Reliability, validity, and factorial structure of the World Health Organization-5 Well-Being Index (WHO-5) in Iranian psychiatric outpatients / Confiabilidade, validade e estrutura fatorial do World Health Organization-5 Well-Being Index (WHO-5) em pacientes psiquiátricos ambulatoriais iranianos

Abstract Introduction: The association between psychological well-being and physical and mental health has been shown in the literature. Psychological well-being is a multifaceted concept. The World Health Organization-5 Well-Being Index (WHO-5) is a 5-item instrument used to screen for depression. However, the validity of the WHO-5 has not been investigated in Iranian psychiatric or psychological settings. Objective: To investigate the validation of the Farsi version of the WHO-5 in a sample of Iranian psychiatric outpatients. Methods: A cross-sectional study was conducted with a convenience sample of 116 Iranian volunteer psychiatric outpatients selected from the psychiatric and psychological clinics at the School of Behavioral Sciences and Mental Health - Tehran Institute of Psychiatry, Iran University of Medical Sciences. Patients completed the WHO-5, the Patient Health Questionnaire-9 (PHQ-9), the Patient Health Questionnaire-15 (PHQ-15), and the short form of the Beck Depression Inventory-13 (BDI-13). Results: The mean score of the WHO-5 was 8.95 (standard deviation [SD] = 5.49). Cronbach's α for the WHO-5 was 0.91. The WHO-5 negatively correlated with PHQ-9 (-0.358), PHQ-15 (-0.328), and BDI-13 (-0.475), indicating good validity. Factor analysis of the WHO-5 items identified one factor labeled psychological well-being. Conclusions: The WHO-5 has a single dimensional structure and acceptable psychometric parameters. The results of this study suggest that WHO-5 can be used in a clinical context in Iran.

Resumo Introdução: A associação entre bem-estar psicológico e saúde física e mental tem sido demonstrada na literatura. Bem-estar psicológico é um conceito multifacetado. O World Health Organization-5 Well-Being Index (WHO-5) é um instrumento composto por 5 itens utilizado para avaliar depressão. No entanto, a validade do WHO-5 não foi investigada em contextos psiquiátricos ou psicológicos iranianos. Objetivo: Investigar a validade da versão persa do WHO-5 em uma amostra de pacientes psiquiátricos ambulatoriais iranianos. Métodos: Um estudo transversal foi conduzido com uma amostra de conveniência composta por 116 pacientes psiquiátricos ambulatoriais iranianos voluntários selecionados nas clínicas psiquiátrica e psicológica da School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences. Os pacientes completaram o WHO-5, o Patient Health Questionnaire-9 (PHQ-9), o Patient Health Questionnaire-15 (PHQ-15) e a versão abreviada do Beck Depression Inventory-13 (BDI-13). Resultados: O escore médio obtido no WHO-5 foi de 8,95 (desvio padrão = 5,49). O alfa de Cronbach para o WHO-5 foi 0,91. O WHO-5 se correlacionaram negativamente com o PHQ-9 (-0,358), o PHQ-15 (-0,328) e o BDI-13 (-0,475), indicando validade adequada. A análise fatorial dos itens do WHO-5 identificaram um único fator, a saber, bem-estar psicológico. Conclusão: O WHO-5 tem uma estrutura dimensional única e parâmetros psicométricos aceitáveis. Os resultados deste estudo sugerem que o WHO-5 pode ser usado em contextos clínicos no Irã.

