OZQOL Conference Abstracts (2000)

Keynote Abstracts

Professor Michael Pusey
Sociology, University of New South Wales

In the space of 20 years Australia has changed from a one of the most protected national economies to one of the most 'open'. The impact on what has been called the 'Lucky Country' has been enormous. The three year long Middle Australia Project interview and questionnaire survey (sample 400) was designed to assess the impacts of this program of vigorous economic restructuring on the experience of the broad urban middle class. The paper briefly reports the results of some of these impacts on a several aspects of quality of life, including self-reported income, distribution, trust, personal and political agency, social insecurity and expectations.

Conference Abstracts

The Quality of Life of Mentally Ill People Living in the Community

Rosalie Austin
School of Social Inquiry, Deakin University

This paper will focus on the quality of life of mentally ill people living in the community. It has been my experience that the quality of life of mentally ill people in the community is quite a precarious thing indeed, this is largely due to the fact that the economic rationalist mode of deinstitutionalisation failed to put money into adequate community supports for mentally ill people. Consequently friends and relatives of the mentally ill person (who often have little or no mental health training) are forced to pick up the slack left by the government, due to the government abdicating its responsibility to the mentally ill (who are a very vulnerable group in the community, but are rarely seen as such).

The chief failure of government in this area is that it doesn't realise that it actually costs more to have a mentally ill person inadequately treated the first time around, as the person is unable to access employment if they are ill. Consequently, they are kept welfare dependent for longer periods of time, it also costs the government more in terms of more G.P. visits and more pharmaceutical subsidisation when a person is in a chronic phase of mental illness. This is due to the mind-body connection, as a person in a chronic phase of mental illness is likely to suffer from physical ailments such as: migraine, sleeping difficulties, T.N.J. nerve pain (due to the grinding of teeth during sleep which upsets the nerves in the jaw), irritable bowel syndrome, gastric reflux, stomach ulcers, colds and flu (due to the immune system being run down due to lack of sleep), diarrhoea and nausea.

This incredibly large amount of stress-related ailments can be avoided if the person can progress through the mental health system smoothly, and have their mental illness treated properly and realistically the first time around. This can allow their illness to go into remission, and allow them to have their illness managed by a mental health practitioner in the community; while they prepare (with the assistance of the Psychiatric Employment Network, if they wish) for a return to work and a productive life, which is far better for both them and the government economically (as we all know that governments are completely obsessed with the bottom line).Furthermore the lot of the mentally ill person could be greatly improved if the media could portray them far more realistically, as far too often the media (particularly the tabloid media) are portraying the mentally ill person as violent, dangerous and out of control. When in reality, the mentally ill person is far more likely to harm themself than to harm others, as the risk of suicide is always there.

Contact with nature and positive affect: An evolutionary analysis

Katie Bagot, Eleonora Gullone
Department of Psychology, Monash University

The presentation will report the results of two separate, yet related studies into biophilia. Based in evolutionary theory, the biophilia hypothesis proposes that an innate attraction to nature, continues to exist today, and as such, facilitates psychological well being. Details of the first study include the development of a feeling good schedule (FGS), designed to measure the intensity of feelings and frequency of exposure to stimuli that facilitate ‘good feelings’ in children. A total of 160 children nominated the top five activities, things or places that made them feel happy, excited, calm or relaxed. Further, senses-based discussions yielded stimuli for each sense.

As hypothesised, more than 25% of the items nominated were considered ‘natural’.The hypothesis that a higher percentage of items would be nominated by the senses-based discussions was not supported.The second study investigated the relationship between stimuli that generate positive affect (i.e. good feelings) and the natural environment. A total of 320 children completed the Coopersmith (1981) Self-esteem Inventory (school short form), the Positive and Negative Affect Schedule, and the intensity and frequency scales of the FGS. Psychometric properties were determined for the FGS and as hypothesised, the underlying structure comprised two factors – nature-related items and non-nature-related items.

Further, as hypothesised, positive affect and self-esteem were significantly associated with both nature-related factors (i.e. intensity and frequency) of the FGS, the sub-factor of animals, as well as the non-nature related factors (i.e. intensity and frequency) of the FGS. Further, parental expression of biophilia was also associated with both nature-related factors. However, the expected inverse associations between negative affect with the nature-related factors, the sub-factor of animals as well as the non-nature-related factors were not found. Nor were the expected inverse associations between negative affect and parental expression of biophilia. Due to limited research in the area, demographic variables of sex, age and location were also analysed for exploratory purposes. Sex yielded significant differences, which are discussed in relation to the hypotheses and findings of the overall sample. However, age and location variables did not reveal any significant associations with the FGS.The presentation will include a discussion of the results in relation to the biophilia hypothesis, and evolutionary proposals.

