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

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

QOL & Walking

QOL with Physical Activity

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

Fatigue

Functional Well-Being

Physical Well-Being

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?