Validity and Reliability of the Assessment of Quality of Life (AQoL)-8D Multi-Attribute Utility Instrument

OBJECTIVE: The purpose of this paper was to report tests of the validity and reliability of a new instrument, the Assessment of Quality of Life (AQoL)-8D, which was constructed to improve the evaluation of health services that have an impact upon the psychosocial aspects of the quality of life. METHODS: Australian and US data from a large multi-instrument comparison survey were used to conduct tests of convergent, predictive and content validity using as comparators five other multi-attribute utility (MAU) instruments—the EQ-5D, SF-6D, Health Utilities Index (HUI) 3, 15D and the Quality of Well-Being (QWB)—as well as four non-utility instruments—the SF-36 and three measures of subjective well-being (SWB). A separate three part Australian survey was used to assess test–retest reliability. RESULTS: Results indicate that AQoL-8D correlates more highly with both the SWB instruments and the psychosocial dimensions of the SF-36, and that it is similar to the other MAU instruments in terms of its convergent and predictive validity. The second Australian survey demonstrated high test–retest reliability. CONCLUSIONS: The results indicate that the AQoL-8D is a reliable and valid instrument which offers an alternative to the MAU instruments presently used in economic evaluation studies, and one which is particularly suitable when psychosocial elements of health are of importance

Exposure to food cues moderates the indirect effect of reward sensitivity and external eating via implicit eating expectancies

Previous research has suggested that the expectancy "eating is rewarding" is one pathway driving the relationship between trait reward sensitivity and externally-driven eating. The aim of the current study was to extend previous research by examining the conditions under which the indirect effect of reward sensitivity and external eating via this eating expectancy occurs. Using a conditional indirect effects approach we tested the moderating effect of exposure to food cues (e.g., images) relative to non-food cues on the association between reward sensitivity and external eating, via eating expectancies. Participants (N\ua0=\ua0119, M\ua0=\ua018.67 years of age, SD\ua0=\ua02.40) were university women who completed a computerised food expectancies task (E-TASK) in which they were randomly assigned to either an appetitive food cue condition or non-food cue condition and then responded to a series of eating expectancy statements or self-description personality statements. Participants also completed self-report trait measures of reward sensitivity in addition to measures of eating expectancies (i.e., endorsement of the belief that eating is a rewarding experience). Results revealed higher reward sensitivity was associated with faster reaction times to the eating expectancies statement. This was moderated by cue-condition such that the association between reward sensitivity and faster reaction time was only found in the food cue condition. Faster endorsement of this belief (i.e., reaction time) was also associated with greater external eating. These results provide additional support for the proposal that individuals high in reward sensitivity form implicit associations with positive beliefs about eating when exposed to food cues

Assessing abstract thought and its relation to language with a new nonverbal paradigm: Evidence from aphasia

In recent years, language has been shown to play a number of important cognitive roles over and above the communication of thoughts. One hypothesis gaining support is that language facilitates thought about abstract categories, such as democracy or prediction. To test this proposal, a novel set of semantic memory task trials, designed for assessing abstract thought non-linguistically, were normed for levels of abstractness. The trials were rated as more or less abstract to the degree that answering them required the participant to abstract away from both perceptual features and common setting associations corresponding to the target image. The normed materials were then used with a population of people with aphasia to assess the relationship of abstract thought to language. While the language-impaired group with aphasia showed lower overall accuracy and longer response times than controls in general, of special note is that their response times were significantly longer as a function of a trial’s degree of abstractness. Further, the aphasia group’s response times in reporting their degree of confidence (a separate, metacognitive measure) were negatively correlated with their language production abilities, with lower language scores predicting longer metacognitive response times. These results provide some support for the hypothesis that language is an important aid to abstract thought and to metacognition about abstract thought

