2001-47 Reprinted from: Women & Health 2001; 32(4): 17-32.
Measuring Women's Psychological Well-Being in Indonesia
Elizabeth Eggleston, DrPH Emelita L. Wong, DrPH Karen Hardee, PhD [rwanto, PhD E. Kristi Poerwandari, MA Lawrence 1. Severy, PhD
ABSTRACT. This paper describes the development of a set of measures of women's psychological well·being in Indonesia. identit'es meaning ful clusters of women based on the well-being measures. and explores the sociodemographic factors associated with these well-being clusters. This is the t.rst published study to measure psychological well-being among a large sample of Indonesians and the t.rst to focus on women in that country. Rather than use standard measures of psychological well being developed in Western nations and untested among Asian women. focus groups were conducted to develop an understanding of Indonesian women's perceptions of their own well-being. The focus group t'ndings were used to develop 41 questionnaire items to measure psychological well-being. and the questionnaire was administered to 796 women in
Elizabeth EggleslOn is affiliated with lht! Population Leadership Progr.lm. Bake ley. CA. formerly Family Health International. Research Triangle Park. NC. Emelita L Wong is aniliared with Family Heahh International. Research Triangle Park. ::\"e. Karen Hardee is aftiliated with The Futures Group International. Washington. DC. for merly Family Health Intemational. Research Triangle Park. NC. lrwanto is affiliated wilh the Centre for Societal Development Studies. Alma Jaya Catholic University. Ja karta. E. Kristi Poerwandari is affilialed with the Women's Studies Program. Unh'cr sity of Indonesia. Jakarta. Lawrence J. Severy is aftiJiared with the Depanment of Psychology. University of Florida. Gainesville. FL. Address correspondence [0; Elizabt!lh Eggleston. Popul;uion Leadership Program. C168 Shattuck Avenue. Suite 300. Berkeley. CA 9~704 (E-mail: eeggbton@hotmail. com). Women & Health. Vol. 31(4) 2001 © :WO I by The Haworth Press. Inc. All rights reserved. 17 18 WOMEN & HEALTH
Sumatra and Lampung. Factor analysis reduced the well-being variables Western cultures (S, into five factors accounting for .+57,-, of the total variance: (1) Q:enerai negative feelings: (2) satisfaction with relationships and ability to con Asian and Western trol fenility; (3) satisfaction with economic. family and personal condi vidual ism versus c tions; (-+) negative feelings regarding marital and domestic issues: and larger collective, a (5) ability to pursue activities outside the home. We constructed five 1998; Hofstede, 19i scales based on these factors. Based on their sco··es on these scales. the link between se women grouped into three clusters differentiated hy their scores on four being found in We, of the five scales. Low levels of psychological well-being were associ non-Western cultun ated in bivariate analyses with: (I) rural residence: (2) young age (under els of perceived per~ age 30): (3) marriage before age 20: (4) low socioeconomic status: and sonal control has I, (5) lower educational attainment. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Asians (Sastry and I
~ well-heing variables Western cultures (Sciortino. 1998). Previous research has indicated that variance: ( I ) general ps and ability to con Asian and Western cultures tend to differ on several dimensions: indi y and personal condi vidualism versus COllectivism. responsibility for self versus for the domestic issues: and larger collective. and mastery versus submission (Sastry and Ross. We constructed live 1998; Hofstede. 1980: Hofstede, 1984: Schwartz, 1995). For examp1e. ores on these scales. the link between sense of personal autonomy and psychological well 'Y their scores on four being found in Western populatio!'s may be nonexistent or weaker in .'II-being were associ non-Western cultures. A recent study found that Asians have lower lev (2) young age {under els of perceived personal control than non-Asians and that Sense of per leconomic status: and sonal control has less of an impact on psychological well-being for milable for a fee ]i'om -9678. E-mail address: Asians (Sastry and Ross, 1998). The purpose of this paper is to describe the development of a set of 'lV, HmnJrthPress.com> I measures of women's psychological well-being in Indonesia and to identify meaningful clusters of women based on the well-being mea sures. We expected that while psychological well-being is considered . Indonesia an individualistic construct in Western societies. Indonesian women's psychological well-being would be to some extent shaped by their per ceptions of their family's well-being and by their relationships with their family members and communities. We also explore the socio demographic factors associated with these well-being clusters. This general well-being study represents the first attempt to measure psychological well-being g, employment and \ndrews and Robin- among a large sample of Indonesians and the first to focus on women in more popular and that country. The only two previous published studies of aspects of nan and Csikszent well-being in Indonesia located in a literature search were very limited ive well-being is a in scope and generalizability. One examined self-efficacy among a avily influenced by sample of university students (Schwarzer et aJ.. 1997). Just 17 percent 000: 68), it is con of Indonesians have at least a senior high school education, and an ex ance versus under tremely small proportion receive a post-secondary education (Govern I-being." However. ment of Indonesia. 1998). The other used only a one-item measure of umber of published general well-being (Bahar et aI., 1992). !veloping countries The data for this study were collected as part of a larger study of the Devi ns et ai., 1997; effects of Indonesia's family planning program on women's psycholog ical well-being (Irwanto et ai., 1997). Indonesia was chosen for the veil-being were de study because it has a strong family planning program, initiated in the ,f European descent late I 960s, that targets women almost exclusively. Although the stated g in Asian cultures. objective oflndonesia's family planning program has traditionally been Itural norms as well to reduce population growth, the government now stresses that a major portance of collec goal of the program is to improve the well-being of women and families -eater extent than in (Sciortino. 1998: \Vilopo. 1994). cO WOME.V & HEALTH
