review of literature quality of work life

Quality of Work Life – A Literature Review

International Journal in Management and Social Science, Vol. 3, Issue 3

10 Pages Posted: 10 Apr 2015

Balaram Bora

Aditya Institute of Technology & Management

Das Saumendra

Aditya Institute of Technology and Management, Tekkali

Vishnu Murthy

Date Written: April 9, 2015

In this mechanical life, workmen reach house after completion of their hectic job with highest stress. Human being cannot be compared with machines. They have their own impulses, instincts, emotions. Employer should design a job which suits the needs of workmen not the technology. By using Quality of Work Life (QWL) worker’s potential can be used to maximum extent. It ensures greater participation and involvement of workers, makes work easier and improves quality and efficiency. For our study purpose, only secondary data is used which is sourced from different journals and books. In discussing the Literature Review of Quality of Work Life, this paper has been divided into four parts. In the first part introduction of QWL, second part Review of Literature of QWL. In the third part Components of QWL, it summarizes different requisite components for QWL, industries observed and contributions of different researchers. It is observed that Researchers differ in their views on the core constituents of Quality of Working Life.

Keywords: Job satisfaction, Quality of work life, Work environment, Work-life balance

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Aditya institute of technology and management, tekkali ( email ).

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Quality of Work Life- A Literature Review

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Volume : IV, Issue : VIII, August - 2014

A literature review on quality of work life.

Mrs. G. Indrani, Dr. Mrs. S. Suma Devi

In this era of globalization, maintaining the quality of human inputs rises from maintaining the quality of work life perfectly. Rise in the quality of work life would help employees well being there by the well being of the whole organization. Quality of Work Life (QWL) has been defined as “The quality of relationship between the employees and the total working environment”. QWL is concerned with the overall climate of work and the impact on work and people as well as on organization effectiveness. Quality of work Life is a Person’s life. It covers a person’s feelings about every dimension of work including economic rewards and benefits, security, working condition, Organizational and interpersonal relations and its intrinsic meaning in person’s life. Therefore we can simply say Q.W.L. is a concern not only to improve life at work, but also life outside work. This paper focuses and analyzes the literature findings which involve QWL. The present paper is an attempt to review the literature and the studies done in past to establish a relationship between QWL, employee performance and career growth opportunities.

Article: Download PDF DOI : 10.36106/ijar Cite This Article:

Mrs.G.Indrani, Dr. (Mrs.) S.Suma Devi A Literature Review on Quality of Work Life Indian Journal of Applied Research, Vol.4, Issue.8 August 2014

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Literature Review On Quality Of Work Life

Type of paper: Literature Review

Topic: Management , Workplace , Relationships , Organization , Aliens , Employment , Employee , Job

