What do women want from a good quality of life?
Women in STEM
Suzanne Skevington PhD, CPsychol, ARCM, FBPsS
Manchester Centre for Health Psychology
suzanne.skevington@manchester.ac.uk
‘(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+)
Sequential Translation process
English
Shona
Hindi
Simultaneous Translation procedure:
‘spoke-wheel’
UK
Zimbabwe
W.H.O.
Panama
Japan
India
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

WHOQOL-100
Overall Quality of Life and Health (General)
Domains
Facets
Physical
Psychological
Pain &
discomfort
Positive
feelings
Energy &
fatigue
Thinking,
Learning,
Memory &
Concentration
Sleep &
rest
Self-esteem
Body image &
appearance
Negative
feelings
Independence
Dependence
on medication
Mobility
Activities of
daily living
Working
capacity
Social
Relationships
Environment
Personal
relationships
Physical safety
& security
Sex life
Home
environment
Practical
social support
Financial
resources
Information
& skills
Recreation
& leisure
Health &
social care
Physical
environment
Transport
SRPB
Spiritual,
religious &
personal
beliefs
Development of WHOQOL instruments
Year
Centres
1992
10
1994
1998
15
15
Methods Qualitative
Versions
-
Domains
-
134
Facets
Items
30
2009 2014
67
87
Quantitative……………..
100
BREF
6
6
4
33
25
25
2,000+ 235
100
26
4,800
11,800
Participants
Pilot
2004
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
WHOQOL Cultural adaptations and Translations (2015)
Arabic: Saudi, Egypt, Kuwait
Amharic: Ethiopia
Bangla: Bangladesh
Bulgarian
Cantonese: S. China, Hong Kong,
Australia
Catalan: Spain
Chichewa: Malawi
Croatian
Czech
Danish
Dutch
Emirati: Sharjah
English: Australia, Canada, USA, NZ,
Fiji, Malta
Estonian
Farsi: Iran, Oman
French: Canada, Switzerland Burkina
Faso, Vanuatu
German: Austria
Greek: Cyprus
Hebrew: Israel
Hindi:: India
Hungarian
Bahasa: Indonesia
Italian
Japanese
Kannada: S. India
Khmer: Cambodia
Korean
Krio: Sierra Leone
Latvian
Liberian
Lithuanian
Malayalam: S.India
Marathi: India
Malay
Mandarin: China
Norwegian
Portuguese: Brazil, Portugal
Polish
Preeti: Nepal
Romanian
Russian: Kyrgyzstan
Serbian
Shessana: South Africa
Shona: Zimbabwe
Sinhala: Sri Lanka
Slovak
Slovenian
Solomon Islands
Somali
Spanish: Argentina, Panama, Uruguay,
Mexico, Chile, Cuba
Swahili: Kenya, Uganda
Swedish
Taiwanese
Tamil: S. India
Thai
Turkish
Ukrainian
Urdu: Pakistan
Vietnamese
Yoruba: Nigeria
Zambian
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
(WHOQOL-100)
17
16
15
14
Physical
Psychological
13
Independence
12
Mean
Social
11
Environment
10
Spiritual
AIDS
HIV + symptoms
HIV+ no symptoms
Health Status
Well
(n=900)
Centres
Melbourne, Australia
Porto Alegre, Brazil
Bangalore, India
New Delhi, India
Bangkok, Thailand
Rome, Italy
Dniepropetrovsk, Ukraine
Harare, Zimbabwe
Phnom Pen, Cambodia
Sample
11,241 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%

Women have significantly better quality of life than men
Overall Quality of Life and Health (General)
Domains
Facets
Physical
Psychological
Independence
Social
Relationships
Pain &
discomfort
Positive
feelings
Dependence
on medication
Personal
relationships
Physical safety
& security
Energy &
fatigue
Thinking,
Learning,
Memory &
Concentration
Sex life
Home
environment
Sleep &
rest
Self-esteem
Body image &
appearance
Negative
feelings
Mobility
Activities of
daily living
Working
capacity
Practical
social support
Environment
Financial
resources
Information
& skills
Recreation
& leisure
Health &
social care
Physical
environment
Transport
Spiritual
Spiritual,
religious &
personal
beliefs
WHOQOL-SRPB
Overall Quality of Life and Health (General)
Domains
Physical
Health
Psychological
Social
Relationships
Environment
SRPB
Pain &
discomfort
Positive
feelings
Personal
relationships
Financial
resources
Meaning
in Life
Energy &
fatigue
Negative
feelings
Sex life
Information
& skills
Purpose
in Life
Recreation
& leisure
Faith
Sleep &
rest
Facets
Dependence
on medication
Mobility
Activities of
daily living
Working
capacity
Self-esteem
Thinking,
learning
memory &
concentration
(Cognitions)
Body image &
appearance
Practical
social support
Home
environment
Hope
Strength
Health &
social care
Peace
Physical safety
& security
Awe
Physical
environment
Spiritual
Connection
Transport
Wholeness
Men have better quality of life than women
Overall Quality of Life and Health (General)
Domains
Facets
Physical
Psychological
Independence
Social
Relationships
Pain &
discomfort
Positive
feelings
Dependence
on medication
Personal
relationships
Physical safety
& security
Energy &
fatigue
Thinking,
Learning,
Memory &
Concentration
Sex life
Home
environment
Sleep &
rest
Self-esteem
Body image &
appearance
Negative
feelings
Mobility
Activities of
daily living
Working
capacity
Practical
social support
Environment
Financial
resources
Information
& skills
Recreation
& leisure
Health &
social care
Physical
environment
Transport
SRPB
Spiritual,
religious &
personal
beliefs
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
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Positive feelings
Activities of daily living
Personal relationships
Home environment
Energy
Financial resources
Recreation & leisure
Self-esteem
Mobility
42%
10.6%
3.9%
3.9%
1.5%
0.9%
0.7%
0.4%
0.3%
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




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Health & social care
Sex life
Sleep
Social support
Medication (-)
Working capacity
Spiritual QoL
Physical environment
0.3%
0.2%
0.1%
0.1%
0.1%
0.1%
0.01%
0.01%