A Factor Structure of Wellness: Theory, Assessment, Analysis, and Practice

Application of the Rasch model to measure five dimensions of wellness in community-dwelling older adults

BACKGROUND AND PURPOSE

Nurse researchers and practicing nurses need reliable and valid instruments to measure key clinical concepts. The purpose of this research was to develop an innovative method to measure dimensions of wellness among older adults.

METHOD

A sample of 5,604 community-dwelling older adults was drawn from members of the COLLAGE consortium. The Wellness Assessment Tool (WEL) of the COLLAGE assessment system provided the data used to create the scores. Application of the Rasch analysis and Masters' partial credit method resulted in logit values for each item within the five dimensions of wellness as well as logit values for each person in the sample.

RESULTS

The items fit the Rasch model, and the composite scores for each dimension demonstrated high reliability (1.00). The person reliability was low: social (.19), intellectual (.33), physical (.29), emotional (.20), and spiritual (.29). The small number of items within each dimension and the homogenous sample appear to have contributed to this low reliability.

CONCLUSION

Ongoing research using multidimensional tools to measure dimensions of wellness among older adults is needed to advance wellness science and wellness promotion in nursing practice.

Reliability of a wellness inventory for use among adolescent females aged 12-14 years

Background

The wellness construct has application in a number of fields including education, healthcare and counseling, particularly with regard to female adolescents. The effective measurement of wellness in adolescents can assist researchers and practitioners in determining lifestyle behaviors in which they are lacking. Behavior change interventions can then be designed which directly aid in the promotion of these areas.

Methods

The 5-Factor Wellness Inventory (designed to measure the Indivisible Self model of wellness) is a popular instrument for measuring the broad aspects of wellness amongst adolescents. The instrument comprises 97 items contributing to 17 subscales, five dimension scores, four context scores, total wellness score, and a life satisfaction index. This investigation evaluated the test-retest (intra-rater) reliability of the 5F-Wel instrument in repeated assessments (seven days apart) among adolescent females aged 12–14 years. Percentages of exact agreement for individual items, and the number of respondents who scored within ±5, ±7.5 and ±10 points for total wellness and the five summary dimension scores were calculated.

Results

Overall, 46 (95.8%) participants responded with complete data and were included in the analysis. Item agreement ranged from 47.8% to 100% across the 97 items (median 69.9%, interquartile range 60.9%-73.9%). The percentage of respondents who scored within ±5, ±7.5 and ±10 points for total wellness at the re-assessment was 87.0%, 97.8% and 97.8% respectively. The percentage of respondents who scored within ±5, ±7.5 and ±10 for the domain scores at the reassessment ranged between 54.3-76.1%, 78.3-95.7% and 89.1-95.7% respectively across the five dimensions.

Conclusions

These findings suggest there was considerable variation in agreement between the two assessments on some individual items. However, the total wellness score and the five dimension summary scores remained comparatively stable between assessments.

The Association of Predeployment and Deployment-Related Factors on Dimensions of Postdeployment Wellness in U.S. Military Service Members

Purpose.

To assess the effects of predeployment and deployment-related factors on dimensions of wellness following deployment.

Design.

Prospective longitudinal study. The dependent variable was dimensions of wellness. Independent variables were measured in terms of modifiable, nonmodifiable, and military factors, such as sex, race/ethnicity, service branch, smoking status, and combat experience.

Setting.

A large military cohort participating in the Millennium Cohort Study.

Subjects.

Included 10,228 participants who deployed in support of the operations in Iraq and Afghanistan.

Measures.

Dimensions of wellness were measured by using standardized instruments assessing self-reported physical health, mental health, and stress. Covariates were measured by using self-reported and electronic data.

Analysis.

Factors of postdeployment wellness were assessed by using ordinal logistic regression.

Results.