Synchronous and Longitudinal Models of Emotional Labour and Occupational Health

There has been close to forty years of investigation in emotional labour. Studying this phenomenon began with Hochschild in the early 1980s when she first identified “acting” as a form of workplace labour. Since then, while there have been numerous studies into the emotional labour associated with customer service and caring professions, little research has specifically targeted leaders. School principals are leaders who manage long-term, rather than short-term, complex relationships with many different stakeholders. Given these responsibilities it might be expected that school leaders experience and employ emotional labour in various ways, perhaps unique to their job/role. <br>    Prior research into customer service workers and helping professionals revealed differential links between personal outcomes (e.g., burnout, job satisfaction, personal accomplishment) and business outcomes (e.g., customer satisfaction), depending on the type of emotional labour utilised: hiding emotions, faking emotions, and deep acting. This study sought to explore whether similar relationships would be seen in the target group of school leaders. <br>    The research project had three aims: first, to assess levels of emotional demands experienced by school leaders; second, to assess the amounts and types of emotional labour utilised in response to the demands associated with the role; and, third, to explore the psychosocial and occupational health indicators related to emotional demands and emotional labour both cross-sectionally and longitudinally. To the best of my knowledge there are few quantitative studies and no longitudinal investigations of emotional labour in this population. <br>    Study 1 involved survey data from 1320 full-time school leaders from all school types, sectors and states across Australia. These data were collected to assess their levels of emotional demands, burnout and job satisfaction (Pejtersen, Kristensen, Borg, & Bjorner, 2010), emotional labour (R.T. Lee & Brotheridge, 2011), and quality of life (Richardson, Iezzi, Khan, & Maxwell, 2014). The study then sought to estimate the relationships between these variables using structural equation modelling (SEM). The findings of Study 1 were extended by collecting three waves of data from the leaders (three year time span) for Study 2. Cross-lagged longitudinal relationships between the emotional labour variables and potential outcomes were estimated. Further, inclusion versus omission of emotional demand levels was compared in the longitudinal modelling to ascertain if differences would be observed in the relationships between other variables. <br>    The main findings were as follows. School leaders experience high levels of emotional demands in their roles. These demands are steady at the group level across years. The leaders involved in these studies utilise all three forms of emotional labour, but use hiding more than faking emotions, and they use deep acting the least. The levels and use of these strategies were stable at the group level across years. High levels of emotional exhaustion were reported, which were also stable at the group level across years. These leaders experienced high levels of job satisfaction and this too was stable at the group level across years. Lastly, school leaders reported average quality of life, which was stable at the group level across years. <br>    Study 1 found that emotional demands were associated with increased use of all emotional labour methods, increased emotional exhaustion, decreased job satisfaction and decreased overall quality of life. Hiding emotions was associated with increased emotional exhaustion, decreased job satisfaction and decreased quality of life. Faking emotions was only associated with decreased job satisfaction. Deep acting had no associations with emotional exhaustion, job satisfaction or quality of life. Study 2 found that employing emotional labour strategies at one time point did not predict future levels of emotional exhaustion, job satisfaction or quality of life at either a one- or two-year time lag. <br>    The findings of Study 1 demonstrate that school leaders experience emotional demands and use emotional labour in similar ways to employees who are not in leadership roles. Hiding emotions explained the most variance in psychosocial occupational correlates, and thus is the emotional labour strategy that is most detrimental. The findings also implied that use of deep acting should be encouraged wherever possible as it was not associated with any negative outcomes. Likewise, school leaders may benefit from professional development programs to better understand and choose specific emotional labour strategies. Such programs may assist them to ameliorate the increased emotional exhaustion, lowered job satisfaction, and lowered quality of life associated with the use of some strategies. <br>    Longitudinally, in Study 2, no causative relationships between emotional labour and personal outcomes were identified. This finding suggests that although emotional labour is definitely used, there were no long-term effects of using any emotional labour strategy at either a one- or two-year time lag. Reverse and reciprocal relationships were also tested, but neither was evident. These findings demonstrate the benefit of performing longitudinal studies to elucidate causative explanations of associations between emotional labour and psychosocial occupational outcomes. Finally, the inclusion or exclusion of emotional demands in the longitudinal modelling demonstrated its primary effect in driving emotional labour use and the potentially spurious results that can be seen when it was not included in modelling. To correctly examine and understand possible outcomes of emotional labour, it is important that emotional demands are accounted for in future research

Emotional demands, emotional labour and occupational outcomes in school principals: Modelling the relationships

Most research into emotional labour is focussed on front-line service staff and health professionals, in short-term interactions. Little exists exploring the emotional labour involved in repeated on-going interactions by educational leaders with key stakeholders. This study explored the relationships between emotional demands, three emotional labour facets, burnout, wellbeing and job satisfaction in 1320 full-time school principals. Principals displayed significantly higher scores on emotional demands at work, burnout and job satisfaction, and significantly lower wellbeing scores than the general population. Structural equation modelling revealed that emotional demands predicted the elevated use of all emotional labour strategies. Surface Acting-Hiding emotions had an inverse relationship with burnout, wellbeing and job satisfaction. Surface Acting-Faking emotions had an inverse relationship with job satisfaction. Deep Acting demonstrated no significant associations with outcome variables. The findings of this study extend the current literature on the effects of emotional labour. The study also extends understanding about the separate effects of the facets of emotional labour, which will aid in the development of interventions to reduce high levels of burnout reported by educational leaders