Anethical defense of the utilization of an ideal theory of quality of life for the purposes of making best interests decisions in acute medical and nursing practice

Susan Bailey
Deakin University, Department of Human Services

In current clinical practice, the best interests principle is commonly relied upon to guide decision-making in circumstances when the patient is incompetent, although it is commonly linked to inconsistent assumptions about what is meant by quality of life.This situation means that there is great potential for moral errors to be made that may result in an unwanted extension of life for some individuals, or the premature death of others. It is proposed that the best interests principle ought to be underpinned by an ideal account of quality of life consists partly of the realisation of specific, explicitly normative ideals, while also acknowledging a plurality of component ideals that place constraints on and/or supplement the extent to which happiness and/or preference satisfaction serves a person’s good.This presentation will discuss and defend a particular version of an ideal account of quality of life (termed a minimal ideal account of quality of life), that is able to cope with the extreme circumstances of making a judgement about the quality of life of an incompetent individual of whom very little is known. It will be argued that such an account does not in itself make value judgements about the quality of life of another person easy, nor normal necessarily ethically defensible. However, it does offer the decision-maker tangible and restraining guidelines for extremely difficult decisions. The minimal account therefore provides an ethically coherent conceptual framework for best interest decisions about the provision of acute medical and nursing care.

The Subjective Quality of Life of Carers of People with Mental Illness

Rachel Cousins, Robert Cummins
School of Psychology, Deakin University

The definition and measurement of subjective quality of life is perhaps the best way to investigate individuals' perceived well-being.This construct can be effectively used to describe populations, gaining an indication their subjective quality of life across a number of life domains including material well-being, health, productivity, intimacy, safety, place in community and emotional well-being.Carers of people with mental illness experience considerable burden and distress that is likely to impact on their subjective quality of life. This research compared the subjective quality of life a sample of primary carers of people with mental illness, with a sample of individuals who do not care for people with disabilities.It was hypothesised that carers would show significantly lower subjective quality of life than the comparison sample.Questionnaires were distributed to the carer sample recruited from the Schizophrenia Fellowship of Victoria and the comparison sample recruited from a list of people who have participated in previous Deakin studies.The results show support for the hypothesis.Carers of people with mental illness had significantly poorer subjective quality of life, across all of the life domains except place in community, than the comparison sample.

Perceived control and subjective well-being

Catherine Croft, Robert, A. Cummins
School of Psychology, Deakin University

Primary and secondary control are now widely acknowledged as important concepts to consider when attempting to understand the link between control and well being. However, conflict regarding how these constructs merge to shape well being has manifested itself in a primacy debate. This conflict is effectively a question of the relative importance of primary and secondary control for individuals at different ages, and from different cultural backgrounds. In order to address the primacy debate I have produced a new model of primary and secondary control. According to the situational/ global model, in order to adequately comprehend the relationship between primary and secondary control and well being, it is important to consider primary and secondary control at both the situational and global level. As a result of this approach three types of control are proposed as being important: situational primary control, situational secondary control and global secondary control. The goal of the following paper is to present the proposed relationships between these three types of control and well-being, and in the process, provide an answer to the question regarding which type of control, primary or secondary, is more fundamentally important to well-being.

A national index of subjective well-being

Richard Eckersley, Australian National University
Robert Cummins, Deakin University

The paper will outline a proposal for a national index of subjective well-being. The proposal is currently being considered by an Australian health insurance and investment company. The aim of the index is to promote greater public and political awareness of the social factors underpinning well-being. The proposed index is based on twice yearly polling of a national sample of adult Australians and constructed in two parts. The first is a 'core' index which is intended as a device to track changes in subjective well-being over time. The second is an 'experimental' index which will generate data to inform theory regarding fluctuations in the core index variables. The scientific understanding of subjective well-being, and what contributes to it, has advanced rapidly over the past decade. However, uncertainties remain about how to measure this in a way that addresses inherent biases and reveals both short-term and long-term trends, so making the index both scientifically valid and publicly interesting.

