Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom; Adolescent Health Research Unit, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa.
Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Soc Sci Med. 2020 Aug;258:113103. doi: 10.1016/j.socscimed.2020.113103. Epub 2020 Jun 6.
Young people in sub-Saharan Africa encounter health and livelihood challenges which may compromise their wellbeing. Understanding how young people's wellbeing is defined could strengthen wellbeing policies. We investigated perceptions and experiences of young people's wellbeing, and whether these aligned with Ryff's psychological wellbeing (PWB) model. Data were collected between January-August 2018 through focus-group discussions (n = 12) and in-depth interviews (n = 16) with young people living with and without HIV, selected purposively from South African healthcare facilities. Key informant interviews (n = 14) were conducted with healthcare workers and subject-matter experts. Using a framework approach, we situated our analysis around dimensions of Ryff's PWB model: autonomy, self-acceptance, purpose in life, environmental mastery, positive relationships, personal growth. Young people's wellbeing was rooted in family and peer relationships. Acceptance and belongingness received from these networks fostered social integration. HIV-related stigma, crime and violence reduced their perceived control and social trust. For males, fulfilling gendered roles made them feel socially valued. Self-perceived failure to uphold sexual norms undermined women's social contribution and autonomy. Social integration and contribution framed young people's wellbeing. However, these dimensions were not fully captured by Ryff's PWB model. Models that consider relationality across socio-ecological levels may be relevant for understanding young people's wellbeing.
撒哈拉以南非洲的年轻人面临着健康和生计方面的挑战，这些挑战可能会影响他们的幸福感。了解年轻人幸福感的定义可以加强幸福感政策。我们调查了年轻人对幸福感的看法和体验，以及这些看法和体验是否与 Ryff 的心理健康幸福感 (PWB) 模型一致。数据是通过 2018 年 1 月至 8 月期间在南非医疗机构进行的焦点小组讨论（n=12）和深入访谈（n=16）收集的，参与者包括 HIV 感染者和非感染者。还对医护人员和主题专家进行了关键人物访谈（n=14）。我们采用框架方法，围绕 Ryff 的 PWB 模型的维度进行分析：自主性、自我接纳、生活目标、环境掌控、积极关系、个人成长。年轻人的幸福感根植于家庭和同伴关系。这些网络给予的接纳和归属感促进了他们的社会融合。与艾滋病相关的耻辱、犯罪和暴力削弱了他们的感知控制和社会信任。对于男性来说，履行性别角色使他们感到自己受到社会重视。自我感知未能遵守性规范会破坏女性的社会贡献和自主性。社会融合和贡献构成了年轻人的幸福感。然而，Ryff 的 PWB 模型并没有完全捕捉到这些维度。考虑社会生态层次上的关系的模型可能对理解年轻人的幸福感具有相关性。
