Validity and Reliability of the Flourishing Scale in a Sample of Older Adults in Iran

Measurement of flourishing: a scoping review

Introduction

Flourishing is an evolving wellbeing construct and outcome of interest across the social and biological sciences. Despite some conceptual advancements, there remains limited consensus on how to measure flourishing, as well as how to distinguish it from closely related wellbeing constructs, such as thriving and life satisfaction. This paper aims to provide an overview and comparison of the diverse scales that have been developed to measure flourishing among adolescent and adult populations to provide recommendations for future studies seeking to use flourishing as an outcome in social and biological research.

Methods

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we conducted a scoping review across PubMed and EMBASE of studies introducing original flourishing scales (defined as a previously unpublished measure of mental health or wellbeing that used "flourishing" in its definition). Studies focusing on adult populations that were published before April 28, 2023 were considered eligible for inclusion.

Results

Out of 781 studies retrieved, we identified seven eligible studies covering seven unique flourishing scales. We find that all seven scales are multidimensional and assess features over monthly or yearly intervals. While most of the scales (six out of seven) include indicators of both hedonic and eudaimonic wellbeing, the operationalization of these dimensions of wellbeing varies considerably between scales. Several of the scales have been translated and validated across multiple geographical contexts, including higher- and lower-income countries.

Discussion

Complementing self-report measures with other social, economic, regional, and biological indicators of flourishing may be useful to provide holistic and widely applicable measures of wellbeing. This review contributes to concept validation efforts that can guide strategies to sustain flourishing societies.

The Flourishing Scale: Psychometric Properties in Breast Cancer Patients

BACKGROUND/OBJECTIVE

Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context.

METHOD

Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage.

RESULTS

The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress.

DISCUSSION

The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.

Body appreciation predicts better mental health and wellbeing. A short-term prospective study

Body appreciation is a key component of positive body image that has been consistently associated with better mental health and wellbeing. Existing research on body appreciation is largely limited to cross-sectional designs, although emerging evidence suggests that body appreciation may predict better wellbeing over time. The current study extends from this literature by testing whether body appreciation prospectively predicts numerous mental health and wellbeing outcomes (i.e., depressive and anxiety symptoms, self-esteem, flourishing, and general wellbeing). The sample consisted of adult women who completed study measures at baseline (n = 1749) and three month follow-up (n = 1258). Linear multiple regressions revealed that body appreciation scores at baseline significantly predicted decreased depressive symptoms (but not anxiety) and increased self-esteem, flourishing, and wellbeing scores at follow-up. Associations were evident after controlling for the influence of negative body image. Findings add to a growing body of evidence highlighting the protective potential of body appreciation and strengthen prior claims about the viability of targeting this facet of positive body image in mental health prevention and early intervention programs.

The Influence of Climate on Flourishing and Motivational Outcomes for U.S. Masters Swimmers

The climate in which older adults exercise and participate in sport may play a role in promoting a lifetime commitment to exercising. However, little research has examined the relationship of caring (C) and task-involving (TI) climates, motivation, and well-being with respect to older adult athletes. The purpose of this study was to examine the relationship between Masters swimmers' perceptions of the climate, effort, enjoyment, and flourishing as well as explore the mediating effects of effort and enjoyment on the relationship between climate and flourishing. U.S. Masters swimmers (n = 294; M_age = 63.57 years; 84.40% White) with 1-80 years of swimming experience (M = 34.54 years) participating in coach-led programs completed an online survey. The results of latent variable, multiple-mediator analyses via structural equation modeling revealed two important contributions to the literature: (1) when Masters swimmers perceived that they were in C and TI climates, they were more likely to report higher levels of effort and greater enjoyment and flourishing; (2) the Masters swimmers' effort levels directly influenced their flourishing, mediating the relationship between climates and flourishing. This research has important implications for practice and policy, as U.S. Masters Swimming appears to be a fruitful avenue for promoting an enjoyable physical activity that can be experienced throughout a lifetime.

Development and Validation of the Digital Life Balance (DLB) Scale: A Brand-New Measure for Both Harmonic and Disharmonic Use of ICTs

The use of new technologies and information communication technology services (ICTs) has greatly increased, especially after the COVID-19 pandemic, resulting in an irrevocable change in people's work-life balance (WLB). Despite the thriving literature on the dysfunctional use of new technologies, a functional use of ICTs also seems to be possible. Inspired by the theory of psychology of harmony and referring to behavioral addiction models and substance use models, we defined the construct of digital life balance to indicate a harmonic balance between digital life and real life. In this context, the imbalance between online and offline life may reflect a dysfunctional use of ICTs and can be seen as a process of disharmonization. With this perspective in mind, the aim of this study was to develop a dedicated measuring instrument that could capture both people's balanced and unbalanced use of ICTs. Through two cross-sectional studies (Study 1= 1473 participants; Study 2 = 953 participants), we validated the scale internally and externally. In line with the literature, Digital Life Balance scores appeared to be negatively associated with addiction measures and positively associated with well-being measures. In conclusion, the Digital Life Balance (DLB) Scale appears to be a reliable (ω = 0.89) and valid instrument to investigate people's harmonic and disharmonic use of ICTs.

Rates and correlates of well-being among youth experiencing homelessness

Mental health concerns have been well studied among youth experiencing homelessness, yet few studies have explored factors that contribute to well-being in this population. The current cross-sectional study examined rates and correlates of well-being among youth experiencing homelessness. This is a descriptive, secondary analysis of the baseline data from a clinical intervention study. Ninety-nine youth (aged 16-25) who were experiencing homelessness were recruited in Chicago. Approximately 40% of the sample reported average or above average well-being relative to existing benchmarks. Having medical insurance, a mobile phone, and a history of more severe childhood trauma were unique cross-sectional predictors of worse well-being (all ps < 0.034). A significant portion of our sample experienced well-being. Having access to certain resources may be counterintuitive indicators of poorer well-being among youth experiencing homelessness, perhaps because they are indicators of greater need or increased social comparison among these youth.

