a population-based cross-sectional study. The statistical population were men and women aged 16 years and above in five western provinces of Iran. The final sample size was estimated to be 1268 people calculated through the correlation coefficient estimation formula, and finally 1185 questionnaires received. Data were analyzed using SPSS and AMOS software.

Results

The mean score of quality of life among women was significantly higher than that of men (p < 0.001). The direct standardized coefficient showed that the sense of happiness (β = 0.40), social trust (β = 0.20), and physical activity (β = 0.12) had a significant effect on the perceived quality of life (p < 0.001). Also, gender had a moderating role in the relationship between sense of happiness and perceived quality of life (z-score = 3.246, p < 0.001). Totally, 21% of the changes in perceived quality of life were explained by three main variables. The main variables were stronger explanatory factors in men (R = 0.26) than in women (R = 0.17).

Conclusions

The final model showed that sense of happiness had the most direct effect on the perceived quality of life, moderated by gender. Considering that the quality of life among men was lower than that among women and the direct effect of happiness on quality of life was more among men than that among women, it is suggested that gender-based health promotion interventions with an emphasis on men be carried out to strengthen the sources of happiness to improve quality of life.

Predictors of Quality of Life in HIV-Infected Persons from Mozambique: The Dual Role of Schooling

Increasing quality of life (QoL) is both an end in itself and a means to optimize the impact of treatment in HIV-infected persons. Possibly due to cultural and social influences, the predictors of QoL vary across studies, highlighting the importance of studying specific populations. In the present study, we aimed to determine the sociodemographic (age, sex and schooling, or number of years at school) and psychosocial correlates (meaning in life, social support, positive and negative affects) of QoL in HIV-infected persons living in Mozambique, a country with a high prevalence of HIV but also with well-structured strategies to fight the disease. To that end, we made correlational analyses followed by regression models and examined potential mediation processes among predictors. All correlates were relevant except for sex. Meaning in life was the strongest predictor, while social support was the weakest. Schooling was both directly and indirectly related with QoL-in the latter case, it was mediated by meaning in life, social support and positive affect. Our findings suggest that investments in education may be highly rewarding to Mozambicans, and that satisfying needs for self-actualization and purpose may be more urgent than improving social connections.

Occupational Happiness of Civilian Nurses in China: a cross-sectional study

BACKGROUND

Civilian nurses have gradually become the main body of military nurses. Our study aimed to understand their occupational happiness and its influencing factors.

METHODS

This descriptive study was conducted with 319 civilian nurses working in 15 military hospitals in China. Based on literature review, expert consultation and combined with the characteristics of civilian positions, this study developed a questionnaire on occupational happiness of civilian nurses in military hospitals. The questionnaire includes 7 dimensions as follows: work emotion, salary, work environment, professional identity, work output, interpersonal relationship, well‑being. The demographic questionnaire and occupational well-being questionnaire of civilian nurses in military hospitals were analysed by t-test, analysis of variance and Pearson correlation analysis.

RESULTS

The occupational happiness score (3.83 ± 0.56, upper limit score: 5) was at the upper middle level. There were significant differences in occupational well-being by gender (t = -2.668, p = 0.008), age (F = 5.085, p = 0.007) and the type of city where the hospital was located (F = 15.959, p < 0.0001). The happiness score of females (3.94 ± 0.60) was higher than that of males (3.47 ± 0.54). Nurses who were over 41 years old had the highest occupational happiness. Compared with nurses younger than 30 years old, the p value was 0.004. The occupational happiness of nurses in hospitals in a "prefecture-level city" (p < 0.0001) and a "sub-provincial city" (p < 0.0001) was significantly higher than that of nurses in hospitals in a "municipality directly under the central government". Correlation analysis showed that the higher the nurses' satisfaction with professional identity, work output, work environment, salary, and interpersonal relationships, the higher their occupational happiness.

CONCLUSION

Occupational happiness of civilian nurses in Chinese military hospitals was above the medium level. Gender, age, and the type of city where the hospital was located had a very significant impact on the level of occupational happiness. In addition, "professional identity", "work output", "work environment", "salary", and "interpersonal relationships" were significantly correlated with the occupational happiness of civilian nurses. They can be improved with some future lines of research.

