Frontpage

Index
Abstract ................................................................................................................................................... 3
Chapter 1: Quality of Life ........................................................................................................................ 4
Chapter 2: review of literature ................................................................................................................ 4
WHOQOL-SRPB-BREF .......................................................................................................................... 4
Adolescents ..................................................................................................................................... 4
Chapter 3: Research methodology .......................................................................................................... 5
Research design................................................................................................................................... 5
Problem statement.............................................................................................................................. 5
Research objectives ............................................................................................................................. 5
Conceptual and operational definitions .............................................................................................. 5
Gypsies of Trichy.............................................................................................................................. 5
Quality of life ................................................................................................................................... 6
Research variables ............................................................................................................................... 6
Data-analyses ...................................................................................................................................... 6
Sources of data-collection ................................................................................................................... 7
Method of data collection ................................................................................................................... 7
Limitations and/or challenges ............................................................................................................. 7
Chapter 4: Data analyses and interpretation .......................................................................................... 7
Chapter 5: Findings and suggestions ....................................................................................................... 9
Bibliography........................................................................................................................................... 11
Abstract
<not complete>
Chapter 1: Quality of Life
The World Health Organization (WHO) developed an international quality of life (QoL) assessment,
such as the WHOQOL-100, for approval of new pharmaceuticals and policy research (programme
evaluation and resource allocation). Having an international QoL assessment makes it possible to
carry out QoL research in different cultural settings, and compare directly results obtained in these
different setting. (Group, 1995)

The assessments have several features. First measure is that fifteen culturally diverse centers were
involved in operationalizing the instrument’s domains of QoL, drafting and selecting questions,
generating response scales and pilot testing. The second feature is the input of practicing health
professionals and patients that are represented in the assessment. The third feature is the review by
groups to ensure conceptual, semantic and technical equivalence in different languages. (Group,
1995)

There is a consensus about the multi-dimensional nature of QoL (Lindström, 1992). The domains are
physical domain, psychological domain, level of independence, social relationships, environment and
spirituality/religion/personal beliefs (SRPB). In this research the short version of the WHOQOL-100,
the WHOQOL-SRPB-BREF by Skevington, Gunson, & O’Connell (2013), will be used. The domain ‘level
of independence’ is not present in the WHOQOL-SRPB-BREF and therefore will be excluded from this
research.

Chapter 2: review of literature

WHOQOL-SRPB-BREF
The WHOQOL-SRPB-BREF is a short-form of the WHOQOL-SRPB. It contains 34 items, scored in five
domains, to assess physical health, psychological health, social relationships, environment and
spirituality/religion/personal beliefs.

It is an ideal tool because it can assess almost every type of person, irrespective of their health state
and status. The assessment can be used in a variety of health, social and educational contexts.

In the study of Skevington et al., (2013), participants (N=5087) were sampled in 18 field sites (16
countries including the cities Bangalore and Pondicherry) with the WHOQOL-SRPB. The performance
of each item was addressed within its own facet, in order to identify the most representative facet
item. Secondly, a user review of the new WHOQOL-SRPB-BREF instrument was undertaken at a
national meeting of hospital chaplains in a medical teaching hospital. Feedback was taken in account
with about the item contents, formatting, instructions, relevance, acceptability, comprehensiveness
and feasibility. This resulted in an addition of 8 items about spirituality/religion/personal beliefs to
the WHOQOL-BREF.

The WHOQOL-SRPB-BREF has a good overall internal consistency reliability (α=0.85), and for the
SRPB domain (α=0.83). The domains were moderately correlated and the domain test-retest was
good (r=0.80) for the WHOQOL-SRPB-BREF. (Suzanne M. Skevington et al., 2013)

Adolescents
The WHOQOL-BREF can be used for adolescents starting from 13 years old. A study by Skevington,
Dehner, Gillison, McGrath, & Lovell (2014) with 208 adolescents (13-19) and 205 young adults (20-
30), conforms this. They’ve found a good internal consistency reliability (α=0.89), especially
psychological and environmental quality of life. Content validity was supported, especially for social
and environment domains. Furtherly, domains validly discriminated between groups with
adolescents having high- and low-depressive symptoms.

