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Looking Beyond Health-Related Quality of Life: Predictors of Subjective Well-Being among People Living with HIV in the Netherlands

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Abstract

Health care interventions are increasingly expected to improve subjective well-being (SWB) rather than health-related quality of life (HRQOL) only. However, little is known about how HRQOL and other relevant quality of life (QOL) domains relate to SWB among people living with HIV. People living with HIV treated in Dutch HIV centers (n = 191) completed a cross-sectional survey on SWB, HRQOL, and other QOL domains (social, financial, sexual, and environmental well-being). In bivariate analyses, all QOL domains were significantly related to SWB (r = .17 to .42). In structural equation models, physical health (β = .14; p < .05), mental health (β = .27; p < .01), and environmental well-being (β = .41; p < .01) directly predicted SWB, while financial and social well-being explained SWB indirectly. Thus, environmental well-being and mental health are the main predictors of SWB, and physical health, social well-being, and financial well-being to a lesser extent. Given that most of HIV-care is directed at improving physical health, from the perspective of promoting SWB HIV care should also be directed at other life domains.

Resumen

Cade vez más se espera que las intervenciones de asistencia médica mejoren el bienestar subjetivo, más que la calidad de vida exclusivamente relacionada a la salud. Sin embargo, existe escaso conocimiento sobre que tan bien la calidad de vida relacionada a la salud y otros dominios relevantes a la calidad de vida se relacionan al bienstar subjetivo entre personas que sufren de VIH. Sujetos que viven con VIH con tratamiento en centros de salud holandeses de VIH (n = 191) completaron una encuesta transversal sobre bienestar subjetivo, calidad de vida relacionada a la salud, y otros dominios relacionados a la calidad de vida (social, financiero, sexual y del medio ambiente). En análisis bivariados, todos los dominios de la calida de vida resultaron significativamente relacionados al bienestar subjetivo (r = .17 to .42). En modelos de ecuación estructural, la salud física (β = .14; p < .05), la salud mental (β = .27; p < .01), y el bienestar con el medio ambiente (β = .41; p < .01), predijeron directamente el bienstar subjetivo, mientras que el bienestar financiero y social explicaron el bienstar subjetivo de manera indirecta. Por lo tanto, la mayor importancia la tuvieron el bienestar con el medio ambiente y la salud mental, y en un menor grado la salud física, el bienestar social y el bienestar financiero. Dado que la gran parte del cuidado del VIH se encuentra dirigido a la salud física, desde una perspectiva subjetiva del bienestar, el cuidado del VIH debería estar dirigido a otros dominios de la vida.

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Acknowledgments

This study was funded by ZonMw (the Netherlands), program Doelmatigheidsonderzoek (Grant Number 171002208). This funding source had no role in study design, data collection, analysis, interpretation, or writing of the report. We thank the HIV-nurses and physicians from the seven HIV-clinics which are involved in the AIMS-study (Academic Medical Center, Amsterdam; Slotervaart hospital, Amsterdam; St. Lucas-Andreas hospital, Amsterdam; the Leiden University Medical Center, Leiden; HAGA hospital, Den Haag; Erasmus Medical Center, Rotterdam; Isala clinic, Zwolle) for their input and collaboration. We would like to express our gratitude to the study participants. We also thank Carmina Rodriguez Hidalgo for translating our abstract into Spanish.

Conflict of interest

The authors (EO, AD, AvH, JP, and MdB) declare that they have no competing interests.

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Authors and Affiliations

  1. Department of Communication, Amsterdam School of Communication Research ASCoR, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands

    Edwin J. M. Oberjé, Alexandra L. Dima & Marijn de Bruin

  2. Division of Infectious Diseases, Department of Internal Medicine, Isala Clinic Sophia, Zwolle, The Netherlands

    Astrid G. W. van Hulzen

  3. Division of Infectious Diseases, Center for Infection and Immunity Amsterdam, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands

    Jan M. Prins

  4. Aberdeen Health Psychology Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK

    Marijn de Bruin

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  1. Edwin J. M. Oberjé
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Correspondence to Edwin J. M. Oberjé.

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Oberjé, E.J.M., Dima, A.L., van Hulzen, A.G.W. et al. Looking Beyond Health-Related Quality of Life: Predictors of Subjective Well-Being among People Living with HIV in the Netherlands. AIDS Behav 19, 1398–1407 (2015). https://doi.org/10.1007/s10461-014-0880-2

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