Oral self-care behavior and its influencing factors in a sample of school children from Central Iran

BACKGROUND

Oral health is an important part of public health and crucial to health promotion and enhancing the quality of life. This research examined childhood oral self-care behavior and their related factors using extended Theory of Planned Behavior (TPB).

METHOD

This cross-sectional study was conducted on 368 sixth-grade elementary school students in Saveh city, Iran, in 2019. The students were selected using a random multi-stage sampling method. The instrument included the socio-demographic questions, TPB constructs, and action and coping plan items. Data were analyzed by SPSS software (Version 21) at alpha level p ≤ 0.05.

RESULT

Overall, 24 (6.6%) students have never used toothbrushes, 222 (62.7%) have never used dental floss, and 298 (82.7%) students have never used mouthwash. The stepwise multiple linear regression analysis results indicated that the TPB with action and coping planning constructs had better predictive power than the original model. In the final model, coping planning (β = .28), intention (β = .24), action planning (β = .23), and perceived behavior control (β = .15) were the most important predictors of oral self-care behavior.

CONCLUSION

The results indicated that the oral self-care behavior status in Iranian elementary students was not favorable, and the extended model of the TPB with action and coping plan constructs were significant predictors of self-care behavior. Therefore, these findings emphasize the need for expanding educational interventions based on the extended model of the TPB to improve the oral self-care behavior of students.

Caregiver burden and coping strategies in caregivers of older patients with stroke

Background

Coping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers.

Methods

A total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests.

Results

The mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson’s correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032).

Conclusions

Caregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00556-z.

The psychometric evaluation of the sense of belonging instrument (SOBI) with Iranian older adults

BACKGROUND

A sense of belonging is a significant predictor of mental health and well-being in later life. A sense of belonging in childhood and adolescence contributes to a number of adult behavioural and psychological outcomes. A high sense of belonging has been associated with better health, longevity, psychological well-being, and disease recovery.

METHODS

In this study, the Persian version of the Sense of Belonging Instrument (SOBI) for older adults in Iran was evaluated psychometrically to develop an accurate measure for belonging. Participants in the study were 302 older adults, 60 years old and above, living independently in Iran and chosen through convenience sampling.

RESULTS

An exploratory factor analysis indicated that the four-factor structure, which included 16 items, accounted for 54.12% of the total variance, and was characterized by strong factor loadings, with values ranging from .50 to .87. Thereafter, a confirmatory factor analysis confirmed the four-factor latent structure of the SOBI, providing adequate data-model fit statistics. All latent structures were characterized by adequate-to-strong latent construct (H) internal reliability (α) coefficients.

CONCLUSIONS

The Persian version of the SOBI is a useful tool in understanding older adult patients' sense of belonging when living independently within the community. The implications for practice and research are discussed.

Adaptation and Measurement Invariance by Gender of the Flourishing Scale in a Colombian Sample

There is increasing interest in the study of flourishing as an indicator of subjective wellbeing. The objective herein was to adapt and study the psychometric properties of Diener's Flourishing Scale (FS) among the Colombian population. Accordingly, a cross-sectional study was conducted with a non-probability sample of 1255 Colombian adults. The scale's structure, invariance by gender, and convergent and concurrent validity were studied from a confirmatory perspective using structural equation models. The confirmatory factor analysis showed excellent fit indicators for the one-dimensional structure (CFI = 0.985, RMSEA = 0.039, SRMR = 0.020) as well as for the convergent (CFI = 0.909, RMSEA = 0.050, SRMR = 0.063) and concurrent (CFI = 0.966, RMSEA = 0.036, SRMR = 0.041) validity models. The correlations calculated among flourishing with positive and negative effects (PANAS), satisfaction with life (SWL), and optimism and pessimism (LOT) were statistically significant and as expected. Configural, metric, and scalar invariance across gender was confirmed. Percentiles were provided for the total score. The FS scale was a valid and reliable measure to assess high levels of wellbeing among the Colombian population.

Psychometric Properties of the Thai Version Psychological Well-Being Scale and the Factors Related to among Thai Patients with Major Depressive Disorder

BACKGROUND

The assessment to provide care and support to patients with major depressive disorder (MDD) currently focuses on the recovery from the disease, but it is still lacking in measuring and developing psychological well-being among Thai patients with MDD. Therefore, this research is aimed at studying the psychometric properties of the Thai version psychological well-being scale and study factors related to among patients with MDD.

MATERIALS AND METHODS

The Thai version psychological well-being scale, an 8-point Likert-type scale, was translated by our research team and used to examine psychometric properties as well as to identify the factors related to psychological well-being in a cross-sectional study among samples of 111 patients diagnosed with MDD from Princess Maha Chakri Sirindhorn Medical Center in Nakhon Nayok Province, Thailand.

RESULTS

Cronbach's alpha for the Thai version psychological well-being scale was .91, unidimensionality was examined with exploratory factor analysis, and the structural validity was assessed with confirmatory factor analysis. The convergent validity was found using the correlation coefficients of the Thai version psychological well-being scale with the Beck Depression Inventory (BDI) and Gratitude Questionnaire (GQ-6). However, none of the social factors were significantly correlated with Thai patients' psychological well-being with MDD.

CONCLUSION

The Thai version psychological well-being scale is a brief and concise scale with high reliability to evaluate Thai patients with MDD which can support and improve their well-being.