The same results were found for Indian adolescents. Although the item “Are you satisfied with your
sex life?” was replaced with “Are you satisfied with the respect you receive from others?”. There
were 525 adolescents who participated in the research. The instrument showed a good internal
consistency (α=0.87) as well a good content, construct and predictive validity (p<0.05).
Psychological domain had the best predictive validity and the social relations domain had the best
content validity. The study further provides evidence that the WHOQOL-BREF is a reliable and valid
instrument and can be used for Indian adolescents. (Agnihotri, Awasthi, Chandra, Singh, & Thakur,
2010)

The WHOQOL-SRPB-BREF, currently, does not have samples specified for (Indian) adolescents.

Chapter 3: Research methodology

Research design
This descriptive quantitative research aims to obtain information about the quality of life for
adolescents (N=30) of the Gypsy-community in Trichy. The results will be achieved through the
English questionnaire WHOQOL-SRPB-BREF. Translators will aid the participants in completing this
form.

Problem statement
The members of the Gypsy community in Trichy, also named as Narikurava, has been left out from
societal aid since the British empire ruled in India. They have been segregated and weren’t even
recognized as ‘tribal’, ‘service caste’ or even ‘indigenous’. (Chatty & Colchester, 2008) Although there
are changes being made for this status.

Research objectives
This research aims to assess a randomized sample of adolescents and measure if any problems exist
with their quality of life. These results can be used for further and more in-depth research.

Conceptual and operational definitions

Gypsies of Trichy
The Gypsies of Trichy, also referred to as the Outcaste Narikuravas, Vagri or Kurrivikaran, are former
Outcaste forest-dwellers. They are known by the society as Narikuravas, but according to Werth
(1993), call themselves Vagri. They aren’t seen as agriculturalists nor a ‘service caste’ or classified as
‘tribal’ or ‘indigenous’. (Chatty & Colchester, 2008)They are commercial nomads, Gypsies who have
traditionally lived apart from surrounding populations with a little sense of identity or attachment to
one particular locality. (Werth, 1993) Although unclear, research of Werth (1993) suggests that they
originate from Gujerat and Rajastan, but this is only half the story. Each community or sub-clan have
their own history and speculate they are origined from a different group or region. Only a small
amount of work has been done on the Narikuravas, usually by foreigners, while Indian social scientist
have somewhat ignored this matter. (Chatty & Colchester, 2008)

The Narikuravas see themselves as culturally distinct by virtue of language, religious practice such as
Shaktism (Hindu), Christianity and Animism, and social organization into twenty-two exogamous
patrilineal sub-clans or Jathi. (Werth, 1993). They have a strong sense of collective identity and
marked sense of family and individual identity. (Chatty & Colchester, 2008)
Because of the social exclusion and financial instability, children are often forced into child-labor.
This excludes them from proper education and loops them into lesser stabile job opportunities. They
often, in Trichy, help the parents make jewelry. In the Gypsy community in Tollgate 1, an initiative
has been launched called the “Child labor school” to give the child labors a chance to get educated.
The parents in this community usually don’t persist on the children getting a formal education.

Quality of life
The questionnaire exists of 34 items, with 3 reversed items, each belonging to one of the following 5
domains: ‘physical domain’, psychological domain’, ‘social relationships’, ‘environment’ and
‘spirituality/religion/personal beliefs’. Each domain gives a processed score between 0 and 100.

The participant answers the question through a Likert-scale ranging from ‘Very poor/Very
dissatisfied/Not at all’ (1) to ‘Very good/Very satisfied/An extreme amount/Extremely’ (5).

Research variables
Independent variables
There are participants from two regions, namely Tollgate 1 (T) and Devarayaneri Village (D). the
following personal data has been collected: age, gender, highest education level, current education,
is working, marital status, religion.

Dependent
Each participant will, for each domain, have a score between 0 and 100.

Physical domain measures the pain and discomfort he participant experiences in his/her daily life,
the amount of energy or feeling fatigue, and the quality of their sleep and rest.

Psychological domain represents the amount of positive feelings, the quality of thinking, learning,
memory and concentrating, the self-esteem, the perceived body-image and appearance, and
negative feelings

Social relationships domain represents the quality of personal relationships, amount of social support
and sexual activity.

Environment domain represents the quality of the physical safety and security, home environment,
financial resources, availability and quality of health and social care, opportunities for acquiring new
information and skills, participation in and opportunities for recreation, physical environment (such
as pollution, noise, traffic, climate), and transport.

Spirituality/religion/personal beliefs domain examines the role of the participant’s personal beliefs,
religious background and spirituality in his/her life, such as ways of coping or way of living.