DATA A,YD ,HETHODS ticipants gave th contidentiality ( A total of 796 women from two Indonesian provinces, Lampung and were conducted South Sumatra. participated in the study. All participants were of repro The discussions ductive age (15-49), were currently or previously married, and had at erators. and sub least one child. Employees of the National Family Planning Coordi analysis was co nating Board fBKKBN) were excluded from ,;tudy participation. In reviewed the wr' each province, a rural and an urban study site were selected purpos that emerged an ively. Then, two neighborhoods (kelurahan) were selected from each Based on the site: for a total of eig-ht neighborhoods. In Lampung, 400 women (200 41 questionnain from the urban site and 200 from the rural site) were selected randomly psychological v from the neighborhoods, using census information provided by local general life sati~ government officials. In South Sumatra, researchers also attempted to and negative f( select women randomly. However, due to extensive mif;ration, the large sociodemograpi majority of selected women no longer lived at the addresses listed in the tive history. we census data. Therefore, quota sampling was used to select respondents, services. 200 urban and 200 rural, from the randomly selected neighborhoods in Female inter' that province. In both Lampung and South Sumatra, only one woman administered th per household was selected. Although 800 selected women agreed to ducted in the 10' participate in the survey, four did not complete the survey question December, 199, naires; they repeatedly reported being "too busy" with housework to an conducted in th swer questions when interviewers visited their homes. This study'S of the purpose, response rate of 99.57c is similar to the 99.1% household response rate terview techniq of the 1994 Indonesia Demographic and Health Survey (Central Bureau interviews in th of Statistics et aI., 1995). a physician's p Because there were no published reports studying women's psycho that was folio, logical well-being in Indonesia, nor had any of the more standard scales women's home ever been validated in Indonesia, we decided not to use these standard of the survey w measures. We expected that Indonesian women might assess their per family plannin sonal well-being differently than the Western populations for whom and their famili standard scales of well-being were developed. As a first step, we con conducted by 2 ducted eight focus groups with a total of 73 women in Lampung and and that their r South Sumatra to develop an understanding of Indonesian women's 45 minutes on daily life experiences and perceptions of their own well-being. Focus not paid for thE group participants were recruited by the study's field coordinator, with The sample: assistance from local leaders and staff from the village authorities. To who answered minimize the social desirability of results, the local coordinators were being. Twenty encouraged to recruit at least half the participants from persons not rec the study samr ommended by government officers. Focus group participants were of considered im the same age range and socioeconomic status as women in the survey, However, biva but no fOCl~ group participants were incl uded in the survey sample. Par- were more likE Eggles[()11 ef (If. 21 ticipants gave their verbal consent to participate and were assured of the confidentiality of all that would be said. The focus :es, Lampung and group discussions were conducted in the local languages, and each lasted nts were of repro about one hour. The discussions were tape-recorded. transcribed verbatim arried, and had at by the mod erators. and subsequently translated into Indonesian. Planning Coordi- The focus group analysis was conducted by a team of two Indonesian researchers participation. In who reviewed the written transcripts transcripts extensively selected purpos to identify themes that emerged among a majority of the groups. : lected from each Based on the focus group results and previous 400 women (200 research in the field. 41 questionnaire items were developed to measure Indonesian elected randomly women's psychological well-being. The items were grouped into lrovided by local five domains: general life satisfaction. relationships, role fultillment, personal also attempted to matters and negative feelings. The questionnaire "Iso collected igration, the large background sociodemographic information and asked women about 'esses listed in the their reproduc tive history. work experience. family relationships, and use of health ,Iect respondents, services. neighborhoods in Female interviewers. recruited from the same region only one woman as respondents, administered the survey questionnaire in face-to-face Nomen agreed to interviews con ducted in the local languages to all study survey question participants between June and December, 1996. Interviewers participated in housework to an four-day training sessions conducted in their respective provinces. The training