Psychological well-being is an important concern for individuals, communities, and health services throughout the world, not only because of the costs associated with psychological ill-health, but also the loss of quality of life for those affected by and their relatives (Nilsson K W, Leppert J, Simonsson Bo, Starrin B., 2008). Kellam et al., (1975) believe that mental health is broadly perceived to consist of two conceptually independent dimensions. One dimension is the principal component of the traditional psychiatric view of mental health, which is known as “psychological well-being”, and the other is called “social adaptational status” (SAS). This dimension provides a societal view of the capability of the role functioning of the individual (Petersen A.C, and Kellam S.G., 1977).
Psychological well-being focuses on the individual’s feelings and other features of psychological functioning. Self-reports are a primary means of measuring this dimension for individuals who are able to evaluate their own psychological well-being. Many scholars have utilized the term “psychological well-being” for various aspects of mental health or psychological functioning. A number of researchers have also measured concepts related to our conception of psychological well-being, but have named them differently. Especially recently, scholars have frequently used psychological well-being to describe “subjective” self-reports about the quality of life (Bradburn and Caplovitz, 1965; Campbell et al., 1976 cited in Petersen et al., 1977). Petersen A.C, and et al., (1977) defined it as an internal, individual view of mental health. In the same line, Peteson et al., (1977) declared that psychological well-being is a multidimensional concept which consists of various aspects of psychopathology, self-esteem and other positive aspects of self.
Although it may not be possible to define what Mental Health precisely is (Public Health Institute of Scotland 2003), but it seems necessary to realize the main factors which form a person’s ‘mental health’ or ‘mental well-being.’ Mental health is generally described as, ‘the ability to develop psychologically, socially, emotionally, intellectually and spiritually’ as well as the ability to, ‘initiate, develop and sustain mutually satisfying relationships, use and enjoy solitude, become aware of others and empathise with them, play and learn, develop a sense of right and wrong and to face and resolve problems and setbacks satisfactorily and learn from them’ (Edwards 2003).
Moreover, the measurement of health outcomes is essential to the development of health services (Hopton J L, Hunt S M, Shiels Ch, and Smith C. (1995). The Scales of Psychological Well-Being measure (SPWB) (Ryff, 1989) includes 84 items rated from 1 ”strongly disagree” to 6 ”strongly agree”. The SPWB consists of six subscales with 14 items in each. These are: (a) self-acceptance, (b) positive relations with others, (c) autonomy, (d) environmental mastery, (e) purpose in life, and (f) personal growth. Ryff has demonstrated the SPWB as a reliable and valid measure of well-being (1989b; Ryff & Keyes, 1995). Cronbach’s alpha for the 20-item scale ranged from .86 to .93 and there was excellent test-retest reliability over a six-week period (R: range from .81 to .88).
The generic 22-item Psychological General Well-being Index (PGWB) has shown to be the most commonly employed questionnaire to assess psychological well-being in adult with a problem such as growth hormone deficiency (GHD) (Dupuy HJ, 1984). This questionnaire consists of six subscales (Anxiety, Depression, General Health, Positive Well-being, Self-control and Vitality), and a Total score.
Yet, General Well-being Index (GWBI) is another generally used scale which is employed in problematic situation. This scale is known to be very similar to the PGWB with only some minor differences in vocabulary, for instance blue becomes sad on the British version, five response categories rather than the six, and also question order. In two samples of British patients with depression validation of the GWBI showed construct validity and high internal consistency reliability for the whole scale (in the range 0.92 – 0.96) (Hunt SM, McKenna SP., 1992). The GWBI contains 22 questions, each with five response options (scoring from 1 to 5). The options have been worded in a different way for each question, to define the intended meaning (e.g. During the past two weeks, have you been waking up feeling fresh and rested? Every day – Most days – Less than half the time – Not often – Not at all). As it is clear, half of the items are positively worded and the other half negatively. There are no recommended subscales. The GWBI Total score is the sum of all 22 items (after reversing the negatively-worded items), and ranges 22-110. Higher scores designate worse well-being (McMillan C V et al., 2006).
McMillan C V et al., (2006) examined reliability, structure and other aspects of validity of GWBI in a cross-sectional study of 157 adolescents with treated or untreated growth hormone deficiency (GHD), and sensitivity to change in a randomised placebo-controlled study of three months’ growth hormone (GH) withdrawal from 12 of 21 GH-treated adults. The findings demonstrated that respondents found both questionnaires acceptable. Factor analyses did not show the existence of useful GWBI subscales, but confirmed the validity of measuring a GWBI Total score. The W-BQ12 is recommended more than the GWBI to assess well-being in adult GHD; it is to a great extent shorter, has three useful subscales, and has greater sensitivity to change.