Words: 3750

Published: 02/07/2020

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2. Literature review The phrase Quality of work life (QWL) according to Stephen and Dhanapal (2011); Bagtasos (2011), originates back in 19th century labor conference at Arden House, Columbia University. Stephen and Dhanapal states that people use the term to refer to the well-being of organization employees. Nevertheless, Normala (2010) uses business perspective to define QWL as employee satisfaction and their work related behaviors. Stephen and Dhanapal indicates that QWL also affects employees in the way they response to their work in terms of job performance, job effort, organization identification, job involvement, job satisfaction, personal alienation, intention to quit and organization employee turnover. In the following section, the writer provides a clear explanation to eight factors that affects QWL in organization. This includes workplace spirituality, employee relations, health work environment, development human capacity, job role ambiguity, job uncertainty, social support and organization success. 2.1. Workplace spirituality Altaf and Awan (2011) illustrates on how organization structures occurs not as a way of executing and implementing on their tasks. However, Altaf and Awan indicate that organization structures only exists to gain from cultural or legitimacy support. In the case of workplace spirituality however Ramdass (2009) asserts that spiritual talks continues to ascendant and help to ascertain the level at which organizations seek legitimacy than commitment to spirituality. According to Petchsawang and Duchon (2009), workplace spirituality seems adopted without an authentic commitment towards its practice. As a tool, workplace spirituality seeks for legitimacy with organization stakeholders. For example, Petchsawang and Duchon note that when legitimacy motivates workplace spirituality, employees are likely to work harder for the benefit of their organizations. Furthermore, Petchsawang and Duchon argue that by organization practicing spirituality, this raises genuine concerns towards economic gains and management aspect. 2.2. Employee relations Work place employee relations Katz, Kochan and Weber (2010) concerns implementing on several factors that provides maintenance of healthy relationships among employees. In their discussion, Katz et al states that organization implements such initiates as a way of motivating employees, providing morale and ensuring that all employees gain satisfaction from their jobs. Essentially, organizations regard employee relations as a way of preventing and dealing with a number of issues that involves employees. Such issues according to Rathi (2009) may arise out of any work situation or end up having a negative effect to employee performance. In addition, employee relations also include the way employees relate with an entire organization environment and with other co-workers. due to the fact that organizations is a constituent of workers and other operations, this implies that employee relations also involves apart from just relating with the co-workers, employees also have an opportunity of relating with several processes involving development, implementation, administration and even analyzing the entire employee-to-employer relationship, management of overall performance and dispute resolution. Rathi asserts that in case management needs to assure organization success, then it means that a pre-requisite aspect has to come from maintenance of healthy employee relations. Saklani (2010) discusses that management through their healthy employee relations; provide stronger relations as a pre-requisite for employee satisfaction and hence high productivity. Different from the external employee relations, Saklani indicates that organization internal employee relations involve different HRM (Human Resources Management) policies that ensure flexible movement of within the firm. In his illustration, Saklani states that such policies may include activities such as resignations, retirement, layoffs, demotions, promotion, transfers and discharge. In general, healthy employee relations according to Rathi (2009), results into efficiency, increased productivity, motivation that as a contributory factor, results into organizational success. As discussed earlier, is that QWL remains a multi-dimensional construct and not as a universal construct. While discussing on how QWL relate to employee relations, Rathi (2009); Normala (2010) asserts that QWL provides favorable work environment and other conditions that offers support to employee satisfaction. However, a multi-dimensional aspect, Normala indicates that employee satisfaction includes a number of aspects but not limited to growth opportunities, job security and rewards. Therefore, the continued efforts to ensure an increase in the level of cooperation between labor and management through disputes resolution to improved performance and overall employee satisfaction largely depend on QWL. In most cases, employees have demanded formation of their own unions in order to help enhance relations amongst themselves. According to Rathi (2009), unions at the work place serve a constructive role in any QWL initiatives. For example, Rathi asserts that it is through unions that management comes to sustain and enhance the relevancy of legitimate institution with aims of representing both interest and rights of all employees. In effect, Rathi asserts that this motivates employees through their unions, to take on collaborative course that minimizes any form of competitive and adversarial effects. This results into employee satisfactions that consequently lead into a better QWL at the workplace. Mutual respect according to Normala (2010) remains one of the foundations and a building block for an entire QWL initiatives. It becomes easier for employees to realize an improvement in their life at work and greater productivity only through an environment that fosters mutual respect. As a way of mutually dealing with problems, creation of cooperation among employees, improvement of general work environment, solving work-related disputes, restructuring employees’ roles, careful management of HR outcomes and employee pay, all comes as a way of benefiting employees and employers. As an effect therefore, determination of work environment solely depends on both management and union commitment. Through their localized experiments and activities, Normala indicates that management can help increase relations amongst employees through participations. As a solution, Normala recommends that this may require organization to foster decentralization, responsibility among works, ensure that workers come together to work as a team and be able to solve their own disputes without having to depend entirely on management hierarchy. In most cases, organizations through their management, initiates aspects such as dispute solving teams and quality circles with an aim of encouraging teamwork and high level of improvement at the workplace. Based on these factors, Rathi (2009) argues that both organization management and employee unions should always strive to create mutual respect based on values and interest in order to generate a flexible, productive and a highly motivate QWL. In this regard, unions adopt creative and proactive job roles at the work place and ensure discarding of reactive strategies that provides a more relation environment. As a result, Rathi also advices and recommends that organizations through their managements should create a work environment that allow unions to participate easily. Management can achieve this as a way of establishing organized, supportive and cohesive groups that entirely depends on educational strategy. In addition, the author also indicates that it is through an educational strategies that management can analyze and assess different processes and come up with programs that increases employee autonomy, social support, empowerment and skills. As a result, Messersmith and Guthrie (2010) argue that employee-management positive and healthy relationship plays a major role of facilitating QWL. 2.3. Health work environment There is a growing acknowledgement that work environment factors affect employees’ health status and their performance outcome. More importantly, such factors affect the overall QWL, individual work outcome and overall organization outcome. In 2011, Nayeri, Salehi and Noghabi conducted a study to investigate Iranian employee health status and their relation to QWL. In their analysis, Nayeri, results indicated that Iranian health staff identified elements in terms of rank, better facilities, better working conditions, more staffs and finally better pay. Despite these factors, Rathi (2009) notes a growing concern that both environmental and organization factors such as management styles, noise, smoke, heat, job design and employee flows, need to gain acceptance among organizations. A healthy work place according to Almalki, FitzGerald and Clark (2012), provides better environment that enables staffs to gain dedication. Almalki, et al states that majority of people prefer working in a sincere environment. According to their research, Nayeri et al., (2011) reveals that employees gain attraction towards their work environment in case there are advancement opportunities, participate in decision-making and continually gain from compensations. For example, Nayeri et al notes that several factors at the workplace can become critical in motivating employee QWL and employee turnover. Different from health work environment, Niks et al., (2013) on the other hand, argues that unhealthy work environments contribute to ineffectiveness and absenteeism among employees. For example, Niks et al., indicates that often, characteristics of unhealthy work environment remains important in determining employee day-to-day interactions. Illustratively, Niks et al., notes that abusive, non-collaborative and disrespectful behaviors contributes to unhealthy work environment that creates unsafe and negative conditions. 2.4. Development human capacity Sinha (2012) career planning as an element of human capacity development program, assist employees to manage their own lives. Sinha also indicates such developmental programs enable employees deal and perceive organizations to implement on promotional policies. Instead of employers promising job securities, Sinha asserts that employers use human capacity development programs to assist employees gain from job market needed skills and remain relevant and viable. According to previous studies, literature indicates on how such programs relate to QWL. For example, Dhanapal (2011) analyses employee perception concerning the quality of work tasks, career opportunities, levels used to make decisions and available job securities. In addition, Bagtasos (2011) also conducted an empirical study to investigate the relation that QWL has career related programs and human capacity development policies. In his analysis, Bagtasos used a sample of 480 managers working in free trade countries for both small and medium corporations (SMC) and Multinational Corporations (MNCs). In his analysis, Bagtasos indicated three exogenous as being statistically significant. These comprises of employee career balance, career achievement and satisfaction. In all these, results indicated an existence of 65 percent QWL variability. In fact, according to Sinha (2012), high level of QWL forms one of the element that employee use to develop their own close personal ties and gain career goals. Sinha indicates that in a work environment where employers understand their employees’ attitudes in the way they are able to multitask between the family roles and organization work, then it becomes easier for them to worry less. This also relates to the way employees are able to develop their careers by reducing the amount of work hours and attend to family responsibilities. 2.5. Job role ambiguity Job role ambiguity (Nanik et al., 2011) refers to single or multiple employee roles that result into role incumbent confrontation. Such confrontations occur in situations where management fails to articulate or communicate clearly the terms, behaviors and employee performance levels. Nanik et al., further indicates that role ambiguity may occur in a situation where management acquire, shift or restructure their organizations. In such scenarios, employees are likely to become uncertain concerning their new job roles or responsibilities. In most cases, Nanik et al., states that lack of information concerning what the role entails, makes employees lack information on where to direct their efforts, success and hence failure in the overall performance. In any organization, Nanik et al., explains that it is through employee defined job roles that enable them to gain QWL. While investigating on how ambiguity relates to QWL, Bedeian and Armenakis (2009) conducted a study on American textile workers. The analyzed results indicate that stress increased with the level of imbalance between employee capabilities to deal with situations and demand for the same job. Furthermore, Bedeian and Armenakis illustration indicates that in case employees gain control over their jobs, there is a high tendency of reducing stress. Nanik et al., (2011) also studies the relationship between job role and stress that eventually affects QWL. In their analysis, the results indicate that employees’ stress concerning their roles, greatly affects the availability of resources. This is because organizations are more likely to divert available resources to help deal with stress than help deal with QWL. In fact, majority of employees that experience high level of job role ambiguity, are unlikely to focus on their performance and give QWL. Furthermore, this may also result into high level of absenteeism, unusual work attitude, psychological problems and low turnover. 2.6. Job uncertainty Debus et al., (2012) likens job uncertainty to job insecurity. Debus et al., refers to job uncertainty as employees’ negative reactions towards different changes concerning their jobs. In addition, it also includes people’s expectations concerning continuity of their job situations. For example, Debus et al., states that such scenario presents an overall scenario that concerns employees’ future expectation and existence of their jobs. Debus et al., notes that intuitively, organization managers may perceive job uncertainties to have a stronger effect towards employee psychology. In long term, Debus et al., explains that job uncertainties are to a larger degree, likely to affect employees’ overall QWL situation. For example, Debus et al. indicates that both economic and other factors that assists performance, becomes threatened. Indeed, a number of studies continue to reveal that employee perception concerning both the nature and existence of jobs may have a greater consequence on job losses. This also presents a consistent results conducted by Hellgren and Sverke (2010) on the stress research. In their research, Hellgren and Sverke results indicate that stressful situations represent greater sources of anxiety, equally important than actual practices. Job uncertainties relate to high levels of employee impairment and well- being (Sinha, 2012). Mental distresses, work-to-leisure and complaints from physical health, carry an increased level of job uncertainties. However, organization work changes from traditionally considered secure and certain environment towards dynamic and uncertain work environment, could have a greater impact not only on the overall wellbeing of employees, but also, on the way they are likely to perform, behave, attitude and in the long run, the overall QWL.. For example, Sinha explains that workers react easily towards job uncertainty or insecurity. Furthermore, studies have also found job uncertainties to associate consistently with reductions in employee work attitudes and job satisfaction. For instance, Messersmith and Guthrie (2010) showed that employees, who experienced insecurity and uncertainty, became more dissatisfied on their present jobs than those who considered and perceived their future jobs as more secure and certain. In a similar effort, employee perception concerning their future role within the organization may also result into employees becoming less inclined towards remaining in the organization. Just like any other stressor, job uncertainty could make employees to withdraw from attending to their daily operations and thus a high level of turnover. 2.7. Social support Besides job uncertainty, the level of support provided to employees by organizations, plays a major role of improving quality of work at the work place. Social support according to Martins (2013); Charu (2013), refers to the degree at which employees develop their perception that other co-workers values their work and hence cares for their social well-being. Social support forms one of the key factors that influences employees towards becoming committed to their work, they derive satisfaction from their work and a general QWL. While investigating on the relationship between the social support and QWL, Stephen and Dhanapal (2011); Harris, Winskowski and Engdahl (2007) found an existence of a positive impact towards employee job satisfaction, employee performance and commitment towards their organization. 2.8. Organization success Organization success (Farjad, 2013); Alexandrova, 2012) comes as a result of implementing initiatives that ensures job satisfaction, job security, better reward systems, employee involvement and overall employee benefits. Alexandrova assesses the effect that QWL has on organization performance and success. Alexandrova acknowledges that employees form core resources that lead into organization success. Organizations implement QWL by acquiring several practices such as training, appraisals, motivational and developments that allows success through employee performance. Indeed, major factors that create QWL arise from better working conditions, employee financial and non-financial benefits, job satisfaction, supervision, growth and development (Abdul Halim, Said and Syed Yusuf, 2012). Job initiatives (Mishra, Dangayach & Mittal, 2011) motivate employees to become committed to their work. In effect, the relationship that occurs between QWL and organization success, arise from employee commitment. In the recent past, studies indicate that committed workers gain motivation to retain their positions for longer period than those with the less commitment. Mishra et at., (2011) more committed workers gain more desire to frequently attend to their work and positive attitude to employment. In his study to Indian textile workers, Abdul Halim et al., (2012) investigates the relation between employee commitment towards organization success and their overall turnover. The results indicate significant inverse relationship between employee commitment and turnover. According to Farjad (2013) organization foster and implement on commitment policy to reduce chances of employees seeking employment opportunities in other organizations. Similarly, Mehdipour et al., (2012) results indicated that workers that had higher level of commitment towards their job positions had also higher level of turnover cognitions. High scores for turnover cognition according to Mehdipour et al indicated employee favorable and less likelihood to consider turnover.

