title: Optimism/pessimism and health-related quality of life during pregnancy across three continents: a matched cohort study in China, Ghana, and the United States.
abstract: BACKGROUND
  Little is known about how optimism/pessimism and health-related quality of life compare across cultures.
  
  
  METHODS
  Three samples of pregnant women in their final trimester were recruited from China, Ghana, and the United States (U.S.). Participants completed a survey that included the Life Orientation Test - Revised (LOT-R, an optimism/pessimism measure), the Short Form 12 (SF-12, a quality of life measure), and questions addressing health and demographic factors. A three-country set was created for analysis by matching women on age, gestational age at enrollment, and number of previous pregnancies. Anovas with post-hoc pairwise comparisons were used to compare results across the cohorts. Multivariate regression analysis was used to create a model to identify those variables most strongly associated with optimism/pessimism.
  
  
  RESULTS
  LOT-R scores varied significantly across cultures in these samples, with Ghanaian pregnant women being the most optimistic and least pessimistic and Chinese pregnant women being the least optimistic overall and the least pessimistic in subscale analysis. Four key variables predicted approximately 20% of the variance in overall optimism scores: country of origin (p = .006), working for money (p = .05); level of education (p = .002), and ever being treated for emotional issues with medication (p < .001). Quality of life scores also varied by country in these samples, with the most pronounced difference occurring in the vitality measure. U.S. pregnant women reported far lower vitality scores than both Chinese and Ghanaian pregnant women in our sample.
  
  
  CONCLUSIONS
  This research raises important questions regarding what it is about country of origin that so strongly influences optimism/pessimism among pregnant women. Further research is warranted exploring underlying conceptualization of optimism/pessimism and health related quality of life across countries.
authors.affiliation: Global REACH, University of Michigan, Ann Arbor, MI 48104, USA. camoyer@umich.edu
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Moyer
authors.forename: Huixia
authors.initials: H
authors.lastname: Yang
authors.forename: Yao
authors.initials: Y
authors.lastname: Kwawukume
authors.forename: Anu
authors.initials: A
authors.lastname: Gupta
authors.forename: YuChun
authors.initials: Y
authors.lastname: Zhu
authors.forename: Isaac
authors.initials: I
authors.lastname: Koranteng
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Elsayed
authors.forename: YuMei
authors.initials: Y
authors.lastname: Wei
authors.forename: Jonathan
authors.initials: J
authors.lastname: Greene
authors.forename: Cecilia
authors.initials: C
authors.lastname: Calhoun
authors.forename: Geraldine
authors.initials: G
authors.lastname: Ekpo
authors.forename: Megan
authors.initials: M
authors.lastname: Beems
authors.forename: Megan
authors.initials: M
authors.lastname: Ryan
authors.forename: Richard
authors.initials: R
authors.lastname: Adanu
authors.forename: Frank
authors.initials: F
authors.lastname: Anderson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health / Q000208:ethnology*; D002681:China; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D005260:Female; D005869:Ghana; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016555:Matched-Pair Analysis; D011247:Pregnancy; D037841:Pregnant People / Q000208:ethnology / Q000523:psychology*; D011581:Psychological Tests; D011788:Quality of Life; D012647:Self-Assessment; D014481:United States