The Impact of Mental Health and Sociodemographic Characteristics on Quality of Life and Life Satisfaction during the Second Year of the COVID-19 Pandemic—Results of a Population-Based Survey in Germany

A decreased quality of life was shown for numerous factors at the beginning of the pandemic. However, it is important to identify people who are at-risk for long-term impairments during the pandemic and its aftermath. Within this study, we aimed to investigate quality of life within a German population-based sample (2515 participants; 51.6% female; mean age 50.09 years) during the second year of the pandemic (2021). Our results showed that the majority reported no pandemic-associated change in quality of life at this state of the pandemic. Higher life satisfaction was associated with fewer mental health problems, no pre-existing somatic and psychiatric disorders, higher income, no income loss during the pandemic, living with others, and younger age. In contrast, in a high-risk group encompassing participants with lower quality of life, only mental health, pre-existing somatic disorders, and living alone had significant associations with quality of life, indicating a smaller scope for improvement in this high-risk group. Age, income loss, and depressive symptoms predicted a decrease in quality of life since the beginning of the pandemic. Our results highlight the importance of mental health, especially in times of pandemic, and underline the need for low-threshold mental health support.

On social and psychological consequences of prolonged poverty–A longitudinal narrative study from Finland

By means of qualitative longitudinal material, this article explores meaningfulness during persistent monetary poverty through an integrative framework, which builds upon conceptualisations of meaning in life (coherence, significance, and purpose) and modes of being (labour, work, action). The material consists of 36 autobiographical accounts and their follow-up accounts from 2006 and 2012. The analysis reveals that in the developed welfare state of Finland, prolonged monetary poverty is connected with the propensity for incoherence and a feeling of insignificance, particularly if life is governed by a vicious cycle of scarcity. Prolonged poverty 1) turns aspirations from long-term to short-term goals and frames life as something characterised by negative anticipation and a circular sense of time. Life primarily takes place in private space. It also 2) weakens the sense of belonging and 3) reduces public participation. These are the domains where the meaning in life is constructed, deconstructed, and reconstructed. In a developed welfare state, the comprehensive and manageable social security scheme maintains coherence, yet universal social policy actions that enable participation in public activities nourish a sense of significance.

Meaning in life and quality of life: palliative care patients versus the general population

BACKGROUND AND OBJECTIVES

Meaning in life (MIL) represent a key topic in palliative care. The aims of this study were to explore (1) the differences in perceived MIL and in the meaning-relevant life areas between a representative sample of the Swiss population and palliative care patients, and (2) to what extent MIL can be considered as a significant predictor of quality of life (QOL).

METHODS

A cross-sectional study was conducted separately for the patients (face-to-face interviews) and the general population (telephone survey). MIL was measured with the Schedule for Meaning in Life Evaluation (SMILE) and QOL with a single-item visual analogue scale (0-10). Sociodemographic variables were controlled for in the analyses.

RESULTS

206 patients and 1015 participants from the Swiss population completed the protocol. Results indicated high MIL scores in both populations even if the difference was significant (patients 81.9 vs general population 87, p<0.001). Patients were more likely to cite 'family' (OR=1.78), 'social relations' (OR=1.9), 'spirituality and religion' (OR=3.93), 'social commitment' (OR=1.94) and 'growth' (OR=2.07), and less likely to cite 'finances' (OR=0.15) and 'health' (OR=0.21) as MIL-relevant areas. The SMILE scores and MIL areas explained 21.8% of the QOL variance for the patients and 15.1% for the representative sample.

CONCLUSIONS

Our data emphasise the importance of MIL as a contributor to QOL in both populations. It highlights the importance of the life areas contributing to MIL, especially social interactions for both populations, and spirituality and areas related to growth in palliative care patients.

The clinical evaluation of the wish to hasten death is not upsetting for advanced cancer patients: A cross-sectional study

BACKGROUND

An important concern of healthcare professionals when exploring the wish to hasten death with patients is the risk of causing them some type of distress.

AIM

To assess the opinion of hospitalized patients with advanced cancer about the proactive assessment of the wish to hasten death.

DESIGN

Descriptive, cross-sectional study.

SETTING/PARTICIPANTS

We assessed 193 advanced cancer patients admitted to an oncology ward for the wish to hasten death using a semi-structured clinical interview. After the assessment the participants were surveyed to determine whether they found the interview upsetting and, if so to what extent, and also their opinion regarding the assessment's importance.

RESULTS

The wish to hasten death was reported by 46 (23.8%) patients. The majority of patients (94.8%) did not find talking about the wish to hasten death to be upsetting, regardless of whether they presented it or not. The majority of patients (79.3%) considered that it was either quite or extremely important for the clinician to proactively assess the wish to hasten death and discuss this topic, regardless of whether they experienced it.