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Role Conflict and Role Ambiguity as Factors in Work Stress among Managers: A Case Study of Manufacturing Sector in Pakistan. Asian Social Science, 7(2), 113-118. Nayeri, N., Salehi, T., & Noghabi, A. (2011). Quality of work life and productivity among Iranian nurses. Contemporary Nurse: A Journal For The Australian Nursing Profession, 39(1), 106-118. Niks, I. W., de Jonge, J., Gevers, J. P., & Houtman, I. D. (2013). Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care. BMC Health Services Research, 13(1), 1-11. doi:10.1186/1472-6963-13-66 Normala, D. (2010). Investigating the Relationship between Quality of Work Life and Organizational Commitment amongst Employees in Malaysian Firms. International Journal Of Business & Management, 5(10), 75-82. Petchsawang, P., & Duchon, D. (2009). Measuring workplace spirituality in an Asian context. Human Resource Development International, 12(4), 459-468. doi:10.1080/13678860903135912 Ramdass, P. (2009). A SPIRITED WORKPLACE: EMPLOYEE PERSPECTIVES ON THE MEANING OF WORKPLACE SPIRITUALITY. South African Journal Of Human Resource Management, 7(1), 230-241. doi:10.4102/sajhrm.v7i1.207 Rathi, N. (2009). Relationship of Quality of Work Life with Employees' Psychological Well-Being. International Journal Of Business Insights & Transformation, 3(1), 52-60. Rathi, N. (2009). Relationship of Quality of Work Life with Employees' Psychological Well-Being. International Journal Of Business Insights & Transformation, 3(1), 52-60. Saklani, D. R. (2010). Non-managerial Perspective of Quality of Work Life. Journal Of Management Research (09725814), 10(2), 87-102. Saklani, D. R. (2010). Non-managerial Perspective of Quality of Work Life. Journal Of Management Research (09725814), 10(2), 87-102. Sinha, C. (2012). FACTORS AFFECTING QUALITY OF WORK LIFE: Empirical Evidence From Indian Organizations Stephen, A. A., & Dhanapal, D. D. (2011). Quality of Work Life and its impact on Organizational Excellence in Small Scale Industrial Units: Employers Perspectives. Journal Of Contemporary Management Research, 5(2), 55-67.

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How to Write a Literature Review | Guide, Examples, & Templates

Published on January 2, 2023 by Shona McCombes .

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .

There are five key steps to writing a literature review:

A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.

What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, frequently asked questions, introduction.

When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

You can also check out our templates with literature review examples and sample outlines at the links below.

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Prevent plagiarism. Run a free check.

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.

Search for relevant sources

Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:

You can also use boolean operators to help narrow down your search.

Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

For each publication, ask yourself:

Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.

You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.

Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, you can follow these tips:

In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

There are several reasons to conduct a literature review at the beginning of a research project:

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other academic texts , with an introduction , a main body, and a conclusion .

An annotated bibliography is a list of source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a paper .

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McCombes, S. (2023, January 02). How to Write a Literature Review | Guide, Examples, & Templates. Scribbr. Retrieved February 27, 2023, from https://www.scribbr.com/dissertation/literature-review/

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Quality of Work Life

Related terms:.

Success Measures of Information Systems

Yong Jin Kim , ... G. Lawrence Sanders , in Encyclopedia of Information Systems , 2003

III.D Quality of Work Life Satisfaction

Quality of work life satisfaction or perceived quality of work life is a set of affective beliefs directed toward the organizational work domain of life. Quality of work life addresses the fit between an IS and the sociotechnical work world of the respective users and involves IS's impacts on people's feelings, physical needs, and psychological states. In this view, users are not only components of the organizational system, but they are also recognized as having their own goals and aspirations separate from the directives of the organization.