les. This study's included a review of the purpose, design and methodology of the study; old response rate instruction in in terview techniques; discussion of each questionnaire . (Central Bureau item; and practice interviews in the tield. In addition, each group of interviewers attended a physician's presentation of an overview of family planning vomen's ps ycho methods that was followed by a discussion session. Interviews took 'e standard scales place at women's homes. and interviewers explained to women ,e these standard that the purpose of the survey was to learn about Indonesian women's experiences assess their per with family planning methods and services and their happiness ,tions for whom with their and their families' lives. Women were also told that the study was rst step, we con being conducted by a private university. not by the Indonesian government. in Lampung and and that their responses would remain contidential. Respondents took nesian women s 45 minutes on average to complete the survey questionnaire and were ell-being. Focus not paid for their participation. 'oordinator, with The sample for this study included the 71 percent of women e authorities. To (n =562) who answered all 41 questionnaire items related to psychological )ordinators were well being. Twenty-nine percent of women (n = n4) were persons not rec excluded from the study sample because they did not answer icipants were of one or more items. We considered imputing mean values for items :n in the survey. with missing responses. However. bivariate analyses indicated that divorced vey sample. Par- or widowed women were more likely than currently married women to be excluded. These
(, " WOMEN & HEALTH women did not answer the questions pertaining to spousal relationships, ing the SPSS clus and imputing values for those items likely would have biased our re by cI usters and co sults, Women excluded from the study also tended to be older (aged 30 sures of agreeme: and over) and to live in urban areas. Other sociodemographic variables scales and cJ uster: examined were not significantly associated with exclusion from the Finally, we co study population in bivariate analyses. These included province, hus tween selected SOl band's age, age at marriage, education, husband's "ducation, socioeco using chi-square t nomic status, work status, husband's income, and duration of residence in study site. In multivariate analyses, only education was associated with exclusion from the study sample, with high school graduates less likely to be excluded. Women responded to all questionnaire items on ordinal scales. Some Sample Characte items had four response categories while others had three. We recoded all variables so that each had three levels of response, with I indicating Table I shows low and 3 indicating high levels of perceived well-being. All variables sample. The sam~ were then standardized by subtracting the mean from the raw value and Sumatra and Larr dividing the difference by the standard deviation, so that each had a than in urban area mean and standard deviation of zero and one, respectively. (data not shown), A factor analysis was performed in order to reduce the 41 well-being der. The mean ag variables down to a smaller set of factors representing the underlying most women (66 I dimensions of the original variables. First, we examined the correlation low educational It matrix for the 41 well-being variables to evaluate the appropriateness of elementary schoo the factor model. The Bartlett test of sphericity allowed us to reject the mentary school. F null hypothesis that the correlation matrix was unsuitable for factor for income, while analysis, and the Kaiser-Meyer-Olkin statistic indicated sampling ade quacy. Next, we used the principal components method offactor extrac Factor Analysis tion with varimax rotation to form the factors. We then examined the eigen values associated with each factor and the scree plot of these val Factor analysis ues. Variables with factor loadings of at least 0.4 were included into a together, these fa< factor. Because the scree Next, a formal scaling analysis was performed, assessing overall reli five factors could ability of each resultant scale and the role each variable played in the factor models. Fir scale. Each scale consisted of the sum of the raw values of the variables factors, we fitted within the factor that had loadings of 0.4 or higher. We calculated abies. Factor I IT Cronbach's alpha and split-half co'efficients to asi"ess the reliability of variables loaded i the scales. As both Shaw and Wright (1967) and Robinson, Shaver and tion with relation~ Wrightsman (1991) report that the average alpha in all published scales abilitv to control is approximately .73, we consider any alpha over .SO as more than ac with ~conomic, fa ceptable. 4 is negative feel Using both the raw and standardized forms of the five scales corre abies), and Factor sponding to the five factors, we classified women into three clusters us- variables). These Eggle.mm e! al. --', '
Dousal relationships. ing the SPSS duster analysis module. We generated plots of the scales have biased our re by clusters and conducted bivariate analyses using kappa-statistic mea to be older (aged 30 sures of agreement to assess the imporrance of different numbers of mographic variables scales and clusters, and the use of raw or standardized scores. exclusion from the Finally. we conducted bivariate analyses of the relationships be uded province. hus tween selected sociodemographic variables and the well-being clusters ~ducation, socioeco using chi-square tests of association. luration of residence ltion was associated chool graduates less RESULTS