Most participants (78.7%) were categorized as “moderately well” post deployment. Significant modifiable predeployment predictors of postdeployment wellness included normal/underweight body mass index (odds ratio [OR] = 1.72, p < .05). Military factors significantly associated with wellness included not experiencing combat (OR = .56, p < .05), member of Air Force (OR = 2.02, p < .05) or Navy/Coast Guard (OR = 1.47, p < .05), and combat specialist occupation (OR = 1.22, p < .05).

Conclusion.

Multiple modifiable factors associated with postdeployment wellness were identified, which may help inform medical and military leadership on potential strategies to ensure a well force. Those trained in combat roles were more likely to be well post deployment though this apparent benefit was not conferred onto those reporting combat experiences.

Holistic Wellness Assessment for Young Adults

Purpose: The purpose of this study was to develop the Holistic Wellness Assessment (HWA) that incorporates conventional dimensions of wellness with a new dimension of wellness influencing young adults: financial wellness that is psychometrically sound and developmentally appropriate. Design of the study: The study design to establish the initial psychometrics of the HWA was the single-group design. The cross-sectional nature of this design allowed for the postclassification of the participants into different demographic groups facilitating comparisons of the instrument’s derived subscales. Method: From 5,075 university students, 2,090 participants completed an online 285-item HWA and 2,086 respondents provided demographic information. Results: Exploratory factor analysis of the HWA revealed eight dimensions: Self-Regard, Self-Awareness and Responsibility, Sustainability, Relational, Risk Prevention, Spirituality, Physical Health, and Health Care Maintenance. Findings: Four of the eight factors were consistent with existing models of wellness. Three new dimensions of wellness— Self-Regard, Self-Awareness and Responsibility, and Sustainability—emerged from the comprehensive item set that included financial wellness and will set the stage for the development and expansion of wellness models and theories. Conclusion: Initial psychometric analysis suggests that this instrument may prove useful in the young adult population for measuring wellness awareness curriculum and behavior change outcomes.

Shifting to a Wellness Paradigm in Teacher Education: A Promising Practice for Fostering Teacher Stress Reduction, Burnout Resilience, and Promoting Retention

Teacher attrition is a growing concern for the U.S. educational system. One promising practice in teacher education to combat this trend is a wellness paradigm focus. This article includes information concerning current teacher stress, burnout, and attrition. In addition, the historical and theoretical underpinnings of wellness will be introduced as well as case illustrations of wellness in teaching practice. Implications for teacher educators will be discussed.

Psychometric Properties of the Wellness Questionnaire for Higher Education

The wellness model is applied widely by student counselling and development practitioners in South Africa. Its holistic focus is inclusive of physical, intellectual, social, environmental, occupational, financial, emotional and spiritual dimensions of individual development. It is used for individual counselling and also to conceptualise student needs in order to plan for student counselling and development group interventions. However, no standardized measures of wellness exist for South African use. The Wellness Questionnaire for Higher Education (WQHE) was developed in response to this assessment deficiency. This article describes the psychometric properties of the WQHE as evidenced to date. The overall findings in terms of the various psychometric properties investigated confirm that (i) wellness is an observable and measureable behaviour, and (ii) the WQHE adequately operationalises the wellness model for South African students of Higher Education across gender, language and academic year level groups — thereby providing users with a valid and reliable indication of their levels of wellness.

Reviewing the meanings of wellness and well-being and their implications for food choice

Wellness and well-being are terms found in a broad range of literature such as economics, social science, food marketing and general social commentary. These terms are often used in contexts that encompass mental, physical and emotional health as well as broader more esoteric aspects of life satisfaction such as happiness. The terms wellness and well-being are also used ubiquitously and variably in health practice. However, there is limited understanding about how they are used in the broader health promotion context and how consumers might interpret these terms in the context of food and nutrition messages. The primary aim of this paper is to review how the terms wellness and well-being are being used within a number of disciplines and describe implications for food choice. It is proposed that identifying the way these terms are used by key players in the food industry would enable more effective communication across sectors. This may assist in the collaborative development of public health food and nutrition messages with a consistent meaning.