Introducing a new IS changes job characteristics such as task autonomy, skill variety, task identity, task significance, and task feedback through deskilling and/or upgrading jobs. Task autonomy is defined as the extent to which the job provides individual discretion relating to the work process. Skill variety means the opportunity to use numerous and varied skills in one's personal repertoire to perform the work. Task identity is defined as the degree to which the job requires the completion of a whole, recognizable piece of work. Task significance is defined as the degree to which a job affects the lives of other people. Finally, task feedback means the well-defined opportunity to know how effectively one is performing directly from the job itself.

Changes in these job characteristics have been shown to have a curvilinear influence on the key indicators of the quality of work life satisfaction, including job satisfaction, job-related anxiety, and emotional exhaustion. Deskilling involves a decrease in the skill content of a particular job over time and an increase in the number of people in less skilled jobs. Upgrading involves increases in time to concentrate on conceptual and decision-making tasks by reducing much of the manual work in information processing. Likewise, introducing a new IS may alter job characteristics and, in turn, influence work outcomes.

Measurement items for quality of work life satisfaction attempt to determine whether the introduction of a new IS changes the perceived quality of work life in terms of changes in five job characteristics: task autonomy, skill variety, task identity, task significance, and task feedback. The examples of measurement items for the quality of work life satisfaction are shown in Table IV .

Table IV . Measurement Items for Quality of Work life Satisfaction

Work and Family, Relationship between

Jeffrey H. Greenhaus , Romila Singh , in Encyclopedia of Applied Psychology , 2004

9 Conclusion

Work and family lives are intertwined in many respects. Experiences at work can influence the quality of family life, and family experiences can affect the quality of work life . Some of these consequences are negative, such as when one role interferes with full and enjoyable participation in the other role. In other cases, however, resources from one role can be used to strengthen the quality of life in the other role. Organizations and individuals can take actions to relieve the stress arising from the intersection of employees’ work and family roles and to strengthen the positive effect of each role on the other role.

Organization Development

W.Warner Burke , in Encyclopedia of Applied Psychology , 2004

4.1 Individual Level

4.1.1 need theory of motivation.

Maslow’s theory concerns a hierarchy of human needs that begin with physiological or creature comfort needs (air, water, safety, etc.), include security, belongingness, and ego status, and conclude at the top of the hierarchy with self-actualization. Herzberg’s theory is more about job satisfaction and dissatisfaction than about needs per se. Factors that reduce dissatisfaction he called “hygiene” or preventive, such as fringe benefits, good working conditions, and salary. Factors enhancing job satisfaction he called motivators and include recognition, challenging work, and autonomy. OD practice that relies on these theories includes job enrichment, quality-of-work-life projects, empowerment interventions, and career development.

4.1.2 Expectancy Theory of Motivation

This theory is cognitive in nature and consists of individuals’ expectations that (i) their efforts will lead to results, (ii) if enhanced these efforts will lead to rewards, and (iii) these rewards will be worth it to them. OD practice associated with this theory includes work redesign and modifying performance appraisal and/or systems.

4.1.3 Job Satisfaction

4.1.4 Positive Reinforcement

Although Skinner’s research and theory were more about individual animal and human behavior in the broad context of learning and change and not about organizational behavior per se, his principles can be applied to organizational reward systems. The primary emphasis is therefore on incentives and the belief that partial and variable reinforcement of behavior is more lasting and effective than continuous reinforcement. OD practice that relies on this theory includes modifying a reward system in general and putting into place some form of an incentive system.

The quality of working Australia and its relevance for HRM and organisational effectiveness in the Asia Pacific

J. Connell , J. Burgess , in Asia Pacific Human Resource Management and Organisational Effectiveness , 2016

What is job quality and why does it matter?

The ‘quality of work’ is a nebulous concept which can be viewed from many perspectives and disciplines. However, following an extensive literature review, it was determined that JQ is associated with a focus on employee well-being as a critical contributor to organisational effectiveness. This approach is consistent with that followed by other researchers who maintain that ‘the quality of work life or job quality is constituted by the set of work features which foster the well-being of the worker’ ( Green, 2006 : 9).

The rationale for this perspective is that it is through work that the material and psychological benefits and costs of employment are allocated. Green (2006) applied Amartya Sen’s ‘capability’ approach to the assessment of job quality. Sen developed a notion of well-being based upon ‘… a general approach that concentrates on the capabilities of people to do things – and the freedom to lead lives – that they have reason to value’ ( Sen, 1999 : 85). The focus on capabilities and freedoms partly circumvents problems of differences in preferences, value judgments and interpersonal comparisons that beset attempts to measure well-being for different people. More recently, this has been explained as a demand for a ‘holistic’ management style, in Indian and Chinese workplaces in particular, ‘which allows strategies, processes and techniques that energize people and aligns resources to emerging opportunities and challenges. The holistic imagination offers the possibility for the first time for corporate leaders to enhance the performance of their human and other resources, but through extensive employee participation’ (Nankervis, Cooke, Chatterjee and Warner, 2013: 20).

Work quality relates to the extent to which a job offers workers a high capability to achieve the things they value. This may include the ability to exercise influence over their work, to pursue their personal and work-related goals, and variations between workers as to the needs they choose to prioritise ( Eurofound, 2012 : 10). When reviewing JQ in Europe, Holman (2012 : 476) similarly defined JQ as the extent to which a job fosters beneficial outcomes for the employee, noting in particular the importance of psychological well-being, physical well-being and positive attitudes such as job satisfaction. In Asian workplaces, spiritual and identity characteristics may also be of significance ( Chatterjee, 2009a, 2009b ; Nankervis et al., 2013). The Eurofound (2012 : 10) project builds on these ideas to develop a potential framework for isolating a limited number of key job characteristics that are linked to well-being in the world of work.

JQ is important at a number of levels. First, it impacts on worker well-being and the well-being of their family member, for example through the quality of workers’ relationships and the health and well-being of their children and others within their relationships and households (see, for example, Bardoel et al., 2008 ).These aspects, including the perceived social responsibility of employers to extended families and local communities, are often crucial in many Asian workplaces. Such consequences have been observed in Australia ( Knox et al., 2011; Pocock et al., 2008 ). A 2002 OECD report which focused on work–family reconciliation in Australia, Denmark and the Netherlands is cited by Pocock et al. (2008) , who noted that a good work–family balance is conducive to, among other things, resilience in the face of the stresses of modern life, better child development outcomes and notably significant savings in health costs (2008: 6). Contributions in the psychological literature from the likes of Bandura (1982), Jahoda (1982) and Warr (1987) have proposed that one’s work is an important source of the factors that promote psychological well-being, such as a sense of purpose, connectedness, self-identity, self-esteem and self-efficacy, and these factors also appear in research conducted within Asian organisations (see, for example, Chatterjee 2001; Chatterjee and Pearson, 2006; Chatterjee, 2009b ). Self-determination theory offers a further approach that considers the psychological needs that promote an individual’s inherent personal growth tendencies and motivation. Specifically, three basic needs relating to competence, relatedness and autonomy have been identified that underlie positive personal and social development and, in turn, personal well-being ( Ryan and Deci, 2000 : 68).

