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

1. Physical Activity in the Big Picture: Quality of Life, Well-Being, and Happiness EPHE 348

2. 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

3. 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

4. WHO

5. HRQOL • Subcomponent that reflects the “goodness” of those dimensions that can be affected by health • Disagreement over the important and relevant dimensions.

6. Satisfaction • The ultimate outcome? • Happiness & Satisfaction– total function • Vitality • Social • Functional • Physical • Spiritual • Meaningfulness/purpose

7. Measurement • Objective vs. Subjective • Domain approach vs. Generalized approach • Generic vs. Disease specific

8. 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?)

9. 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

10. Moderators of QOL: Values • Weight of importance on each domain • Former athletes? • Regular exercisers?

11. 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

12. Blacklock et al. (2007) • Random sample of 341 adults • Measured sociodemographics, SF-36, and self-reported walking and physical activity

13. QOL and Sociodemographics

14. QOL & Walking

15. QOL with Physical Activity

16. PA & QOL Cont. • PA & QOL related with a medium ES in ageing populations (McAuley et al., 2006). Mechanisms also supported Activities of Daily Living Task Efficacy Physical QOL Satisfaction with Life PA

17. 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.

18. 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.

19. Fatigue

20. Functional Well-Being

21. Physical Well-Being

22. 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?