ordinal scales. Some Sample Characteristics d three. We recoded se, with I indicating Table I shows the sociodemographic characteristics of the study -bein!!. All variables sample. The sample was split fairly evenly between residents of South 1m thi raw value and Sumatra and Lampung, and slightly more women lived in rural areas . so that each had a than in urban areas. The mean age of women in the study was 31.3 years ectively. (data not shown). and about 41 percent of the women were age 30 or un ce the 41 well-being der. The mean a2e at marria!!e was 18,4 vears (data not shown). and nting the underlying most women (66-percent) had married bef~re age 20. Most women had nined the correlation low educational levels; 19 percent were uneducated or had not finished le appropriateness of elementary school, and 42 percent had left school after completing ele Jwed us to reject the mentary school. Forry-six percent of women reporred that they worked msuitable for factor for income. while 54 percent were homemakers. cated sampli ng ade hod of factor extrac Factor Allalysis ~ then examined the ree plot of these val Factor analvsis vielded nine factors with ei!!en values of at least one: were included into a together. thes~ factors accounted for 57.6 per~ent of the total variance. Because the scree plot of the eigen values indicated that either four or ssessing overall reli tive factors could be optimally retained, we titled both four and tive lriable played in the factor models. First, based on substantive meanings associated with the dues of the variables factors. we titled a model with tive factors. retaining 38 of the 41 vari !her. We calculated ables. Factor I measures women's !!eneral ne2ative feelin!!s, and 13 'ess the reliability of variables loaded inca this factor. Factor:2 meas~res women~s satisfac obinson, Shaver and tion with relationships I seven variables) and their satisfaction with their 1 all published scales ability to control their fertility (one variable). Factor 3 is satisfaction .80 as more than ac- with economic. family .nd personal conditions (eight variables). Factor 4 is ne!!ative feelings regardin!! marital and domestic issues (six vari he live scales corre abies). and Factor 5 is ability to-pursue activitieS outside the home I four "to three clusters us- variables). These live factors explained 45.1 percent of the total vari- --..• ------.-. - --...... -
2-1 WOMEV & HEALTH and South TABLE 1. Sociodemographic characteristics of women, Lampung TABLE 2. Varimax-r~ Sumatra, Indonesia, 1996 (n = 562) well-being'
Percent Distribution Characteristic Item General negative feelings Province 50.5 Lampung 49.5 Unable to solve personal preblE South Sumatra Doubtful and cOnf!\cted Residence 52.7 Angry with myself Rural 47.3 Overwhelmed by responsibililie Urban Feel helpless about handling fe Age group 41A Feelings of guilt 15·29 58.6 by responsibililie 30 and over Overwhelmed Uncertain about my family's lut Age at marriage 66.2 Angry with others (e.g .. husbar <20 years 33.8 ~20 years Need support/help from extenc Disappointed with family life SES' 22.6 to control Low 29.4 Anxious about abIlity Medium 48.1 of pregnancieSibirths High Ashamed of family's living can, of education level 19.2 Satisfaction with relationshil None/some elementary 41.5 fertility Completed elementary 19.0 Satisfaction with relationship VI Some high school 20.3 High school graduate or higher Satisfaction with relationship 'A with relationshIp '" Work status 46.1 Satisfaction Wage/income earner 53.9 Satisfaction with relationship 'to Homemaker Satisfaction with sexuailife and may vary due to item non-response. Note: Ns apply to total number of respondents in each group Satisfaction with ability to mar. low, using an index based on the number 01 house ·Socioeconomic status (SES) was ranked as high, middle. or of children hold amenities. Satisfaction with religious life Satisfaction with economic, conditions the family's financial ance. Table 2 shows the 38 psychological well-being items in Able to meet these items were retained Satisfaction with famIly incom, tive-factor model, with their factor loadings; ill had loadings Feel healthy, rarely because their loading were at least 0.4. Only three items Have time to take care of self that Satisfaction with life as a who below 0.4: feeling free, feeling useful to others, being concerned family. Satisfaction with health one's family is a burden to the extended Satisfaction with ability to mal Have enough time to care for Scale Development alld Cluster Allalysis Negative feelings regarding issues five scales Husband not understanding ( To facilitate interpretation of our tindings, we constructed Marital problems due to haus that correspond to the fi ve factors identitied in the factor analysis. Table Ashamed of personal appear of the scales and items Unable to visit relatives due I 3 shows the means and standard deviations Overwhelmed by household, four of the within each scale. Cronbach 's alpha measures indicated that Difficult to raise children well women·s tive scales had substantial reliability. The fifth scale, measuring Ability to pursue activities of their opportunities to pursue personal interests. had very Have enough lime to socializ perceptions Have opportunity to earn adc low reliability. Have time for community aCI For the most part, women in South Sumatra and Lumpung reported Have opportunity to pursue ~ positive perceptions of their own well-being (Table 3). The mean scores ·\tems with factor loadings IE EgglestoJJ el al. 25 .ampung and South TABLE 2. Varimax-rotated factor matrix for items measuring psychological well-being"