Data-analyses
This research will work with adolescents out of two communities: participants from Tollgate, and
participants from Devarayaneri Village (DV). These are approximately 26km apart from each other
and have a different infrastructure. The region of the Gypsies in DV seems more developed than the
region of the Gypsies in Tollgate 1. DV has well build schools, houses, shops, farms, etc. they seem to
be mainly self-sustaining community. Tollgate 1 has self-build homes made out of plant-materials,
this in contrast to the cemented walls in DV. It has one school for children who are doing child labor,
and doesn’t seem to have shops, or agricultural land. This could be due the region is near shops and
easier access to the main city, while DV has more difficulty going to the city. This is because,
according to the members of the village, the bus drivers refuse to stop in front of the region while
they should stop.
Sources of data-collection
The questionnaire is originally from the World Health Organization, but has been modified for the
current needs by the authors Skevington et al. (2013).

The literature is mainly taken from books and journals. Because of the lack of information about the
Gypsies communities in Tamil Nadu, more specific Trichy, the number of bibliographical sources are
low.

A simple random sample has been taken (N=30), which includes male and female adolescents from
both communities. Except for the age, there were no criteria to participate the assessments.

Method of data collection

Translators guided the participants in filling the questionnaire. In this sense, only quantitative data
has been collected and only a few notes.

The data has then been fed into Excel and processed according the scoring norms of the WHOQOL.

Limitations and/or challenges

Due the translation work, there is a possibility that the questions were phrased differently. The
translators consisted of professionals, a post-graduation student and a professor.

Because of the relatively small sample size, this research is explorative. It should help and inspire
other researchers and students to explore the Gypsy communities.

Chapter 4: Data analyses and interpretation

Gypsies at Tollgate 1
Table 1. Gypsies at Tollgate 1

N Minimum Maximum Mean Std.

Deviation
Physical 15 39,31 96,44 66,43 16,07

Psychological 15 37,5 100 68,33 17,16

Social relations 15 16,69 83,31 62,79 15,70

Environment 15 34,38 75 61,67 11,41

Spirituality/Religion/Personal 15 40,63 84,38 63,96 10,62

beliefs

Physical health
On average, the sampled adolescents average score 66,43 for physical health, with 7 scoring below
the group average. There were adolescents reporting they were struggling with a physical condition,
but didn’t have access to the proper treatment. There were only four adolescents who felt
completely physical healthy
Psychological health
There were five adolescents scoring lower than the average. Mostly the girls score low for questions
that involves self-image and purpose in life. Also, 1 adolescent scored 100, this could be due lack of
skill to understanding the gradations on the Likert-scale or answering socially desirable.

Social relationships
Averagely, adolescents scored near the mean for social relationships. This could indicate a certain
need and needs more qualitative investigation.

Environment
Five adolescents score below the average score of the sample. The Tollgate 1 community is under
developed and the common sense of the people is that they don’t need any development in the
infrastructure. There is mainly a focus on doing business, which could partially neglect other needs.
Public defecation is common, and only recent there was another toilet built for the Child Labor
School. In total, there are two toilets, with one which wasn’t used until the day of data-collection.

Spirituality/Religion/Personal beliefs
Seven adolescents scored lower than average, with one participant below 50. Still, the results don’t
show any major problems.

Gypsies at Devarayaneri Village

Table 2. Gypsies at Devarayaneri Village

N Minimum Maximum Mean Std.

Deviation
Physical 15 39,31 85,69 63,81 11,75

Psychological 15 29,19 75 58,61 14,21

Social relations 15 33,31 75 63,34 9,36

Environment 15 18,75 62,5 48,13 12,15

Spirituality/Religion/Personal 15 37,5 75 54,79 11,62

beliefs

Physical health
There are 8 adolescents who score lower than the average. Participants with a health condition,
explained that their condition isn’t getting better or is recovering slowly because of the lack of proper
treatment.

Psychological health
It is noticeable that out of the 6 adolescents who score below average, 3 of them scored lower than
50 and 1 adolescent scored 50. Because of the relatively low average, further exploration through
quantitative research is recommended for the psychological health of this community. It is not clear
if the adolescents wanted to ventilate, understood the questions differently or another reason for
the participants an average lower psychological health.
Social relationships
On average, the participants scored around the mean with 4 of them only below the mean. Although
it doesn’t seem problematic, further quantitative research could be done to explore this domain
deeper.

