Physical Activity in the Big Picture: Quality of Life, Well-Being, and

Happiness

EPHE 348

Terms• Emotional well-being

– Greater amount of positive or negative affect that leads to satisfaction with life

• Emotion (e.g., fear, pride)– States following an event (mental processing attached to the

event)• Mood (e.g., irritation, cheerfulness)

– States that have a cognitive basis but may persist, and have no defining event

• Affect (e.g., tension, calmness)– Valenced response that does not require cognition

Quality of Life

• Describes both the subjective and objective evaluations of the “goodness” of one’s life overall and the domains that make-up one’s life

WHO

Psychological Health

Positive affect, sensory functions, thin king, learning, memory, self-esteem, body image

Physical Health

General health, pain, energy/ activity, sleep

Spirituality

Religion, personal beliefs

Independence

Mobility, daily living, dependence on medicine, communication & work capacity,

Social Relationships

Intimacy/loving relationships, receiving and providing social support,

Environment

Safety, home, work, finances, health care, education opportunities, leisure, transport

QUALITY OF LIFE

HRQOL

• Subcomponent that reflects the “goodness” of those dimensions that can be affected by health

• Disagreement over the important and relevant dimensions.

Satisfaction

• The ultimate outcome?

• Happiness & Satisfaction– total function– Vitality– Social– Functional– Physical– Spiritual– Meaningfulness/purpose

Measurement

• Objective vs. Subjective

• Domain approach vs. Generalized approach

• Generic vs. Disease specific

Moderators of QOL: Personality

• Optimism– shown to affect QOL post treatment for medical

conditions– Looking on the bright side or just less realistic?

• Neuroticism– More daily negative affect

• Extraversion– Positive affect and tendency to have stronger

social ties (buffer?)

Moderators of QOL: Beliefs

• Sense of control– Over pain– Over treatment– Over outcomes of daily living

• Religious or spiritual beliefs– Preliminary evidence for higher QOL

Moderators of QOL: Values

• Weight of importance on each domain– Former athletes?– Regular exercisers?

PA & QOL

• PA & HRQOL shows a positive relationship (small effect) in the general populace (Bize et al., 2007)

• PA & Happiness is a often a small to negligible effect .

• Lack of true experimental and longitudinal studies

Blacklock et al. (2007)

• Random sample of 341 adults

• Measured sociodemographics, SF-36, and self-reported walking and physical activity

QOL and Sociodemographics

Age

Gender

Education Level

Annual Income

Living w/ Partner

Working

M

SD

General Health

-.17**

.05

.28**

.26**

.02

.26**

3.6

.97

Mental Health

.21** -.08 .06 .22** .09 -.06 2.2 .80

Vitality .07 -.11* .14** .26** .08 .06 2.9 .96

Social Functioning

.00 -.12** .16** .30** .13* .16** 4.3 .94

Satisfaction with Life Scale .10 -.07 .20* .29** .18** .04 5.0 1.4

QOL & Walking

General Health

Mental Health

Vitality

Social Functioning

Satisfaction with Life

Strenuous Walking Frequency

.05

-.01

.11

.05

-.09

Moderate Walking Frequency

.13* .09 .11 .05 .03

Mild Walking Frequency

.00 .05 .02 .02 .04

Total Mild Walking (frequency x duration)

.02 -.01 .03 .02 .04

Total Moderate Walking

.15** .07 .18** .13* -.04

Total Strenuous Walking

.09 .03 .11* .04 -.04

Total Walking (all levels) .14* .05 .18** .11* -.01

QOL with Physical Activity

General Health

Mental Health

Vitality

Social Functioning

Satisfaction with Life

Strenuous Physical Activity Frequency

.23**

.00

.16**

.10

-.03

Moderate Physical Activity Frequency

.15** .07 .09 .06* .06

Mild Physical Activity Frequency

-.02

.02

.02

.01

.02

Total Strenuous Physical Activity Minutes (frequency x duration)

.25** .03 .17** .11* -.02

Total Moderate Physical Activity Minutes

.19** .08 .16** .15** -.01

Total Mild Physical Activity Minutes

.03 .03 .04 .03 .06

Total Physical Activity (all levels)

.26** .08 .20** .16** .02

PA & QOL Cont.

• PA & QOL related with a medium ES in ageing populations (McAuley et al., 2006). Mechanisms also supported

PATask Efficacy

Activities of Daily Living

Physical QOL

Satisfaction with Life

Research Focus: Cancer Survivors• Conducted a randomized controlled trial to determine if exercise could

improve QOL in cancer survivors beyond the known benefits of group psychotherapy (GP).

• Matched 22 GP classes (N=108) on content and then randomly assigned 11 (n=48) to GP alone and 11 (n=60) to GP plus home-based, moderate-intensity exercise (GP+EX).

• Participants completed a physical fitness test and QOL measures at the beginning and end of GP classes (about 10 weeks). We had excellent recruitment (81%), retention (89%), and adherence (84%) rates and a modest contamination (22%) rate.

Research Focus

• Using intention-to-treat repeated measures analyses of variance, we found significant Time by Condition interactions for functional well-being, fatigue, and sum of skinfolds.

• All interactions favored the GP+EX condition. • Courneya, K.S., Friedenreich, C.M., Sela, R., Quinney, H.A., Rhodes, R.E., &

Handman, M. (2003). The group psychotherapy and home-based physical exercise (GROUP-HOPE) trial in cancer survivors: Physical fitness and quality of life outcomes. Psycho-Oncology, 12, 357-374.

Fatigue

18.0

18.5

19.0

19.5

20.0

20.5

21.0

21.5

22.0

22.5

23.0

23.5

24.0

Baseline Posttest

GP

GP + EX

Functional Well-Being

14.0

14.5

15.0

15.5

16.0

16.5

17.0

17.5

18.0

Baseline Posttest

GP

GP + EX

Physical Well-Being

18.0

18.5

19.0

19.5

20.0

20.5

21.0

Baseline Posttest

GP

GP + EX

Practical Applications• Passion vs. zealotry

– Improving quality of life first– Physical activity has a role but it may not be the same

for all

• Health Promotion vs. Health Facisim– Educate and facilitate but respect the right to decline– Removal of civil liberties via sedentary choices?– Do we know what is “good” for everybody?