The work–life balance and psychosocial well-being of South Korean workers

BACKGROUND: It is challenging to balance work and life, and little attention has been paid to the work–life balance and psychosocial well-being of South Koreans. We assessed the association between work–life balance and psychosocial well-being among paid Korean workers. METHODS: This study was based on data from the fourth Korean Working Conditions Survey. We evaluated only paid workers, which constituted 30,649 of the total of 50,007 subjects surveyed. Poor work–life balance was defined based on the goodness of fit between working hours and social commitments. Well-being was measured using the World Health Organization WHO-5 index. Poisson regression with robust variances was used to calculate the estimated prevalence ratios (PRs) with confidence intervals. RESULTS: Poor work–life balance was associated with poor psychosocial well-being (PR = 1.25; 95% CI 1.21 to 1.28) even after adjusting for work-related and individual characteristics. Poor well-being was associated with low-level job autonomy (PR = 1.06; 95% CI 1.03 to 1.09), working for ≥53 h per week (PR = 1.10; 95% CI 1.06 to 1.14), blue-collar status (PR = 1.16; 95% CI 1.11 to 1.21), low-level support at work (PR = 1.32; 95% CI 1.29 to 1.36), age ≥ 50 years (PR = 1.21; 95% CI 1.15 to 1.26), the female gender (95% CI PR = 1.04; 95% CI 1.01 to 1.07), and cohabitation (living with somebody) (PR = 1.08; 95% CI 1.04 to 1.12). Good well-being was associated with high-intensity work (PR = 0.96; 95% CI 0.94 to 0.99), being the secondary earner in a household (PR = 0.82; 95% CI 0.79 to 0.85), and higher income (PR = 0.75; 95% CI 0.71 to 0.79). CONCLUSION: Work–life balance was associated with psychosocial well-being after adjusting for both work-related and individual characteristics.

The association between perceived discriminations and well-being in Korean employed workers: the 4th Korean working conditions survey

BACKGROUND: Around the globe, discrimination has emerged as a social issue requiring serious consideration. From the perspective of public health, the impact of discrimination on the health of affected individuals is a subject of great importance. On the other hand, subjective well-being is a key indicator of an individual's physical, mental, and social health. The present study aims to analyze the relationship between Korean employed workers' subjective health and their exposure to perceived discrimination. METHODS: The Fourth Korean Working Conditions Survey (KWCS, 2014) was conducted on a representative sample of the economically active population aged 15 years or older, who were either employees or self-employed at the time of interview. After removing inconsistent data, 32,984 employed workers were examined in this study. The data included general and occupational characteristics, perceived discrimination, and well-being. Well-being was measured through the WHO-Five index (1998 version). Multiple logistic regression analysis was used to examine the association between perceived discrimination and well-being. RESULT: As a group, employed workers who were exposed to discrimination had a significantly higher likelihood of “poor well-being” than their counterparts who were not exposed to discrimination. More specifically, the workers exposed to age discrimination had an odds ratio(OR) of 1.51 (95% CI: 1.36–1.68), workers exposed to discrimination based on educational attainment had an OR of 1.43 (95% CI: 1.26–1.61), and workers exposed to discrimination based on employment type had an OR of 1.68 (95% CI: 1.48–1.91) with respect to poor well-being. Furthermore, workers exposed to a greater number of discriminatory incidents were also at a higher risk of “poor well-being” than their counterparts who were exposed to fewer such incidents. More specifically, the workers with three exposures to discrimination had an OR of 2.60 (95% CI: 1.92–3.53), the workers with two such exposures had an OR of 1.69 (95% CI: 1.44–1.99), and the workers with one such exposure had an OR of 1.32 (95% CI: 1.20–1.45). CONCLUSION: The present study found that discrimination based on age, educational attainment, or employment type put workers at a higher risk of “poor well-being,” and that the greater the exposure to discrimination, the higher the risk of poor well-being.