Environment
The average score of this domain is below 50. With 7 adolescents scoring lower than the mean. This
domain needs further qualitative research. Participants noted that it is difficult for them to use public
transport. There is a bus stop in front of their region, but the bus drivers usually refuse to stop there
and pick them up, which makes it harder for the members to travel to the city for work, college or
others.

Spirituality/Religion/Personal beliefs
Adolescents scored lower for this domain, with 7 of the participants scoring lower than the mean.
Further quantitative research is necessary for tis domain, there were no notes for this domain.

Chapter 5: Findings and suggestions

The Devarayaneri Village community is more infrastructurally developed than the Tollgate 1
community. Although, according to the results, the adolescents in the Devarayaneri Village seem to
score lower on the domains: psychological health, environment, and spirituality/religion/personal
beliefs.

Further quantitative research is needed to explore these differences in scores.

Research design  descriptive design

Problem statement

Objectives of study/ research objectives

Conceptual and operational definitions  wie zijn de gypsies of Trichy, QoL

Research variables: Dependent (all the dimensions) and independent (age, education, personal
details,…)variables

Data-analyses (brief information  informatie over de respondents living area, hoeveel mensen, wat
is de afstand)

Sources of data-collection

- Primary source: WHO titel van de questionaire

- Secondary source: magazines, books, journals, websites
- Universe of the study (hoeveel mensen)
- Sampling procedure (hoeveel samples ‘30’)
- Sampling method: Simple random sampling

Method of data collection

- Questionaire method

Limitations and/or challenges

4. Data analyses and interpretation

5. Findings and suggestions

Bibliography
Agnihotri, K., Awasthi, S., Chandra, H., Singh, U., & Thakur, S. (2010). Validation of WHO QOL-BREF
instrument in Indian adolescents. The Indian Journal of Pediatrics, 77(4), 381–386.
http://doi.org/10.1007/s12098-010-0041-1
Chatty, D., & Colchester, M. (2008). Conservation and Mobile Indigenous Peoples: Displacement,
Forced Settlement and Sustainable Development (1st ed.). Berghah Books. Retrieved from
http://www.jstor.org/stable/j.ctt1btbx2j
Group, T. W. (1995). The World Health Organization quality of life assessment (WHOQOL): Position
paper from the World Health Organization. Social Science & Medicine, 41(10), 1403–1409.
http://doi.org/10.1016/0277-9536(95)00112-K
Lindström, B. (1992). Quality of life: a model for evaluating health for all. Conceptual considerations
and policy implications. Sozial- Und Praventivmedizin, 37(6), 301–6. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/1492503
Skevington, S. M., Dehner, S., Gillison, F. B., McGrath, E. J., & Lovell, C. R. (2014). How appropriate is
the WHOQOL-BREF for assessing the quality of life of adolescents? Psychology & Health, 29(3),
297–317. http://doi.org/10.1080/08870446.2013.845668
Skevington, S. M., Gunson, K. S., & O’Connell, K. A. (2013). Introducing the WHOQOL-SRPB BREF:
developing a short-form instrument for assessing spiritual, religious and personal beliefs within
quality of life. Quality of Life Research, 22(5), 1073–1083. http://doi.org/10.1007/s11136-012-
0237-0
Werth, L. (1993). The Vagri of South India and their Ancestors. Journal of Indian Anthropological
Society, 28, 275–84.
The quality of life of the adolescents (14y-17y) of the Gypsy community in Tiruchirappalli

Adolescents in India  14y-17y

Brief information chapter 1

Background QoF

Meaning

Special characteristics

Chapter 2 review of literature (findings)

Algemeen QoF van een groep, adolescenten

Statistische dingen van journals, magazines, secondairy sources

Chaptor 3 Research methodology

Research design  descriptive design

Problem statement

Objectives of study/ research objectives

Conceptual and operational definitions  wie zijn de gypsies of Trichy, QoL

Research variables: Dependent (all the dimensions) and independent (age, education, personal
details,…)variables

Data-analyses (brief information  informatie over de respondents living area, hoeveel mensen, wat
is de afstand)

Sources of data-collection

- Primary source: WHO titel van de questionaire

- Secondary source: magazines, books, journals, websites
- Universe of the study (hoeveel mensen)
- Sampling procedure (hoeveel samples ‘30’)
- Sampling method: Simple random sampling

Method of data collection

- Questionaire method

Limitations and/or challenges

4. Data analyses and interpretation

5. Findings and suggestions

Type analyses

Simple percentage analyses

Student T-test (type analyses)

WHO research proposal!