Within the organisational context, JQ impacts upon worker performance and, in turn, organisational performance and effectiveness. There is evidence that the job quality/well-being relationships outlined here may act as significant mediators in the job quality/productivity nexus. In their study of HR practices, operational practices and the impacts on productivity, Birdi et al. (2008) investigated the practices of 308 organisations over more than twenty years. They identified that the practice most likely to affect organisational productivity was employee empowerment, indicating that, not only does empowerment promote an improved quality of work life, but it also has economic value. In developing a JQ framework it is important to indicate not only why and how JQ is important for employee well-being but also how JQ may be linked to employee and organisational performance and effectiveness. This provides a context for developing a JQ agenda as part of an organisation’s strategic HRM programme which encompasses both employee and organisational effectiveness objectives.

Workplace Autonomy

Linda C. Forbes , John M. Jermier , in International Encyclopedia of the Social & Behavioral Sciences (Second Edition) , 2015

Autonomy and Groups and Teams

The theme of workplace autonomy also runs through over six decades of research on groups and teams in organizations. Of primary concern here are the streams referred to by Moldaschl and Weber (1998) as the sociotechnical systems theory approach (STS) and the lean management approach. Both approaches focus on teams that are, to varying degrees, autonomous or self-organizing. Self-organizing teams have been theorized as having processes of self-management and collaborative teamwork. In self-organizing teams, members experience relatively high autonomy by collectively controlling, for example, the pace of work, task allocation, performance evaluation, recruitment and selection of new members, training, and even reward distributions. As noted by several researchers, because groups can undertake much larger pieces of work than individuals can, the potential to experience positive outcomes through heightened control is greatly enhanced.

Beginning with Trist and Bamforth's (1951) classic study of autonomy among long wall coal miners, through to recent reviews and meta-analyses of research in the STS tradition, positive results have been reported. Despite ‘substantial variance’ in research findings regarding the consequences of autonomous work groups ( Guzzo and Dickson, 1996 : p. 326), positive impacts on motivation and productivity (especially performance quality and cost savings), attitudes and perceived quality of work life , and (to a lesser extent) attendance and retention are routinely reported. Failures of some STS projects and the fact that STS interventions in organizations have not been used as widely as initially anticipated have been attributed to poorly designed (imbalanced) programs and internal political conflicts.

The lean management approach, used initially by Japanese manufacturers such as Toyota, differs from the STS approach primarily in the degree of autonomy experienced by team members. The lean management approach tends to be more supervisor-centered as team leaders are appointed rather than elected, decision-making is consultative rather than consensual, and the domain of decision-making authority for the team is more limited. Ilgen et al. (1993) noted that when team-based structures are created in organizations, there is a tendency to retain an overarching hierarchical structure and to require teams to report to leader-managers in a very formal and traditional way. In situations where teams are teams mostly in name, autonomy is very limited, leading to negative results. When interventions empower teams to become more self-directed and autonomous, results tend to be positive across a number of indicators, including financial performance (cf Latham and Pinder, 2005 ).

While the body of research on teams is rapidly mounting, with much of it supporting the benefits of autonomous or semiautonomous teams, scholars continue to call for a better understanding of the causal mechanisms that produce beneficial results and for complex models examining micro and macro contingencies ( Delarue et al., 2008 ). They continue to explore new areas of research, such as the relationship of individual autonomy to team autonomy, responses to conflict in teams, team dynamics in service delivery firms, intergroup coordination across autonomous work teams, and shared leadership in teams.

Many scholars are quick to point out that work is often done by groups that are merely labeled ‘teams’ by managers but that lack the defining qualities of teams (see Procter and Burridge, 2008 ). Others point out that teams are not a panacea for producing high organizational performance or team members' well-being (e.g., D'Innocenzo et al., in press ). Moreover, despite the positive results often attributed to autonomous and self-organizing teams, one cannot assume that the approach frees members from hierarchical control that automatically creates emancipated practice. Some writers contend that while workers in the typical self-managed team situation might feel a measure of influence, upon closer inspection, it is only an illusion of self-control. This theme is developed further by Ezzamel and Willmott (1998) and others who show that teams, through peer pressure and behavioral regulation, can intensify work and coerce their members in ways that are perhaps even more tyrannical than are the forms of control exercised by managers.

Review of nursing turnover research, 1977–1996

Teresa Wai Chi Tai , ... Chester D. Robinson , in Social Science & Medicine , 1998

Dialysis employees' quality of work life and turnover were significantly related in the study of Robinson (1995) . Quality of work life was defined as one's perception of promotional opportunity, job security, interesting work, and supervisor's technical skills. There were no specific references relating the quality of work life of health care staff to turnover. However, several investigators reported that turnover and promotional opportunities were inversely related ( George, 1979 ; Decker, 1985 ; Price and Mueller, 1986 ; Cavanagh, 1990 ). Others found that supervisory employees had lower rates of turnover than did non-supervisory employees ( Seybolt et al., 1978 ; Decker, 1985 ; Volk and Lucas, 1991 ). None of the references reported on possible correlation between turnover and either job security or perceptions that the work was interesting.

Developing a Job Exposure Matrix of Work Organization Hazards in the United States: A Review on Methodological Issues and Research Protocol

BongKyoo Choi , in Safety and Health at Work , 2020

2.2.3.1 Selection of important NIOSH QWL items

Among the original NIOSH QWL 60 items for working conditions, we will select important NIOSH QWL items for analysis with the following criteria: (1) whether they have been used in all five waves of GSS (2002–2018); (2) whether item wording is clear; (3) whether they are important work stressors from the perspectives of contemporary work stress theories, such as the Demand-Control model [ 40 ], the Effort-Reward Imbalance model [ 61 ], or organizational justice model [ 92 ]; or/and (4) whether their health effects have been documented in the literature. A preliminary list of important NIOSH QWL items and scales is presented in Table 1 (31 items for 16 domains).

Roles of Participatory Action-oriented Programs in Promoting Safety and Health at Work

Kogi Kazutaka , in Safety and Health at Work , 2012

Reflecting the current international trends toward proactive risk assessment and control at work with practical procedures, participatory action-oriented approaches are gaining importance in various sectors. The roles of these approaches in promoting the safety and health at work are discussed based on their recent experiences in preventing work-related risks and improving the quality of work life , particularly in small-scale workplaces. The emphasis placed on the primary prevention at the initiative of workers and managers is commonly notable. Participatory steps, built on local good practices, can lead to many workplace improvements when the focus is on locally feasible low-cost options in multiple aspects. The design and use of locally adjusted action toolkits play a key role in facilitating these improvements in each local situation. The effectiveness of participatory approaches relying on these toolkits is demonstrated by their spread to many sectors and by various intervention studies. In the local context, networks of trainers are essential in sustaining the improvement activities. With the adequate support of networks of trainers trained in the use of these toolkits, participatory approaches will continue to be the key factor for proactive risk management in various work settings.

