The effect of long-term life dissatisfaction on health-related quality of life among general population subjects



Accessible summary

  • Health-related quality of life (HRQL) measures subjects perceived well-being and functioning in physical, mental and social domains of life. In mental health nursing there is a need for improving knowledge of how life dissatisfaction, as an indicator of poor mental health, is associated and impacts on HRQL.
  • In the present study, both long-term and concurrent life dissatisfaction (Life satisfaction scale; LS-4) were found to have a strong adverse impact on HRQL in the general population.
  • Screening of life dissatisfaction with only four items may help mental health nurses to identify service users with poor HRQL or those at risk of it, and then investigating HRQL particularly among the dissatisfied service users would provide information on the domains and factors that most require intervention.
  • Monitoring of life satisfaction and HRQL in mental health nursing practice or in primary care can help nurses to cooperate with service users in promoting their mental, physical or social well-being and functioning and in alleviating adverse consequences of disease.


The aim of this population-based study (n = 329) was to explore how long-term life dissatisfaction (LS burden) and concurrent life dissatisfaction are associated with the concurrent health-related quality of life (HRQL) (RAND-36), and how long-term life dissatisfaction predicts HRQL in the general population. The sum of the life satisfaction scores in 1998, 1999, 2001 (LS burden) and the concurrent life satisfaction score (LS) in 2005 were used to categorize the study participants into satisfied, intermediate and dissatisfied groups. Differences in RAND-36 dimensions in 2005 were investigated with respect to the LS burden and concurrent life dissatisfaction. The predictive power of the LS burden for HRQL dimensions was assessed with logistic regression models. Both a high LS burden and concurrent life dissatisfaction were strongly associated with HRQL and were risk factors for poor HRQL, regardless of its dimensions. The LS burden predicted all of the RAND-36 dimensions, except for physical functioning. Screening of life dissatisfaction can be used to identify service users whose HRQL should be further investigated. Assessment of HRQL provides information on the domains and factors that require mental health nursing intervention. This knowledge could assist mental health nurses in both the alleviation of disease consequences and promotion of well-being of service users.