Percent Distribution Item Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 50.5 General negative feelings 49.5 Unable to solve persooal problems .710 Doubtful and conflicted .694 52.7 Angry '1lIlth myself .676 47.3 Overwhelmed by responsibilities as Wife .660 Feel helpless about handling family ma"ers .650 41.4 Feelings of guilt .645 , 58.6 Overwhelmed by responsibilities as mother .636 I I 66.2 Uncertain about my family'S future .619 I 33.8 Angry with others (e.g,. husband. children) .600 ! Need supportlhelp from extended family. neighbors .585 22.6 DisapPOinted with family life .585 29.4 Anxious about ability to control number and liming .537 48.1 of pregnancieSlbinhs I Ashamed of family's livlrt9 conditions .490 I 19.2 Satisfaction with relationships and ability to control I 41.5 19.0 fertility 20.3 Satisfaction with relationship with husband .820 Satisfaction with relationship WJlh extended family .819 46.1 Satisfaction wrth relationship wrth children .819 53.9 Satisfaction with relationship wrth fnends and neighbors .798
'Tl non-response. Satisfaction with sexual life .748 ad on Ihe number of house- Satisfaction wrth ability to manage spacing and number 498 of children Satisfaction with religious life .441 i Satisfaction with economic, family and personal 'ing items in the conditions Able to meet famtly's financial needs .657 ·ms were retained Satisfaction '.... ith famdy tncome .596 I oms had loadi ngs Feel heaHhy. rarely ill .592 Have time to take care of self .586 19 concerned that Salisfaction with life as a whole .563 Satisfaction wrth health .527 Satisfaction wtth ability to manage family .493 Have enough time to care for children I AOI Negative feelings regarding marital and domestic issues , ructed five scales Husband not understanding or caring i .728 Marital problems due to housellold chores .664 .x analysis. Table Ashamed of personal appearance .521 scales and items Unable 10 VtS,t relatives uue to child care respons.bllities .475 ,d that four of the Over..... helmed by household chores .-lea Difficult to raise children well .407 ~asuring women"s Ability to pursue activities outside the home lterests, had very Have enough lime to socialize .588 Have oppor1untty to eam additional income .556 ampung reported Have time for community activ,ties .522 Have opportunrty to pursue personal Interests ...;63 The mean scores 'Uems ..... tth faclor loadings less than A are not .ncluded. 26 WOMEN & HEALTH
TABLE 3. Means and standard deviations of scales and items for the scales would indica Mean Standard Scale and Items tion with reh Deviation economic, fa Scale 1: General negative feelings (Cronbach's alpha", 0.883. Split-half 2.41 .46 reliability coefficient for firsl 7 items", 0.840, last 6 items", 0.71 3) regarding rna Unable to solve personal problems 2.44 .66 tivities outsic Doublful and confJicted 2.38 .68 Angry with myself 2.27 .72 Next, we E Overwhelmed by responsibilities as wife 2.55 .64 ated by score Feel helpless about handling family matters 2.53 .61 Feelings of gUilt 2.25 .68 importance 0 Overwhelmed by responsibilities as mother 2.56 .64 ters. We foun Uncertain about my family's future 2.07 .72 Angry with others (e.g .. husband. children) 2.17 .66 side the hom. Need supporVhelp from extended family. neighbors 2.34 .66 statistic for r Disappointed with family life 2.54 .63 Anxious about ability to control number and timing of pregnancies/birthS 2.49 .67 and at the san Ashamed of family's living conditions 2.69 .54 clusters. Bas. Scale 2: Satisfaction with relationships and ability to control fertility 2.21 .35 ing poor reli; (Cronbach's alpha", 0.857, Split-hall reliability coefficient for first 4 items =0.885. last 3 items", 0.579) cI uster anal y Satisfaction with retationship with husband 2.26 .54 cI usters. We Satisfaction With relationship with extended family 2.21 .54 Satisfaction with relationship wi!h children 2.29 .55 no particular Satisfaction with relationship with friends and neighbors 2.20 .52 tain the origit Satisfaction wilh sexual life 2.30 .57 Satisfaction with ability to manage spacing and number of children 2.14 .65 the items Iikt Satisfaction with religiOUS life 2.05 .69 and standard Scale 3: Satisfaction with economic. family and personal conditions 1.98 .44 Women's (Cronbach's alpha", 0.803, Split-halt reliability coefficient for first 4 items", 0.665, last 4 items", 0.662) Figure I. HiE Able to meet family's financial needs 1.85 .66 1 and4. Simi Satisfaction with family income 1.73 .67 Feel healthy, rarely ill 2.11 .68 of satisfactio Have lime to take care of self 1.99 .63 levels of per Satisfaction with life as a whole 1.91 .68 Satisfaction with health 1.99 .65 (42%) were i ; Satisfaction with ability 10 manage family 1.99 .58 i though they ( Have enough time to care for children 2.23 .64 I Women in cI Scafe 4: Negative feelings regarding marital and domestic issues 2.17 .72 (Cronbach's alpha:: 0.803. Split·half reliability coefficient for first 3 items", 0.629, all scales in ( last 3 items", 0.571) in cluster 1 ( Husband not understanding or caring 2.30 .84 Mantal problems due to household chores 2.30 .79 level of "ge Ashamed of personal appearance 2.30 .83 women and ( Unable to visit relatives due to child care responsibilities 1.86 .82 Overwhelmed by household chores 2.06 .86 Difficulty raising children well 2.18 .87 Psychologic, Scale 5: Ability to pursue activities outside the home (Cronbach's alpha '" 2.26 .63 and Sociode 0.465, Split-half reliability coefficient for first 2 items", 0.177. last 2 items =0.265) Have enough time to socialize 1.97 .57 Have opportunity 10 earn additional income 2.28 .89 Table 4 sr Have time for community activities 2.50 .76 being c1uste: Have ~portunity 10 pursue personal interests 2.29 .83 All Note: A mean 011 Indicates low perceived well-being, while 3 Indicates high perceived well-being. c1ust~rs. for work sta Eggle:ilOtl et al.