Interventions to mitigate moral distress: A systematic review of the literature

Georgina Morley , ... Christian Burchill , in International Journal of Nursing Studies , 2021

3.5.4 Single-group design studies

Results were mixed for single-group design studies. Brandon et al. (2014) found a statistically significant decrease in the unadjusted frequency for the moral distress subscale ‘ Not in the patient's best interests’ using their modified two subscale version of the instrument. There were no significant differences when adjusted for discipline, setting, or years at institution. They did find a statistically significant difference in the adjusted analysis for intensity of work quality of life post-intervention. Monteverde (2016) hypothesized that those who scored lower levels of moral distress when considering ethically complex situations had greater moral resilience. Monteverde (2016) found a significant decrease in MDT responses for three of four purposely written vignettes following the educational intervention. Rushton et al. (2021) reported no change in moral distress pre-to-post the MEPRA intervention. Wocial et al. (2017) found that MDS-R scores 12-months after the implementation of multidisciplinary PEACE rounds were lower overall but not all scores were statistically significant. Results showed physicians experienced a significantly improved score for one item feel pressure to order what I consider to be unnecessary tests and treatments and nurses experienced improved scores for three items: initiate extensive life-saving actions when I think they only prolong death; work with nurses or other healthcare providers who are not as competent as the patient care requires ; and witness diminished patient care quality due to poor team communication .

Published: 08 February 2017

Work-Life Balance: an Integrative Review

Applied Research in Quality of Life volume 13 , pages 229–254 ( 2018 ) Cite this article

Based on a thorough review of the literature we introduce an integrated conceptualization of work-life balance involving two key dimensions: engagement in work life and nonwork life and minimal conflict between social roles in work and nonwork life. Based on this conceptualization we review much of the evidence concerning the consequences of work-life balance in terms work-related, nonwork-related, and stress-related outcomes. We then identify a set of personal and organizational antecedents to work-life balance and explain their effects on work-life balance. Then we describe a set of theoretical mechanisms linking work-life balance and overall life satisfaction. Finally, we discuss future research directions and policy implications.

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Sirgy, M., Lee, DJ. Work-Life Balance: an Integrative Review. Applied Research Quality Life 13 , 229–254 (2018). https://doi.org/10.1007/s11482-017-9509-8

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DOI : https://doi.org/10.1007/s11482-017-9509-8

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A Complete World Literature Review of Quality of Life (QOL) in Patients with Kidney Stone Disease (KSD)

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Purpose of review: The purpose of this study was to review the current evidence for quality of life (QOL) in patients with kidney stone disease (KSD).

Recent findings: A review of literature from inception to May 2016 for all prospective English language articles on QOL in patients with KSD was done. QOL studies post urological procedures or ureteric stents were excluded. Nine studies (1570 patients) were included of which most (n = 6) used the SF-36 QOL tool. Overall, seven of the nine studies demonstrated a lower QOL in patients with KSD. Bodily pain and general health were significantly lower in patients with KSD compared to their control groups. Patients with KSD have an overall lower QOL with most impact on bodily pain and general health domains. Compared to the scale of patients suffering from KSD, more work needs to be done in measuring QOL both in terms of 'Stone specific' QOL measuring tools and the quality/number of studies in this field.

Keywords: KSD; Kidney stone disease; QOL; Quality of life.

Conflict of interest statement

Francesca New reports personal fees from Coloplast and other from Storz. Bhaskar K. Somani declares no potential conflicts of interest. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.

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Patient Related Outcome Measures

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Quality of life in adolescent and young adult cancer patients: a systematic review of the literature

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Introduction

Adolescent and young adult (AYA) cancer survivors experience many unique challenges and quality of life (QoL) effects that persist beyond cancer diagnosis and treatment. Due to continuous improvements in technology and cancer treatments resulting in improved survival rates, the identification of late effects, survivorship issues, and QoL is moving to the forefront of cancer research. The goal of this systematic review was to identify key psychosocial factors impacting QoL in AYA oncology populations.

A systematic review of the literature was conducted using combinations of these phrases or keywords: “adolescent and young adult or AYA” AND “health outcomes OR quality of life OR psychology” AND “neoplasm OR cancer OR oncology”. A total of 35 articles were included in this review. Studies were classified into two categories: AYA perceptions and stakeholder perceptions.

AYA cancer survivors were more likely to have “worse” or impaired QoL compared with the general population, regardless of other demographic factors. AYAs described both positive and negatives experiences with their medical care, the educational information received, and the supportive care services. Although health care professionals were likely to underestimate or misjudge the health preferences and support needs of AYAs, these perceptions varied across disciplines and levels of experience.

The literature is lacking in sufficient evidence-based interventions to improve QoL in AYA cancer populations. Further, the tools to adequately measure QoL in this population are also unsatisfactory. The literature, however, consistently shows agreement regarding the unique needs of this population, indicating a trend toward health care standardization within age ranges or life stages. We suggest the need for AYA-specific programs in health care institutions that comprise a multidisciplinary team that addresses all the unique medical and QoL needs of AYAs.

Adolescent and young adult (AYA) cancer survivors experience many unique challenges and quality of life (QoL) effects that persist beyond cancer diagnosis and treatment, including issues with infertility, Citation 1 , Citation 2 body image dissatisfaction, Citation 3 difficulty establishing relationships, Citation 3 , Citation 4 and many other aspects of physical and social functioning. Citation 5 – Citation 7 Health-related QoL can be defined as a broad, multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life. Citation 8 Overall, AYA cancer survivors are at least as likely or more likely to engage in risky health behaviors like smoking, alcohol use, and unprotected sex when compared with the general population. Citation 9 , Citation 10 In addition, recent literature suggests that some health behaviors, such as a lack of physical activity, poor nutrition, lack of sun safety, and pain reliever addiction, are more common in AYA cancer survivors than in their healthy peers or siblings. Citation 11 , Citation 12

While the National Cancer Institute Citation 13 and the LIVESTRONG Foundation Citation 14 define AYAs as those aged 15–39 years, definitions vary among other organizations and AYA literature, ranging from as low as 12 years Citation 15 to as high as 45 years. Citation 16 Individuals in the lower bracket of this age range are often transitioning to independence and autonomy from parents, including the development of their own social and financial responsibilities, joining the workforce, and establishing a personal set of values and goals. Citation 17 – Citation 19 A cancer diagnosis during this multifaceted phase of psychosocial and physical growth can cause significant disruption to major developmental milestones, leading to reduced QoL. Citation 20 Older AYAs may experience psychological distress due to interruptions to family planning, Citation 21 romantic and/or intimate relationships, Citation 22 and accumulation of financial burdens. Citation 23

Due to continuous improvements in technology and cancer treatments resulting in improved survival rates, the identification of late effects, survivorship issues, and QoL is moving to the forefront of cancer research. Recently, there has been a focus in the literature on QoL factors impacting the AYA population and identification that these factors are vastly different from those for older cancer patients/survivors. To develop targeted, developmentally appropriate QoL interventions for AYA populations, a review of the literature is required. The identification of the most prominent factors affecting AYA cancer survivors will aid in developing meaningful and relevant programs. The goal of this systematic review was to identify key psychosocial factors impacting QoL in AYA oncology populations. Further, we examined psychosocial factors in relation to age, stakeholder perceptions, AYA perceptions, and outcomes (eg, QoL, adjustment).

