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

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.ResumenCade 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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