Another generic measure of psychological well-being is the Well-being Questionnaire (W-BQ). The 12-item version, the W-BQ12, is derived from the longer W-BQ22. W-BQ12 This has been employed in several studies to assess the effects of new treatments and interventions in diabetes (Bradley C, 1994), a condition for which it has good internal consistency and validity (Plowright R, Witthaus E, Bradley C., 1999). The W-BQ12, nevertheless, has less respondent burden than the W-BQ22, and redresses an imbalance between numbers of positively worded and negatively worded items in the longer questionnaire (Riazi A, Ishii H, Barendse S et al., 1999).
Hopton J L, Hunt S M, Shiels Ch, and Smith C. (1995) also investigated the validity of a 22 item measure of psychological well-being and the adapted common well-being index (AGWBI) in 266 patients, who ranged about 16 or over years old, drawn from the computerized list of one general practice in UK. The findings are largely supportive of the validity of the AGWBI and propose that it may be suitable in the evaluation of several developing areas of primary care. In Barlow J. H, Cullen L. A, and Rowe. L. F study on 82 rheumatoid arthritis patients, the psychological well-being was evaluated employing the hospital anxiety and depression scale (HADS) (Zigmond A.S, and Sniaith R. P., 1983). The HADS contains 14 items (7 for anxiety and 7 for depression), which is quick and easy to complete, and posses established reliability and validity (35). The HADS was designed to identify the presence and severity of relatively mild degree of mood disorder in non- psychiatric, hospital out-patients. Scores range from 0 to 21, with the higher scores signifying greater anxiety and greater depression (Moorey Greer S, and Watsa M, et al., 1991).
In a number of studies, scholars have utilized General Health Questionnaire (GHQ) for evaluating well-being over a whole lifetime (Nilsson K W, Leppert J, Simonsson Bo, Starrin B., 2008). Goldberg D.P et al. (1970) designed the GHQ to detect psychiatric disorder. This questionnaire evaluates the individual present functioning from his or her usual state. GHQ has several types such as 60, 32, 28, and 12 items but the most popular type of the GHQ is 28 items which has four subscales as follow:
A. Somatic Symptoms (items 1-7) B. Anxiety/Insomnia (items 8-14)
C. Social dysfunction (items 15-21) D. Severe depression (items 22-28)
These individual subscales are merely used for diagnosis of information and identification purposes, while the total subscales score is used. Ryff (1989) developed a multidimensional model designed to capture the broad elements of eudemonia. And six dimensions of well-being are identified which include: self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth.
The Scales of Psychological Well-Being (PWB; Ryff, 1989) indicates the ways in which people react to a range of specific experiences, such as community relocation (Ryff & Essex, 1992). Ryff’s measure of PWB is relevant to analysis of experience of either advantage or adversity over the lifetime (Ryff & Singer, 1996 cited in Grossbaum M F, and Bates G W. (2002). The Scales of Psychological Well-Being measure (SPWB; Ryff, 1989b) contains 84 items rated from 1 “strongly disagree” to 6 “strongly agree”. This scale also consists of six subscales with 14 items in each. These are: (a) self-acceptance, (b) positive relations with others, (c) autonomy, (d) environmental mastery, (e) purpose in life, and (f) personal growth. Ryff (1989b; Ryff & Keyes, 1995) established the SPWB to be a reliable and valid measure of well-being.
Cronbach’s alpha for the 20-item scale ranged from .86 to .93 and over a six-week period the reports showed excellent test-retest reliability (r’s range from .81 to .88). Allardt (1981) suggested a model for evaluating well-being in academic setting. Allardt’s model of well-being is categorized in to four variables of (1) school condition (having), (2) social relationship (loving), (3) means for self-fulfilment (being) and (4) heath status. The School well-being model origins from Allardt’s sociological theory of welfare and is constructed to measure well-being in educational settling (Konu & Rimpela, 2002).
In this model, well-being is associated with teaching, education, learning activities and outcomes. Allardt’s model “Means for self fulfilment” contains situation for each student to act according to his/her own resources and capabilities. “Health status” is assessed based on student’s symptoms, diseases and illnesses. The main preference of this model is due to its diverse sub categories of well-being in students’ life in educational centre as well as considering the impact of pupils’ homes and neighbourhood. Allardth further in 1989 developed his model cross – tabulating “having”, “loving” and “being” with the dichotomy of objective and subjective indication and obtained six cells of different types of indicators. According to the literature, Allardth model is employed in this relationship study to measure international student’s well-being.
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