lies and items tor the scales were: 1A I for general negative feelings (a score of three would indicate absence of negati ve feelings); 2.1 I for level of satisfac Mean Standard tion with relationships and for satisfaction with Deviation f~rtility contr~I~.1.98 2.41 .46 economic, family and personal conditions; '2.17 for negative feelings regarding marital and domestic issues, and 2.26 for ability [0 pursue ac 2.44 .66 2.38 .68 tivities outside the home, 2.27 .72 Next, we explored whether women clustered into groups differenti 2.55 .64 ated by scores on the well-being scales, In this analysis, we assessed the 2.53 .61 2.25 .68 importance of using different numbers of scales (four or five) and clus 2.56 .64 ters. We found that the lifth scale (opportunities to pursue activities out 2.07 .72 2.17 .66 side the home) was not important in forming clusters of women (kappa 2.34 .66 statistic for measurement of agreement = ,805). It had low reliabilitv 2.54 63 2.49 .67 and at the same time had little effect on how women were classified int; 2.69 .54 clusters. Based on this finding and the Cronbach's alpha score indicat 2.21 .35 ing poor reliability, we elected to use just the lirst four scales. using cluster analysis, we found that the women grouped clearly into three 2.26 .54 clusters. We also determined that the standardized scale scores offered 2.21 .54 2.29 .55 no particular advantage to the raw scores (kappa= .747), and thus we re 2.20 .52 tain the original raw scores. The relative homogeneity of the variance of 2.30 .57 2.14 .65 ;. the items likely accounts for the similar cluster distributions of the raw 2.05 .69 and standardized scales. 1.98 .44 Women's mean scores on the lour scales are depicted, by cluster, in Figure I. Higher means indicate absence of negative feelings on scales 1.85 .66 I and 4. Similarly, higher means on scales 2 and 3 indicate higher levels 1.73 .67 2.11 .68 of satisfaction. Women in cluster 3 (28'lc of the sample) had the highest 1.99 .63 levels of perceived well-being on all four scales. Women in cluster 2 1.91 .68 1.99 .65 (42'7c) were in the middle in terms of their perceptions of well-being, al 1.99 . 58 though they did rank the highest on scale I along with cluster 3 women . 2.23 .64 Women in cluster I (30'7c) consistently reported worse experiences on 2.17 .72 all scales in comparison with the other two profiles. However, women in cluster I differ from women in cluster 1 most dramatically in their 2.30 .84 2.30 .79 level of "general negative feelings'; in other aspects of well-being 2.30 .83 women and clusters I and 2 do not differ considerably. 1.86 .82 , 2.06 86 2.18 .87 Psychological Well-Being Clusters ., 2.26 .63 and Sociodemographic Characteristics: Bivariate AnalysiS 1.97 .57 2.28 89 Table 4 shows women's sociodemographic characteristics, by well 2.50 .76 being cluster. to illustrate some of the differences between the three 2.29 .83 clusters. All the sociodemographic characteristics we examined except lor work status were associated in bivariate analyses with a woman's 28 WOMEN & HEALTH
> FIGURE 1. Mean Scores on Well-Being Scales, by Cluster TABLE 4. Select Lampung and So 40 Sociodemographic 35 Characteristic Province' 30 lampung ~ South Sumatra 0 ~-.--- u 25 -+-Cluster 1 ' Residence' __Cluster 2: Rura! .."' 20 •u Urban -+-Cluster 3: Age group' "'c • 15 15·29 • 30 and over " 10 Age at marriage" <20 years 5 0:20 years SES' 0 Low Medium 1. General 2. Satisfaction wI 3. Satisfaction wI 4. Negative feelings High negative relationships & economic. family & regarding marital & feelings ability to control personal conditions domestic issues level of education' fertility None/some elementary Completed elementary Some high school Well·Being Scale High school graduate or Work status Wage/income earner Homemaker cluster identification. Cluster 3 had a higher proportion of urban women Note: 'p < .05. Ns apply (56'7c) than clusters I (46%) and 2 (43%), while cluster 2 had the high est proportion of rural women (57%). Cluster 3 had a much higher pro portion of women from Lampung (75%) than the other two clusters, likely, along w while almost two-thirds (65'7c) of the women in cluster I were from ter 3 were mos South Sumatra. Cluster I had the highest proportion of younger women married at an C aged 15-30 (50%), while about two-thirds of the women in cluster 2 and cluster 3 were over 30 years of age. Cluster I had the largest share of women who married before age 20 (74%), while cluster 3 had the high est proportion of women who married at age 20 or later (46%). Over one-third of the women in cluster I were of low socioeconomic status