Life satisfaction homeostasis and the role of personality

Francie Garretto, Robert, A. Cummins
School of Psychology, Deakin University

It has recently been proposed that a homeostatic mechanism operates to maintain life satisfaction within a narrow adaptive range and that neuroticism and extraversion are central to this homeostatic system. However, it is unclear whether the strongest personality predictors of life satisfaction are neuroticism, extraversion, or conscientiousness. It is also equivocal whether the areas of life, such as work, are similarly held under homeostatic control. The present study will investigate the idea of life satisfaction homeostasis, of which job satisfaction may be a part, and explore the personality predictors of life satisfaction and job satisfaction. Respondents to a 68-item anonymous questionnaire were 212 (101 females) full-time working in a diverse array of occupations. Professionals, clerical-service employees, trades people, and laborers did not significantly differ in their levels of life satisfaction and job satisfaction. There is evidence that the stability of life satisfaction could be due to life domain compensation. In addition, neuroticism appeared to be the strongest personality predictor of life satisfaction and job satisfaction. That is, the absence of depression and anxiety may suggest the presence of satisfaction. Various directions for future studies will also be discussed.

Life in the 21st Century: Increasing Mental Health or Increasing Pathology?

Eleonora Gullone
Department of Psychology, Monash University

Wilson's biophilia hypothesis includes the claim that, as a consequence of evolution, humans have an "innate tendency to focus on life and lifelike processes." A review of various literatures converges to support this central claim. One area of support for our innate affiliation with nature comes from research demonstrating increased psychological well-being upon exposure to natural features and environments. Support also comes from the strength and prevalence of phobic responses to stimuli of evolutionary significance and near absence of such responses to potentially dangerous human-made stimuli. That survival emotions of equivalent intensity and prevalence have failed to develop in response to modern life-threatening stimuli can be explained by the extremely rapid process of change and progress that has occurred post World War II and continues at an ever increasingly rapid pace. Given that our modern ways of living, as prescribed by Western industrialised culture, stand in stark contrast to our evolutionary history, it is proposed that we may currently be witnessing the beginnings of significant adverse outcomes for the human psyche.

The Quality of Life of People with Multiple Sclerosis and Their Partners: Newly Diagnosed versus Long Term Diagnosed

Kylie King, Robert, A. Cummins
School of Psychology, Deakin University

This research seeks to analyse how people with MS and their partners maintain their subjective quality of life. Specifically, this research is interested in comparisons between the subjective quality of life of people newly diagnosed with Multiple Sclerosis, those living a longer time with Multiple Sclerosis, partners of people with Multiple Sclerosis, and a group of people not affected by Multiple Sclerosis. This research hypothesised that these different groups of people have different levels of subjective quality of life and maintain their subjective quality of life in different ways. A model based on previous research is proposed for the maintenance of subjective quality of life. This research proposes that subjective quality of life can be affected by subjective circumstances, and is maintained through a combination of cognitive processes. This research will address the hypotheses through two linked studies. The main study will investigate the various components of the model in people newly diagnosed with MS, those who have lived a longer time with MS, partners of these types of people, and controls through self-administered questionnaires. Whilst the utility of the questionnaires has been established for other populations, they have not been used for a population affected by MS. A preliminary study is therefore required to ensure that these questionnaires are relevant to this population. A preliminary, qualitative study will seek to gain information so that proposed questionnaires for the larger study can be examined for their utility with such a population and be modified, or substituted, where necessary. This study employs a technique called 'photovoice'. Participants are given disposal cameras and are asked to take photographs of things that positively and negatively affect their quality of life. These photographs are then discussed in an in-depth interview.

Factor Stability of the Schalock and Keith (1993) Quality of Life Questionnaire

Ralph Kober, Ian R. C. Eggleton
Department of Accounting and Finance, The University of Western Australia

The 1990's saw a significant change in how governments viewed publicly provided services. In the area of disability service provision it has been suggested that service providers could demonstrate their effectiveness with reference to the quality of life of their clients. One instrument often used in quality of life research for people with intellectual disabilities is the Schalock and Keith (1993) Quality of Life Questionnaire (QOL.Q). However, before this instrument can be used with confidence its reliability must be demonstrated. Given the potential factor stability problems highlighted by past research this paper further investigates the stability of the four factors of the QOL.Q over various heterogeneous sub-populations. We find that the QOL.Q factors consistently and when analysed across various sub-populations the four factors have a high degree of stability. We conclude that the QOL.Q is a reliable instrument and thus suited to the measurement of outcomes in the provision of services.

