Michaelson Valerie, Freeman John, King Nathan, Ascough Hannah, Davison Colleen, Trothen Tracy, Phillips Sian, Pickett William
Department of Public Health Sciences, Carruthers Hall, Queen's University, Kingston, ON, K7L 3 N6, Canada.
School of Religion, Queen's University, Kingston, Canada.
BMC Public Health. 2016 Nov 28;16(1):1200. doi: 10.1186/s12889-016-3834-y.
Spiritual health, along with physical, emotional, and social aspects, is one of four domains of health. Assessment in this field of research is challenging methodologically. No contemporary population-based studies have profiled the spiritual health of adolescent Canadians with a focus on health inequalities. In a 2014 nationally representative sample of Canadians aged 11-15 years we therefore: (1) psychometrically evaluated a series of items used to assess the perceived importance of spiritual health and its four potential sub-domains (connections with: self, others, nature and the natural environment, and the transcendent) to adolescents; (2) described potential inequalities in spiritual health within adolescent populations, overall and by spiritual health sub-domain, by key socio-demographic factors.
Cross-sectional analysis of survey reports from the 2014 (Cycle 7) of the Canadian Health Behaviour in School-aged Children study (weighted n = 25,036). Principal components analysis followed by confirmatory factor analysis were used to explore the psychometric properties of the spiritual health items and the associated composite scale describing perceived importance of spiritual health. Associations among this composite scale, its individual sub-domains, and key socio-demographic factors were then explored.
The principal components analysis best supported a four-factor structure where the eight scale items loaded highly according to the original four domains. This was also supported in confirmatory factor analyses. We then combined the eight items into composite spiritual health score as supported by theory, principal components analysis findings, and acceptable tests of reliability. Further confirmatory factor analysis suggested the need for additional refinements to this scale. Based upon exploratory cross-sectional analyses, strong socio-demographic inequalities were observed in the spiritual health measures by age, gender, relative material wealth, immigration status, and province/territory.
Study findings highlight potential inequalities in the spiritual health of young Canadians, as well as opportunities for methodological advances in the assessment of adolescent spiritual health in our population.
精神健康与身体、情感和社会层面一样，是健康的四个领域之一。该研究领域的评估在方法上具有挑战性。目前尚无基于人群的当代研究对加拿大青少年的精神健康进行剖析，且未关注健康不平等问题。因此，在2014年全国代表性的11 - 15岁加拿大人样本中，我们：（1）从心理测量学角度评估了一系列用于评估青少年对精神健康及其四个潜在子领域（与自我、他人、自然和自然环境以及超验的联系）重要性认知的项目；（2）按关键社会人口学因素描述了青少年总体人群以及按精神健康子领域划分的精神健康方面潜在的不平等情况。
对2014年（第7轮）加拿大学龄儿童健康行为研究的调查报告进行横断面分析（加权样本量n = 25,036）。采用主成分分析随后进行验证性因素分析，以探索精神健康项目的心理测量特性以及描述精神健康重要性认知的相关综合量表。然后探讨该综合量表及其各个子领域与关键社会人口学因素之间的关联。
主成分分析最有力地支持了一个四因素结构，其中八个量表项目根据最初的四个领域进行了高度加载。验证性因素分析也支持了这一点。然后，我们根据理论、主成分分析结果以及可接受的信度检验，将这八个项目合并为综合精神健康得分。进一步的验证性因素分析表明该量表需要进一步完善。基于探索性横断面分析，在按年龄、性别、相对物质财富、移民身份和省份/地区划分的精神健康测量中观察到了强烈的社会人口学不平等。
研究结果凸显了加拿大年轻人精神健康方面潜在的不平等，以及我国青少年精神健康评估方法改进的机遇。