This study, (SES), while cluster 2 had the highest proportion of high SES women well-being in I (66%). Cluster 3 also had the highest proportion of women with a high being using 41 school degree; 30% of women in cluster 3 finished high school, com Factor analysi pared to 14'7c in cluster I and 18% in cluster 2. well-being int [n summary, women in cluster I were most likely to have the follow ( I) general ne ing characteristics: South Sumatra residence, rural residence, young age ability to cont (15-30), young age at marriage « 20 years), low SES, and low educa personal condi tionallevel. Women in cluster 2 were likely. as were women in cluster tic issues; and I. to live in rural areas and have low levels of education. They were also structed fi ve s( £gg!estOll eta!. 29 ster TABLE 4. Selected sociodemographic characteristics of women, by cluster. Lampung and South Sumatra, Indonesia, 1996 (n = 56;1)
Sociodemographic Cluster 1 Cluster 2 Cluster 3 Characteristic [n= 171) (n '" 233) (n= 158) Province' Lampung 35.1 45.1 75.3 SoUlh Sumalra "'.9 54.9 24.7 -+-Cluster 1 Residence" ___ Cluster 2 Rural 54.4 57.1 "".3 Urban 45.6 42.9 55.7 -,-Clusler 3· Age group" 15·29 50.0 36.8 39.0 30 and over SO.O 63.2 61.0 Age at marriage" .;:20 years 73.7 69.1 53.8 2:20 years 26.3 30.9 46.2 SES' Low 33.1 25.2 6.7 'v1edium 31.3 29.2 27.5 High 35.5 45.6 65.8 Level of education' None/some elemenlary 22.2 20.8 13.5 Compleled e1emenlary 46.8 43.3 32.9 Some high school 17.0 17.7 23.2 High school graduale or higher 14.0 18.2 30.3 Workstatu$ Wagelincome earner 44.4 48.9 "'3.7 Homemaker 55.6 51.1 56.3 Jan women .. ,d the high NOle. p.;: .05. Ns apply 10 10lal number 01 respondents Ifl each group and may vary due to Item non-response. higher pro ·0 clusters. likely, along with women in cluster 3, to be over age 30. Women in clus were from ter 3 were most likely to be: urban, from Lampung, aged 30 and older. gerwomen married at an older age (20 or older), high SES, and well educated. uster 2 and ·S! share of d the high- SUJLHARYA.ND DISCUSSION 6'7c). Over )mic status This study. the lirst published to examine women's psychological :OS women well-being in Indonesia, measured women's perceptions of their well vith a high being using 41 questionnaire items about live domains of well-being. 1001. com- Factor analysis reduced 38 of the 41 variables measuring women's well-being into five factors accounting for 45'k of the total variance: he follow (I) general negative feelings; (2) satisfaction with relationships and young age ~bility to control fertility; (3) satisfaction with economic, family and ,)weduca personal conditions; (4) negative feelings regarding marital and domes . in cluster tic issues: and (5) ability to pursue activities outside the home. We con were also structed live scales based on these factors and explored whether women JO WOMEN & HEALTH
clustered into groups based on their scores on these scales. It is notable Our data su~ that these scales tap into similar domains as those found among U.S. logical well-bE samples. For example, several items in the "general negative feelings," an important i "satisfaction with relationships and ability to control fertility," and "sat isfaction with economic, family and personal conditions" scales reflect logical well-be quality of life issues comparable to those reported in U.S. studies produce result (Diener, 1984; Andrews and Withey, 1976). naire items, In Overall, Indonesian women expressed positive perceptions of their research that psychological well-being, scoring 2.2 (out of a possible 3) or higher on then demonstr four of five scales. Most notably, women reported an absence of general of well-being negative feelings. It should be noted that in most regions of Indonesia, Further, at 1 cultural norms place a high value on politeness and discourage expres sian women c, sions of dissatisfaction (Hull, 1997; Bahar et aI., 1992), making mea lives should b surement of negative feelings particularly difficult. However, there groups of wo were measurable differences in levels of well-being, and women did status, dyadic differentiate among domains of their lives when assessing their psycho these new too logical well-being; they felt least satisfied with economic, family and relations with personal conditions (mean score of \.98). hance well-be Women grouped into three clusters, differentiated by their scores on Finally, itv four of the five scales of well-being. Women in cluster 3 were character the political al ized by their high level ofperceived well-being. Women in cluster 1 had cent years. In the lowest level of perceived well-being, and