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?
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