Quality of Life and Sense of Coherence in People with Arthritis

RoseAnne Misajon, Dominic Germano, Robert A. Cummins
School of Psychology, Deakin University

This study investigated the physical and psychological impact of arthritis on people's quality of life. A range of variables were examined in a sample of 375 participants who comprised three groups: people with arthritis receiving a support based service from the Arthritis Foundation of Victoria, people with arthritis receiving standard treatment, and agroup of people from the general population. The results revealed that the two arthritis groups reported a significantly higher level of functional impairment, pain, and negative affectivity, and lowered mood, positive affect, and Sense of Coherence, compared to general population group. They also reported normal levels of importance, but lower levels of satisfaction on various life domains. After statistically controlling for pain however, group differences were eliminated on all variables except for functional impairment and for all satisfaction domains except health. These data are interpreted as evidence that the combination of low domain satisfaction coupled with high domain importance yields a negative psychological state. This, then suggests the possibility of a therapy based on reducing the perceived importance of health.

Tertiary Students' Stories of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Dorothy Morris
Faculty of Education, Deakin University

My research with tertiary students with ME/CFS, has gathered the stories of forty participants, enrolled since 1995, at thirty-three Australian Universities and TAFE Institutions. The expected themes of difficulties meeting the physical demands of the institutions and of illness experience appeared, but another theme emerged - of the political struggle of the participants with discredibility, disbelief, and disempowerment of a newer poorly understood, badly named and defined invisible disability. Out of these three themes, and particularly the third theme, has emerged the fourth theme of the social and emotional impact of this disease on the student participants. Often they endeavored to struggle on, deciding not to reveal that they had this condition due to the stigma and misperceptions of laziness that they received not only from university staff, but also their peers. Retrospective stories of personal stress were told, stories of current crisis, and even contemplation of suicide.

Damning with faint praise: Indefensible weaknesses in health-related quality of life instruments

Rod O'Connor
Rod O'Connor & Associates P/L and School of Health Services Management, University of NSW

What does validity mean in health-related quality of life measurement? Seemingly not a lot to do with patients views of their health-related quality of life. This paper examines a range of instruments to argue that HQoL instruments are generally flawed and without demonstrable sensitivity. Arguments for the validity of health measurement instruments tend to be based on general and loose patterns of results, when criterion-related validity based on direct patient report is needed. The absence of criterion-related validity is seen as a virtue, reflecting inability or unwillingness to clearly conceptualize the purpose of the instruments in the first place.

Balancing personal, relational, and collective wellness

Isaac Prilleltensky, Ph.D.
Department of Psychology, Victoria University

The paper will present an ecological model of wellness developed by a team of researchers in Canada. The team, entrusted with the task of formulating values, programs and policies for the promotion of child and family wellness, created a model of wellness based on empirical research and social values. The paper will describe the different components of wellness and present the underlying empirical and philosophical reasoning behind it. The model proposes that wellness is achieved by the satisfaction of personal, collective, and relational needs. These needs, in turn, are satisfied by the presence of cogent values, adequate psychological and material resources, and effective programs and policies. Values such as caring, compassion and justice attend to diverse personal, relational, and collective needs. Psychological resources such as self-esteem and social support contribute to wellness, as do material resources. Programs and policies, in turn, target the needs of individuals and communities by offering educational, health, recreational, and social services. The presence of these services increases the life opportunities of community members. Wellness is an hierarchical concept in that the needs of the individual are predicated on the satisfaction of needs of the family. The needs of the family, in turn, depend on community welfare, which is based largely on the level of social wellness. I will conclude by sharing a research program currently underway at Victoria University to test parts of this model with children and youth and with adults from diverse cultural backgrounds.

Children and Nature

Sylvie Shaw, Gary Bouma, Peter Cock
School of Political and Social Inquiry and Graduate School of Environmental Science, Monash University

Concern for the environment is linked to people's childhood experience of the nature as well as to their childhood perception of the natural world as alive and conscious. This nature connection is fostered mainly by parents and other significant adults in the child's life. My study looks at three aspects of childhood nature connection. I have interviewed a range of people connected with nature, from organic farmers to forest activists, landscape painters to nature religion practitioners to explore the roots of their nature caring. I found that for one group in Melbourne, nature played almost no role in their lives. They are Jewish, and children and grand children of Holocaust survivors. For another group, those who were physically or sexually abused, nature became a place to escape their trauma. A third group, mainly forest activists, were traumatised as saw nature being destroyed. This may have been their favourite tree or special play space. To what extent did these early experiences pave the way for their later involvement in projects that are connected to nature, especially in their desire to protect it?