Related Outcome Tools

Subjective Evaluations and Reactions (Box E)

Subjective well-being refers to an individual’s evaluative reaction to his or her life. There are two approaches within the movement of well-being, with one concentrating as an overall judgment of one’s life, and the other being a subjective evaluation of one’s functioning in more or less broad domains of life.  Within the broader concept of well-being, which is considered to be a hierarchical and multidimensional concept, these approaches would be considered part of the cognitive aspect. The other main aspect is affective, which contains positive emotions (e.g., joy, pleasure) and negative emotions (e.g., anxiety, sadness).

A large number of outcome tools assessing subjective well-being may be global or domain-specific.  Global measures typically ask respondents to judge how satisfied they are with their life as a whole whereas domain-specific measures ask separate judgments of satisfaction with different life domains (satisfaction with relationships, satisfaction with self-care, etc.).  Regardless of specificity, measures of subjective well-being should reflect the person's viewpoint, and not that of society or the investigator.

Life Satisfaction: Life satisfaction refers to a judgmental process, in which individuals assess the quality of their lives on the basis of their own set of criteria.  Arguably, well-being and life satisfaction are the same construct, and are used interchangeably in the literature, although life satisfaction appears to emphasize only the cognitive aspect of well-being and not the affective component.

Negative and Positive Affect: Positive affect is the frequency and intensity of happiness and similar moods, whereas negative affect is considered to be sadness.  Positive affect represents the extent to which an individual experiences pleasurable engagement with the environment, whereas negative affect is defined as the tendency to experience states such as sadness, fear/anxiety, guilt, and anger/hostility. However, positive and negative affect should not be considered as two extremes of a single continuum but rather as independent experiences.

Self-Esteem: Self-esteem refers to the individual’s positive or negative attitude toward the self as a totality.  As with well-being or life satisfaction, self-esteem may be global or domain specific.  Self-esteem is a component of affect.

Happiness: Happiness is a state of mind or feeling such as contentment, satisfaction, pleasure, or joy. 

Related Constructs to Subjective Evaluations and Reactions

Self-Efficacy: A person’s judgment about his or her ability to perform certain activities.  Applied to the field of rehabilitation, self-efficacy is defined as an individual’s beliefs about his or her abilities to cope with life’s exigencies.

Key References:

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Dijkers M. Measuring quality of life: Methodological issues. Am J Phys Med Rehabil. 1999;78:286-300.

Dijkers MP. Individualization in quality of life measurement: Instruments and approaches. Arch Phys Med Rehabil 2003;84:S3-S14.

Pavot W, Diener E. Review of the satisfaction with life scale. Psychol Assess 1993;5:164-72.

Watson D, Clark LA. Negative affectivity: The disposition to experience aversive emotional states. Psych Bull 1984;96:465–90.

Rosenberg M, Schooler C, Schoenback C, Rosenberg F. Global Self-Esteem and Specific Self-Esteem: Different Concepts, Different Outcomes American Sociological Review 1995;60:141-56.

Bandura A. Self-efficacy: Toward a unified theory of behavior change. Psychol Rev 1977;94:191-215.

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