CONCLUSIONS

In this study, most of the advanced cancer patients did not find the assessment of wish to hasten death to be upsetting, and a substantial proportion of patients in this study believe that it is important to routinely evaluate it in this setting. These findings suggest that healthcare professionals can explore the wish to hasten death proactively in routine clinical practice without fear of upsetting patients.

[Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study]

Most research on (multidimensional) frailty focuses on deficits and risks of adverse outcomes. However, frail older people can still report positive outcomes, such as a relatively high QoL. In order to develop more positively oriented prevention strategies, this exploratory study aimed (a) to identify characteristics related to QoL among frail older people; and (b) to explain discrepancies between higher and lower levels of QoL, with a specific focus on strengths frail older people with a higher QoL still may have. Quantitative and qualitative data was gathered by means of semi-structured interviews with Flemish community-dwelling, frail older people with higher (n = 16) and lower QoL levels (n = 18). Quantitative analyses showed that frail older people with a higher QoL were older, had lower levels of psychological frailty, and reported higher meaning in life compared to those with a lower QoL. Outcomes of qualitative analysis showed that participants in the high QoL subgroup adapted more effectively to difficulties, had more things in prospect, performed more activities, and were more satisfied with their social network compared to the low QoL subgroup. To conclude, this exploratory study suggests possibilities to promote and improve QoL by strengthening specific resources among frail older people.Please note that an English version of this article has been published in BMC Geriatrics: van der Vorst A, Zijlstra GAR, De Witte N, Vogel RGM, Schols JMGA, Kempen GIJM, D‑SCOPE Consortium. Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study. BMC Geriatr. 2017;17(1): 251. https://doi.org/10.1186/s12877-017-0641-y .

"People don't understand what goes on in here": A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care

BACKGROUND

The age demographic of the incarcerated is quickly shifting from young to old. Correctional facilities are responsible for navigating inmate access to healthcare; currently, there is no standardization for access to end-of-life care. There is growing research support for prison-based end-of-life care programs that incorporate inmate peer caregivers as a way to meet the needs of the elderly and dying who are incarcerated.

AIM

This project aims to (a) describe a prison-based end-of-life program utilizing inmate peer caregivers, (b) identify inmate-caregiver motivations for participation, and (c) analyze the role of building trust and meaningful relationships within the correctional end-of-life care setting.

DESIGN

A total of 22 semi-structured interviews were conducted with inmate-caregivers. Data were analyzed using Consensual Qualitative Research methodology.

SETTING/PARTICIPANTS

All inmate-caregivers currently participating in the end-of-life peer care program at Briarcliff Correctional Facility were given the opportunity to participate. All participants were male, over the age of 18, and also incarcerated at Briarcliff Correctional Facility, a maximum security, state-level correctional facility.

RESULTS

In total, five over-arching and distinct domains emerged; this manuscript focuses on the following three: (a) program description, (b) motivation, and (c) connections with others.

CONCLUSION

Findings suggest that inmate-caregivers believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative to work toward greater standardization of and access to end-of-life care for the incarcerated.

Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study

Background

Most research on multidimensional frailty focuses on deficits and risks of adverse outcomes. However, although some frail older people report a low quality of life (QoL), others still report a relatively high QoL. More knowledge about these discrepancies might give new insight into developing frailty prevention strategies. Therefore, this mixed-method study aimed (a) to identify characteristics related to QoL among frail older people; and (b) to explain discrepancies between higher and lower levels of QoL, with a specific interest in identifying strengths frail older people with a higher QoL still have.

Methods

Semi-structured interviews were held with community-dwelling, frail older people with higher (n = 16) and lower levels of QoL (n = 18). Frailty was assessed with the Comprehensive Frailty Assessment Instrument, which measures environmental, physical, psychological, and social frailty. Other quantitative measures included socio-demographic characteristics, overall QoL, meaning in life, and mastery. The qualitative part focused on the meaning and maintenance of QoL (among other factors), despite being frail. Possible explanations for discrepancies in QoL were explored.

Results

Frail older people with a higher QoL were older, had lower levels of psychological frailty, and reported higher meaning in life compared to those with a lower QoL. Outcomes of qualitative analysis showed that participants in the high QoL subgroup adapted more effectively to difficulties, had more things in prospect, performed more activities, and were more satisfied with their social network compared to the low QoL subgroup.

Conclusion

This exploratory study suggests possibilities to promote and improve QoL by strengthening specific resources among frail older people.

Electronic supplementary material

The online version of this article (10.1186/s12877-017-0641-y) contains supplementary material, which is available to authorized users.