The Holistic Well-being Scale: development and validation of a self-reported measure on equanimity and affliction

PURPOSE. In recent years, interest in incorporating Eastern philosophies in the study of holistic well-being has increased. In describing this renewed understanding of holistic well-being, which focuses on the dual goals of alleviating suffering and achieving enduring happiness, the Eastern notions of ‘affliction’ and ‘equanimity’ are often brought to fore respectively. Nonetheless, there have been few systematic attempts to operationalize constructs surrounding the two concepts. The purpose of this study is to provide an overview of the two concepts, and to develop an instrument that measures holistic well-being through an affliction-equanimity model. METHOD. An expert panel developed a pool of items, which were tested in a community sample of 2,423 adults through an online questionnaire with other measures of well-being, emotion, quality of life, sense of coherence and mindfulness. Exploratory and confirmatory analyses were conducted to determine the factor structure. Correlational analysis examined the instrument’s convergent validity. RESULTS. Exploratory factor analysis (n = 1228) revealed seven factors, which accounted for 68.9%of variance. Confirmatory factor analysis (n= 1195) showed the first-order sever-factor structure was an adequate fit (CFI = .936; TLI = .926; RMSEA = .057). The seven factors correlated in expected directions with measures of quality of life, mood, meaning of life, mindfulness and hope. For affliction-related characteristics, there were factors related to bodily irritation, emotional vulnerability and spiritual disorientation. For equanimity-related characteristics, there were factors that reflect a sense of vitality, an empathetic mind for both self and others, an accepting attitude to changes, and a willingness to take care of one’s spiritual well-being. CONCLUSION. The resultant 30-item Holistic Well-being Scale (HWS) had seven factors related to affliction and equanimity. Results showed it had good psychometric properties and validity, and suggested its usefulness in future studies of holistic well-being