Psychological health and well-being: why and how should public health specialists measure it? Part 2: Stress, subjective well-being and overall conclusions.
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.
Bartlett
C J
CJ
Welsh Combined Centres for Public Health, University of Wales College of Medicine, Cardiff.
Coles
E C
EC
D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011634:Public Health / Q000379:methods*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires / Q000592:standards; D006113:United Kingdom / Q000453:epidemiology