Search strategy and study selection

A review was conducted using the PubMed database and PRISMA guidelines, including all peer-reviewed journals, without limits on publication date. The search terms included combinations of these phrases or keywords: “adolescent and young adult or AYA” AND “health outcomes OR quality of life OR psychology” AND “neoplasm OR cancer OR oncology”. PsycINFO and CINAHL databases were reviewed for additional articles. The following selection criteria were then applied: studies conducted exclusively with AYA survivors or stakeholders (parent[s] of AYA survivors, siblings of AYA survivors, caregivers, and health care providers working with AYA populations); outcome variables were any psychosocial factors impacting QoL in AYA populations, including perspectives from both AYA populations and stakeholders (excluded studies focusing on biological or medical outcomes, as well as studies focusing on improving research participation); studies published in the English language; and primary research (excluded review articles, conference abstracts, editorials, commentaries, correspondence, and case reports). The review was not limited to a specific age range; all primary research articles that defined the population of interest as “AYA” were eligible for inclusion. The review included mixed methods, quantitative, and qualitative studies.

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Figure 1 Flow diagram illustrating the search strategy for articles included in the review.

review of literature quality of work life

Table 1 Articles included in the review

The criteria used to assess the methodological quality of qualitative research papers included in this review were based on two sets of guidelines for appraising qualitative research. Citation 24 , Citation 25 Two reviewers assessed each paper for the following items: 1) clearly described aims and objectives; 2) detailed information on sampling, data collection, and analysis; 3) context of study described; 4) credible data analysis methods; 5) main results presented clearly; 6) quotations supported the results; 7) innovative and credible interpretation of results; 8) study limitations included; and 9) conclusion presented a synthesis of the study and proposed further research. Each reviewer assessed the presence or absence of these items with a rating of 0 or 1 for a maximum score of 9. Disagreements or discrepancies in scoring between reviewers were discussed until a conclusion was reached. A final assessment combining both reviewers’ results placed each paper into these categories: high quality (a score of 8 or higher), medium quality (a score of 5–7), and low quality (a score of 1–4). The papers included in this review were all placed in the high or medium quality.

The criteria used to assess the methodological quality of quantitative research papers included in this review were based on two sets of guidelines for appraising quantitative research. Citation 26 , Citation 27 Two reviewers assessed each paper for the following items: 1) study design identified and appropriately applied; 2) study sample representative of the group (response rate included); 3) use and appropriateness of control group; 4) confounders discussed and/or controlled; 5) valid data collection tools; 6) reliable data collection tools; 7) discussion of dropouts and study withdrawals; 8) appropriate statistical methods; and 9) influence of negative factors on study results credibility. Each reviewer assessed the presence or absence of these items with a rating of 0 or 1 for a maximum score of 9. Disagreements or discrepancies in scoring between reviewers were discussed until a conclusion was reached. A final assessment combining both reviewers’ results placed each paper into these categories: high quality (a score of 8 or higher), medium quality (a score of 5–7), and low quality (a score of 1–4). The papers included in this review were all placed in the high or medium quality.

Data synthesis

Eligible studies were classified into two categories: AYA perceptions and stakeholder perceptions. Data from each study included in this review are presented in Table 1 . Key information was collected on study origin, QoL measures, definition of AYA, study population, cancer type, sample size, aims, methods, outcomes and measures, and key findings. All authors reviewed the articles and confirmed the inclusion of selected articles for this review. The information included for each article was reviewed by the authors to ensure congruence of information extracted.

Study information

The studies used a variety of age groupings to classify AYA. The youngest age used was 10 years and the oldest 44 years. The majority of studies used the range 15–39 years (n=9). The most common lower age limit was 15 years (n=15) and the most common upper age limit was 39 years (n=11). The study populations were primarily AYA cancer survivors (n=26) followed by stakeholders (clinicians or parents) (n=5) and a combination of survivors and stakeholders (n=4).

Nineteen studies used quantitative methods, 13 studies used qualitative methods, and three studies used mixed methods. The majority of studies examined all or most cancer types (n=21). Others were specific to combinations of sarcoma, brain, and hematological cancers (n=6); stem cell transplant patients (n=2); breast and gynecological cancers (n=1); hematological cancer (n=5); and testicular cancer (n=1). Study stages of data collection varied from time of diagnosis, during active treatment, up to 18 years posttreatment, deceased, and unspecified stages. The sample sizes of the studies ranged from 8,375 to eight. Seven studies used the Surveillance, Epidemiology, and End Results (SEER) cancer registry with a sample size of 523 (ie, the same data set was used).

For the majority of studies, the primary goal was to describe or characterize the QoL or psychosocial impact or examine need for information or social support in relation to QoL of AYA survivors (n=16). Two studies examined QoL in relation to fertility and sexuality. Four studies examined QoL in relation to theoretical models or constructs (posttraumatic stress disorder, positive growth, optimism, and resilience). Citation 1 , Citation 40 Four studies examined parents’ perceptions of their AYA son’s or daughter’s QoL. Provider perceptions of AYA QoL were explored in two studies. Two studies inspected QoL in AYA transplant populations. The remaining studies examined QoL of AYA compared with matched healthy controls (n=1), work and education (n=1), end-of-life issues (n=1), and the impact of music (n=1).

