One of the fundamental issues in the area of assessment of quality of life is to determine what is important to the individuals' quality of life. This is even more crucial when the instrument is for use in diverse cultural settings. This paper reports on the importance ratings on WHOQOL-Bref items obtained as a part of WHOQOL pilot field trial on 4804 respondents from 15 centres from 14 developed and developing countries using 12 languages. All items were rated as moderately or more important, but this was expected because the items were selected by extensive qualitative research for their salience across the centres. Significant differences on mean importance ratings were found between centres, but rank orders of item for their importance showed highly significant correlations between centres. This was especially true for items in the top and the bottom thirds of the item list arranged by overall importance. Most items were rated as more important by women compared to men and by younger compared to older persons. The results are discussed for their relevance in cross-cultural research on quality of life assessment.

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Results from empirical studies on the role of religiosity and spirituality in dealing with stress are frequently at odds, and the present study investigated whether level of religiosity and spirituality is related to the way in which religious coping is used relative to other coping strategies. A sample of 616 university undergraduate students completed the Brief COPE (Carver in Int J Behav Med 4:92-100, 1997) questionnaire and was classified into groups of participants with lower and higher levels of religiosity and spirituality, as measured by the WHOQOL-SRPB (WHOQOL-SRPB Group in Soc Sci Med 62:1486-1497, 2006) instrument. For participants with lower levels, religious coping tended to be associated with maladaptive or avoidant coping strategies, compared to participants with higher levels, where religious coping was more closely related to problem-focused coping, which was also supported by multigroup confirmatory factor analysis. The results of the present study thus illustrate that investigating the role of religious coping requires more complex approaches than attempting to assign it to one higher order factor, such as problem- or emotion-focused coping, and that the variability of findings reported by previous studies on the function of religious coping may partly be due to variability in religiosity and spirituality across samples.

For religious and nonreligious medical students, reduced meaning in life and hope were the strongest indicators of psychological distress. Interventions to improve the mental well-being of medical students may be more effective if aimed at teaching students how to find meaning and purpose in their lives and how to foster an enduring sense of hope and optimism.

The concept of noise sensitivity emerged in public health and psychoacoustic research to help explain individual differences in reactions to noise. Noise sensitivity has been associated with health problems, but the mechanisms underlying this relationship have yet to be fully examined. Participants (n = 1102) were residents of Auckland, New Zealand, who completed questionnaires and returned them through the post. Models of noise sensitivity and health were tested in the analyses using bootstrapping methods to examine indirect effects. Results indicated that gender and noise exposure were not significant moderators in the model. Perceived stress and sleep problems were significant mediators of the relationship between noise sensitivity and subjective health complaints, even after controlling for the influence of neuroticism. However, the relationship between noise sensitivity and mental health complaints (anxiety and depression) was accounted for by the variance explained by neuroticism. Overall, this study provides considerable understanding of the relationship between noise sensitivity and health problems and identifies areas for further research in the field.

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Rasch analysis was conducted to enhance the precision of the widely used 10-item Perceived Stress Scale using two datasets ( n = 450 each) randomly selected from samples of the New Zealand general population ( n = 1102), New Zealand university students ( n = 479) and US university students ( n = 396). The best Rasch model fit ( χ(27) = 29.92, p = .36), good person separation reliability (.80) and coverage (98%) of the sample by the scale items were achieved when locally dependent items were combined into subtests. These findings support reliability and internal structural validity of the 10-item Perceived Stress Scale. The instrument precision can be further improved using the ordinal-to-linear conversion tables published here.

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