Association between second-hand smoke and psychological well-being amongst non-smoking wageworkers in Republic of Korea

BACKGROUND: Worldwide, exposure to second-hand smoke (SHS) has been responsible for more than 0.6 million deaths and 10.9 million disability-adjusted life years (DALYS) lost in never smokers in 2004. The world health organization (WHO) reported smoking-related death of 58,000 per year in South Korea. There is recent emerging evidence of the associations of SHS exposure with anxiety or depression and poor mental health. Although exposure to second-hand smoke (SHS) has been associated with various physical health conditions and mental health, we are unaware of any studies examining its association with psychological well-being as mental factor. This study aimed to investigate the association between self-reported exposure to SHS and well-being among non-smoking wageworkers.  METHODS: The Third Korean Working Conditions Survey (KWCS, 2011) was conducted on a representative sample of economically active population aged 15 years or over, who were either employees or self-employed at the time of interview. In this study, after removing inconsistent data, 19,879 non-smoking wageworkers among 60,054 workers were participated. Psychological well-being was measured through the WHO-Five Well-Being Index (1998 version). Univariate and multiple logistic regression models were used to examine the association of SHS exposure with psychological well-being. RESULTS: The unadjusted OR of poor psychological well-being (OR: 1.594, 95 % CI: 1.421-1.787) was significantly higher for SHS exposure group compared to non-exposure group. Multiple logistic regression analysis results indicated that these relationships were still significant after adjusting for potential confounders (adjusted OR: 1.330, 95 % CI: 1.178-1.502). CONCLUSIONS: Exposure to SHS was associated with poor well-being measured by the WHO-5 well-being index, indicating the importance of reducing SHS exposure at the workplace for psychological well-being amongst non-smoking wageworkers.

Reproducibilidad del Índice de Bienestar General (WHO-5 WBI) en estudiantes adolescentes / Reproducibility of the Weil-Being Index (WHO-5 WBI) among adolescent students

Objetivo: Conocer la reproducibilidad del Índice de Bienestar General (WHO-5 WBI) en estudiantes adolescentes de noveno grado de Cartagena (Colombia). Método: Participaron en el estudio 157 estudiantes adolescentes, con una media para la edad de 15,1 años (DE = 1,1), el 56,1 % eran varones. WHO-5 WBI se compone de cinco ítems que cuantifican estado de ánimo triste, reducción del interés por las actividades relevantes y nivel de energía durante las dos últimas semanas. Se calcularon los coeficientes de alfa de Cronbach y omega de McDonald como indicadores de consistencia interna, y la correlación de Pearson (r) y el coeficiente de correlación intraclase(CCI) como estimadores de la estabilidad. Resultados: WHO-5 WBI mostró aceptable consistencia interna en la primera y segunda aplicación, con valores de alfa de Cronbach de 0,668 y 0,697 y omega de McDonald de 0,671 y 0,686, respectivamente. Igualmente, WHO-5 WBI presentó alta estabilidad a cuatro semanas con coeficiente de Pearson (r = 0,612; p<0,001) y el CCI 0,613 (IC95 % 0,505-0,702). Conclusiones: WHO-5 WBI presenta aceptable reproducibilidad, estabilidad, a cuatro semanas en estudiantes adolescentes. Se necesita conocer el desempeño de esta escala frente al mejor criterio de referencia, una entrevista clínica estructurada.

Objective: To know the reproducibility of results of the WHO-5 WBI among nine-grade adolescent students in Cartagena (Colombia). Method: A total of 157 students participated in the research with mean age of 15.1 (SD = 1.1), 56.1 % were boys. WHO-5 WBI consists of five items that quantify depressed mood, decreased interest in activities and energy lost during the last two weeks. It was calculated Cronbach alpha and omega McDonald coefficients as indicators of internal consistency; and Pearson correlation coefficient (r) and intraclass correlation coefficient (ICC) as estimators of the stability. Results: WHO-5 WBI showed acceptable internal consistency in the first and second application, Cronbach's alpha of 0.668 and 0.697, respectively, and omega of McDonald and 0.686 0.671, respectively. Similarly, WHO-5 WBI showed high stability over four weeks with Pearson coefficient (r = 0.612, P <0.001) and ICC 0.613 (95% CI 0.505-0.702). Conclusions: The WHO-5 WBI presents acceptable reproducibility over four-weeks among adolescent students. It is needed to know the psychometric performance of the WHO-5 WBI using the best gold standard.