AYA perceptions

AYA cancer survivors were more likely to have “worse” or impaired QoL compared with the general population, regardless of other demographic factors. Citation 28 – Citation 33 However, AYA transplant patients reported QoL equal to or better than older transplant patients. Citation 34 AYAs described both positive and negatives experiences with their medical care, the educational information received, and the supportive care services. Citation 6 , Citation 23 , Citation 35 – Citation 39 Respondents typically wanted more information about side effects, alternative treatment options, fertility and childbearing options, and long-term survivorship care. Citation 1 , Citation 23 , Citation 35 , Citation 40 Females were more likely to report distress or poor QoL related to fertility issues. Citation 1 , Citation 29 AYAs reported ongoing struggles and fears related to the cancer experience, including financial problems and negative emotions related to death, body image, and perceived stigma. Citation 3 , Citation 11 , Citation 40 , Citation 41 Terminally ill AYAs in particular experienced substantial physical and psychological symptoms throughout end-of-life stages. Citation 42 Treatment type, lack of insurance, and quitting school or work after diagnosis had a negative impact on work/educational outcomes for survivors. Citation 3 , Citation 43 Relationships with family, friends, other cancer survivors, and church as primary sources of support, when present, contributed to improved QoL. Citation 23 , Citation 37 , Citation 40 Belonging to a support group and engaging in physical activity were associated with reduced distress. Citation 36 , Citation 40

Stakeholder perceptions

Although health care professionals were likely to underestimate or misjudge the health preferences and support needs of AYAs, these perceptions varied across disciplines and levels of experience. Citation 44 , Citation 45 Health care professionals agreed on the challenge of addressing unique developmental characteristics of this population. Citation 44 , Citation 45 Siblings of AYA survivors experienced high levels of psychological distress that were comparable with the AYA survivor and much greater than the general population. Citation 30 Similarly, parents and caregivers of AYAs reported negative QoL issues such as ongoing negative emotions related to diagnosis and discussion of diagnosis. Citation 41 Connectedness and communication were perceived as positive, and the presence of the “nuclear family” led to greater QoL. Citation 41 Maternal beliefs related to health care influenced the mother’s well-being and involvement in the AYA’s health care; however, the impact of parental involvement on the offspring’s development and autonomy was not reported. Citation 46

This systematic review sought to identify key psychosocial factors impacting QoL in AYA oncology populations, specifically factors in the context of age, stakeholder perceptions, AYA perceptions, and outcomes (eg, QoL, adjustment). There is a paucity of research from randomized controlled trials or interventions providing evidence of factors affecting QoL in AYA cancer patients or interventions that may improve QoL. Results from this review highlight that AYAs report lower QoL than their healthy peers and older cancer survivors. There is a significant amount of unmet needs in the AYA population, including long-term survivorship care, fertility preservation, and mental health services. Results also show that AYAs receive insufficient information on cancer impact on fertility, body image, relationships, and financial assistance. Parents, siblings, and partners of AYA with cancer also report varying positive and negative experiences with information and communication needs and distress. Although health care providers tend to underestimate or misjudge the health preferences and support needs of AYAs, they appear to agree that AYA cancer patients present a unique challenge that most institutions are not prepared to handle. Citation 44

Some organizations have developed guidelines specific to AYA populations. The Canadian health care system has developed a set of AYA recommendations to improve QoL. Citation 47 These include the following sections: 1) Active Therapy and Supportive Care, 2) Psychosocial Needs, 3) Palliation and Symptom Management, 4) Survivorship, 5) Research and Metrics, and 6) Awareness and Advocacy. In addition, the National Comprehensive Cancer Network has issued clinical practice guidelines for AYAs with cancer. Citation 48 These guidelines include: 1) management of AYA patients with cancer: special considerations, 2) psychosocial and behavioral issues, 3) survivorship issues, and 4) palliative and end-of-life care.

There is clear agreement on AYA psychosocial needs and survivorship issues across these two guidelines. Most health care institutions have recognized the need for improvements in AYA care and are developing AYA-specific programs to approach this area of need. Citation 49 AYA-specific programs should include a multidisciplinary team with specialized skills, including an “AYA champion” (a highly motivated individual with a professional interest in cancer who is often affiliated with complementary programs such as AYA oncology or survivorship), mental health professionals, peer support groups, reproductive endocrinologists, and religious and legal counsels, among others. Citation 49 In addition, the AYA population represents a significant percentage of patients and is a source of revenue for both pediatric and adult institutions. Citation 49 Creating AYA-specific programs is a benefit for both the population and health care institution.

Evidence from this systematic review suggests there is a wide age range used for describing the AYA population and an equally wide range of measurement strategies for assessing QoL. Nightingale et al Citation 50 reviewed the literature on health-related QoL in young adult survivors of childhood cancer and concluded that the traditional domains assessed in QoL are not comprehensive enough for the AYA population. Huang et al Citation 51 examined the psychometric properties of QoL instruments typically used with the AYA population. The study concluded poor discernibility between homogeneous and heterogeneous domains on the instruments in relation to AYA survivors. Quinn et al Citation 52 conducted qualitative interviews with 30 participants from the Nightingale et al Citation 50 study and identified three key content areas missing from traditional QoL measures. These areas included perceived sense of self, relationships, and parenthood. The study further noted that existing QoL instruments do not take into account the impact of a cancer diagnosis on the interrelationship between emotional development and dependence on caregivers.

Limitations

Our study has several limitations. This search did not assess the quality of studies included in the review; thus, all articles are treated as equally credible, having met the criteria of being published in a peer-reviewed journal. In addition, there was significant variation in the design and methods of studies included in this review. The search strategy was limited to three databases and restricted to English language studies only, which may be a further limitation of this review. Due to methodological variations across studies focusing on the AYA population, it can be problematic to generalize results.

The literature is lacking in sufficient evidence-based interventions to improve QoL in AYA cancer populations. Further, the tools to adequately measure QoL in this population are also unsatisfactory, and in several cases do not comprehensively target QoL domains relevant to AYA populations. The literature, however, consistently shows agreement regarding the unique needs of this population, indicating a trend toward health care standardization within age ranges or life stages. We suggest the need for AYA-specific programs in health care institutions that comprise a multidisciplinary team that addresses all the unique medical and QoL needs of AYAs.

† Type A: quantitative methods; type B: qualitative methods, type C: mixed methods.

Abbreviations: AYA, adolescent and young adult; M, male; F, female; BRFSS, Behavioral Risk Factor Surveillance System; QoL, quality of life; CI, confidence interval; FACT-BMT, Functional Assessment of Cancer Therapy-Bone Marrow Transplantation; GVHD, graft-versus-host disease; SF-36, 36-Item Short-Form Health Survey; 2MWT, 2-minute walk test; HAP, Human Activity Profile; HCT, hematopoietic cell transplantation; FACT-G, Functional Assessment of Cancer Therapy – General; TOI, trial outcome index; AYA HOPE, Adolescent and Young Adult Health Outcomes and Patient Experience Study; NCI, National Cancer Institute; SEER, Surveillance, Epidemiology, and End Results; EORTC QLQ-C30, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30; TAC, talk about cancer; MPS, meet peer survivors; SF-12; 12-Item Short-Form Health Survey; HR-QoL, health-related quality of life; BSI-18, Brief Symptom Inventory-18; PTG, post-traumatic growth; PTSS, posttraumatic stress symptoms; RIM, Resilience in Illness Model; OR, odds ratio; N/A, not applicable; SD, standard deviation; CDM, career decision making; HCBI, Health Competence Beliefs Inventory; PCL-C, Posttraumatic Stress Checklist-Civilian Version; PTSD, posttraumatic stress disorder; REP, representative sample; STAI-S, State-Trait Anxiety Inventory-State Form; SCT, stem cell transplant; TMV, therapeutic music video.

The authors report no conflicts of interest in this work.

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