青少年在生活质量研究中对生活质量与自评健康的区分。
Adolescent distinctions between quality of life and self-rated health in quality of life research.
作者信息
Zullig Keith J, Valois Robert F, Drane J Wanzer
机构信息
Department of Physical Education, Health, & Sport Studies, Miami University, Oxford, OH 45056, USA.
出版信息
Health Qual Life Outcomes. 2005 Oct 25;3:64. doi: 10.1186/1477-7525-3-64.
BACKGROUND
In adult quality of life (QOL) research, the QOL construct appears to differ from self-rated health status. Although increased QOL continues to be recognized as an important outcome in health promotion and medical intervention, little research has attempted to explore adolescent perceptual differences between self-rated health and QOL.
METHODS
Correlational analyses were performed between self-rated health, physical health days and mental health days, and QOL. Data were collected from two different public high school adolescent samples during two different time periods (1997 & 2003) in two different geographic regions in the USA (a southern & midwestern state) with two different sample sizes (N = 5,220 and N = 140, respectively) using the CDC Youth Risk Behavior Survey (YRBS). The Centers for Disease Control and Preventions' health-related quality of life scale (HRQOL) provided estimates of self-rated health, physical health days and mental health days, and QOL.
RESULTS
All correlation coefficients were significant in both samples (p < or = .0001), suggesting sample size was not a contributing factor to the significant correlations. In both samples, adolescent QOL ratings were more strongly correlated with the mean number of poor mental health days (r = .88, southern sample; r = .89, midwestern sample) than with the mean number of poor physical health days (r = .75, southern sample; r = .79, midwestern sample), consistent with adult QOL research. However, correlation coefficients in both samples between self-rated health and the mean number of poor physical health days was slightly smaller (r = .24, southern, r = .32, midwestern) than that between self-rated health and the mean number of poor mental health days (r = .25, southern, r = .39 midwestern), which is contrary to adult QOL research.
CONCLUSION
Similar to adults, these results suggest adolescents are rating two distinct constructs, and that self-rated health and QOL should not be used interchangeably. QOL, in the context of public high school adolescents, is based largely upon self-reported mental health and to a lesser extent on self-reported physical health. Conversely, although self-reported mental health and self-reported physical health both contribute significantly to adolescent self-rated health, mental health appears to make a greater contribution, which is contrary to observations with adults. Health promoting efforts for adolescents may need to focus more on mental health than physical health, when considering population needs and type of micro or macro intervention.
背景
在成人生活质量（QOL）研究中，生活质量结构似乎与自评健康状况有所不同。尽管生活质量的提高在健康促进和医学干预中仍然被视为一项重要成果，但很少有研究试图探讨青少年在自评健康和生活质量之间的认知差异。
方法
对自评健康、身体健康天数和心理健康天数与生活质量进行相关性分析。数据是在两个不同时间段（1997年和2003年），从美国两个不同地理区域（一个南部州和一个中西部州）的两所不同公立高中的青少年样本中收集的，样本量分别为两种不同规模（分别为N = 5220和N = 140），使用的是美国疾病控制与预防中心青少年风险行为调查（YRBS）。美国疾病控制与预防中心的健康相关生活质量量表（HRQOL）提供了自评健康、身体健康天数和心理健康天数以及生活质量的估计值。
结果
两个样本中的所有相关系数均显著（p≤0.0001），表明样本量不是显著相关性的影响因素。在两个样本中，青少年生活质量评分与心理健康不佳天数的平均数（南部样本r = 0.88；中西部样本r = 0.89）的相关性，高于与身体健康不佳天数的平均数（南部样本r = 0.75；中西部样本r = 0.79）的相关性，这与成人生活质量研究一致。然而，两个样本中自评健康与身体健康不佳天数平均数之间以及自评健康与心理健康不佳天数平均数之间的相关系数，前者（南部r = 0.24，中西部r = 0.32）略小于后者（南部r = 0.25，中西部r = 0.39），这与成人生活质量研究相反。
结论
与成年人一样，这些结果表明青少年对两种不同的结构进行评分，自评健康和生活质量不应互换使用。在公立高中青少年中，生活质量在很大程度上基于自我报告的心理健康，在较小程度上基于自我报告的身体健康。相反，虽然自我报告的心理健康和自我报告的身体健康对青少年自评健康都有显著贡献，但心理健康似乎贡献更大，这与对成年人的观察结果相反。在考虑人群需求以及微观或宏观干预类型时，针对青少年的健康促进工作可能需要更多地关注心理健康而非身体健康。
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