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© 1998 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom

research-article

Psychological health and well-being: why and how should public health specialists measure it? Part 2: stress, subjective well-being and overall conclusions


Christopher J. Bartlett, Research and Development Specialist
Edward C. Coles, Head of Department

Welsh Combined Centres for Public Health, University of Wales College of Medicine Abton House, Wedal Road, Cardiff CF4 3QX
Department of Medical Computing and Statistics, University of Wales College of Medicine Heath Part, Heath, Cardiff CF4 4XN


Address correspondence to Dr C. J. Bartlett, Division of Psychiatry, University of Bristol, 41 St Michael's Hill, Bristol BS2 8DZ

BACKGROUND: There are cogent reasons why public health specialists should take an active interest in and measure the psychological health and well-being of populations. These are discussed in Part 1 of this study, where methods of measurement from the field of ‘Psychiatric Epidemiology’ are evaluated. This paper continues the review of methods by which psychological health and well-being might be measured by public health specialists.

METHODS: The methods of the literature search and review are described in Part 1. In Part 2, approaches from the fields of ‘Stress’ and ‘Subjective Well-being’ are examined and evaluated.

RESULTS: Many stress questionnaires, such as those that relate to ‘life events’, ‘hassles’ and ‘perceived stress’ pose conceptual problems and do not seem to have any advantages over a simple psychiatric symptom questionnaire, such as the General Health Questionnaire or HAD Scale. The Short Form 36 (SF-36) is a well-being or health outcome instrument. Its mental health and vitality scales encompass both positive and negative psychological well-being. The instrument also contains scales for aspects of physical well-being, which make it attractive for public health use. However, it was found that the positive aspect of these scales has not been validated to the same extent as the negative aspect.

CONCLUSIONS: Some of the methods reviewed in Parts 1 and 2 of this study can and have been used, with certain provisos, in public health research and practice. However, a truly valid measure of both positive and negative psychological well-being has not yet been devised.

Keywords: psychiatric epidemiology, stress, subjective well-being, survey instruments


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