Warwick-Edinburgh Mental Well-being Scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment.

BACKGROUND: Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 16 years and over in the UK. We report here a study designed to establish the validity and reliability of WEMWBS in teenagers in the UK. METHODS: WEMWBS and comparator scales, together with socio-demographic information and self-reported health, were incorporated into a self-administered questionnaire given to pupils aged 13 to 16 years in six schools in Scotland and England. Psychometric properties including internal consistency, correlations with comparator scales, test-retest stability and unidimensionality were investigated for WEMWBS. Twelve focus groups were undertaken to assess acceptability and comprehensibility of WEMWBS and were taped, transcribed and analysed thematically. RESULTS: A total of 1,650 teenagers completed the questionnaire (response rate 80.8%). Mean WEMWBS score was 48.8 (SD 6.8; median 49). Response scores covered the full range (from 14 to 70). WEMWBS demonstrated strong internal consistency and a high Cronbach's alpha of 0.87 (95% CI (0.85-0.88), n = 1517). Measures of construct validity gave values as predicted. The correlation coefficient for WEMWBS total score and psychological wellbeing domain of the Kidscreen-27 was 0.59 (95% CI [0.55; 0.62]); for the Mental Health Continuum Short Form (MHC-SF) was 0.65, 95% CI [0.62; 0.69]; and for the WHO (WHO-5) Well-being Index 0.57 (95% CI [0.53; 0.61]). The correlation coefficient for the Strengths and Difficulties Questionnaire (SDQ) was -0.44 (95% CI [-0.49; -0.40]) and for the 12-item General Health Questionnaire (GHQ12) -0.45 (95% CI [-0.49; -0.40]). Test-retest reliability was acceptable (Intraclass correlation coefficient (ICC) 0.66 (95% CI [0.59; 0.72] n = 212)). Confirmatory factor analysis demonstrated one underlying factor. WEMWBS was significantly associated with the Family Affluence Score (WEMWBS increased with increasing household socio-economic status) and had a positive association with the physical health dimension of the Kidscreen-27, but was unrelated to age, gender or location/school. Eighty students took part in focus groups. In general, although some students considered some items open to misunderstanding or misinterpretation, WEMWBS was received positively and was considered comprehensible, and acceptable. CONCLUSIONS: WEMWBS is a psychometrically strong population measure of mental wellbeing, and can be used for this purpose in teenagers aged 13 and over.

Relational mechanisms and psychological outcomes in couples affected by breast cancer: a systematic narrative analysis of the literature.

INTRODUCTION: Relationships are a significant dimension of illness experience. At the couple level, partners will respond to illness as an interpersonal unit rather than individuals in isolation. Research adopting a relational perspective have focused on communication, relational coping and relationship functioning and satisfaction. To our knowledge, there is no published systematic review of literature that reports associations between a couple's relationship and psychological outcomes of patients and partners affected by breast cancer. AIM: To review studies that examine the impact of relational mechanisms on psychological outcomes in couples affected by breast cancer and thereby improve understanding of the connections between patient, disease and family. METHODS: A systematic search for literature was conducted, which was followed by a thematic analysis of study findings and a narrative synthesis. RESULTS: Sixteen papers were included. Papers were published relatively recently between 1988 and 2010. Three relational components were identified: (i) couple coping, (ii) relationship functioning and satisfaction, (iii) communication. While the literature indicates associations between relational and psychological variables, with such a small evidence base, the use of different terminology and different theoretical frameworks makes it almost impossible to draw definitive conclusions about which relational component holds greatest potential for effecting change on psychological well-being. CONCLUSIONS: While there remain many opportunities for contributing to the theoretical and empirical work in this field, there is sufficient evidence to propose a relational approach to supporting people affected by cancer.