women in cluster 2 were women were in the middle in terms of their perceptions of well-being. Low levels of likely that mD psychological well-being were associated in bivariate analyses with: this economic (I) rural residence; (2) young age (under age 30): (3) marriage before age 20; (4) low socioeconomic status; and (5) lower educational attain ment. This study had some limitations that may have influenced our find ings. We converted four-point item responses to three-point responses. Andrews. F.M. , By doing this, we may not have captured the actual variation in well-be sures of Per ing among women in the study, as short scales tend to capture less of the Press. Pp. 62 variation in a population than do longer scales (Andrews and Robinson, Andrews. F. am 1991: 108). We recommend that other researchers using these items of Press. Bahar. E.• Hend well-being design questionnaires with response scales of five or more mental health points. Patterns of non-response may also have influenced the findings SCClndillavic( of this study. Divorced and widowed women, women age 30, and older Cantril. H. (19( and urban women were more likely than others to have missing re University P sponses and thus be excluded from analysis. As age and area of resi Central Bureau dence were also found to be associated with the types of clusters tional Famil (NIOH) and formed, a potential for bias in forming the clusters could have existed. Health Sun'! •
Egglestoll e( al. 31 cales. It is notable Our data suggest, however, that there is clear variation in the psycho 'ound among U.S. logical well-being of Indonesian women. Further, this study represents legative feelings:' 'ertility,"' and "sat an important initial step in developing measures to assess the psycho ons " scales reflect logical well-being of Indonesian women. While factor analytic techniques j in U.S. studies produce results rellective only of the originally developed question naire items, Indonesian women generated these concerns in qualitative Tceptions of their research that informed the development of the individual items, and )Ie 3) or higher on then demonstrated that at least four, if not live, independent dimensions ,bsence of general of well-being are important to their lives. ions of Indonesia, Further, at least three different protiles of well-being among Indone iscourage expres- sian women can be identified. Implications for other aspects of women's 12), making mea lives should be explored. For example, further analysis of these three . However, there groups of women might show relationships with reproductive health , and women did status, dyadic relationships, and women's empowerment. We hope that ;ing their psycho these new tools and tindings spur further research aimed at specifying omic, family and relations with other aspects of women's lives, and factors that might en hance well-being in all of these areas. 'JY their scores on Finally, it would be interesting to conduct a similar study now, given 3 were character the political and economic turmoil that Indonesia has experienced in re ~n in cluster 1 had cent years. In 1996, when this study was conducted, the area in which in cluster 2 were women were least satisfied was their family's economic situation. It is ilg. Low levels of likely that many women would have even less positive perceptions of te analyses with: this economic well-being today. I marriage before jucational attain- REFERENCES uenced our find -point responses. Andrews. F.:VL and Robinson. J.P. ( 1991 ). :\;kasures of subjecliw \\;cll-being. In Jlell iation in well-be .Hlres of Personality alld Social Psychological Altitudes. :"-iew York: Acadt!mic apture less of the Press. Pp. 62-11~. vs and Robinson, Andrews. F. and Withey, R.S. (1976). Social Im/iemurs of \Vell-Beillg. :NY: Plenum 19 these items of Press. , of fi ve or more Bahar. E.. Henderson. A.S .. and ~rackinnon. AI. (1992). An epidemiological srudy of ml!nlal heallh and socioeconomic conditions in SumatcrJ. Indonesia . .-\CTa Psychiacrica lced the findings ScalldiullI-ica 85H). 257-263. 'ge 30, and older Camril. H. (1967). Tht! P(lllel"ll of Humall Concerns. Nt!w Bruns\\li~k. ~J: Rutgers lave missing re l' niversiry Press . .md area of resi Cl.!mral Bureau of Statistics (CBS) [Indonl.!siaJ and StJte \Iinistry of Population/?'\a vpes of clusters tional Family Planning Coordinating Board (~FPCB) and ~ljnislry of Hl.!alth dd have existed. (vIOH) and ;vla~ro Imemarional Inc. (:VII). 1995. Inciollc!sia Demographic WId Health SltrI'er 199~. Calvenan. :V!D: CBS and :VU. /~ ------,------
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