Natvig Gerd Karin, Albrektsen Grethe, Qvarnstrøm Ulla
Department of Public Health and Primary Health Care, University of Bergen, Norway.
Int J Nurs Pract. 2003 Jun;9(3):166-75. doi: 10.1046/j.1440-172x.2003.00419.x.
The concept of health contains aspects of social and mental well-being and not just the absence of disease. The concept of well-being is sometimes used interchangeably with the term happiness, although focus has been on other aspects as well. Here we explore associations between happiness and experience of stress at school, personal and social factors among 887 Norwegian school adolescents participating in a World Health Organization project on health-promoting schools. Happiness was measured by a one item question (ordered responses 1-4). The psychosocial factors were represented by an average score of 3-12 items. Odds ratios of feeling very/quite happy were calculated in multiple logistic regression analyses. An increasing degree of stress experience reduced the feeling of happiness significantly. Furthermore, increasing levels of general self-efficacy increased the odds of feeling happy, whereas the more specific measure of school self-efficacy showed no independent effect. Social support from teachers also enhanced happiness significantly. A less consistent pattern was found for support from peers, but the most happy pupils experienced significantly more support than pupils who reported being unhappy. No significant trend was found with decision control. We also explored associations between happiness and psychosomatic symptoms. Pupils feeling unhappy reported a particular symptom more often and they also had the highest mean number of reported symptoms. To evaluate whether these health indicators represent different dimensions of health, a comparison of strength of associations with common risk factors is made. Implications for health promotion practice are discussed.
健康的概念包含社会和心理健康方面，而不仅仅是没有疾病。幸福的概念有时与“快乐”一词互换使用，尽管关注点也在其他方面。在此，我们探讨了参与世界卫生组织健康促进学校项目的887名挪威青少年学生的幸福与学校压力体验、个人及社会因素之间的关联。幸福通过一个单项问题进行衡量（答案按1 - 4排序）。心理社会因素由3至12个项目的平均分来表示。在多元逻辑回归分析中计算了感觉非常/相当幸福的比值比。压力体验程度的增加显著降低了幸福感。此外，总体自我效能感水平的提高增加了感到幸福的几率，而学校自我效能感这一更具体的衡量指标则没有独立影响。来自教师的社会支持也显著增强了幸福感。在同伴支持方面发现的模式不太一致，但最幸福的学生比那些表示不幸福的学生体验到的支持显著更多。在决策控制方面未发现显著趋势。我们还探讨了幸福与身心症状之间的关联。感到不幸福的学生更频繁地报告某种特定症状，并且他们报告的症状平均数量也最高。为了评估这些健康指标是否代表健康的不同维度，我们对与常见风险因素的关联强度进行了比较。并讨论了对健康促进实践的启示。
