Joliot E, Deschamps J P
Ecole de Santé Publique, Faculté de Médecine, Vandoeuvre-lés-Nancy.
Promot Educ. 1997 Dec;4(4):7-9. doi: 10.1177/102538239700400403.
Hundreds of studies carried out in the past 20 years have worked on youth and adolescent health indicators linked to general morbidity and mortality and to specific pathologies. The majority of research has focused on evaluating the impact of risk behaviours such as tobacco, alcohol and drug use, non-protected sexual intercourse, and unbalanced nutrition on the health of youth. The usefulness of medical care and health education programmes has thus traditionally been evaluated on the basis of their impact on mortality and morbidity. However, these measures have proven insufficient and the necessity to pay more attention to quality, and not only length of life is now apparent. This article focuses on the question of whether the tool for measuring quality of life linked to health, adapted from what now exists for "sick" adolescents, can constitute a new indicator allowing for evaluation of the unknown realm of adolescent health needs. The authors address the concept of measuring the quality of life by providing several of its definitions, noting the difficulties and insufficiencies of their measurement. The authors also wonder why the multiple professionals preoccupied with adolescent health have not yet imagined using a participative approach to developing these measures, i.e. an approach including the adolescents themselves, has not been used. The authors propose that to include adolescents in the development of evaluation tools would ensure that the adolescent's needs for expression and to be heard are fulfilled. The authors also maintain that education, both health and general, should enable individuals to understand what is positive within themselves, and thus develop these aspects to their fullest. It should not force models of behaviour onto individuals or groups. If this approach is taken in developing quality of life indicators for young people, a positive health promotion approach to enabling adolescents can be developed.
在过去20年里开展了数百项研究,致力于与总体发病率、死亡率以及特定病症相关的青少年健康指标。大多数研究聚焦于评估诸如吸烟、饮酒、吸毒、无保护性行为以及营养不均衡等风险行为对青少年健康的影响。因此,传统上医疗保健和健康教育项目的效用是根据它们对死亡率和发病率的影响来评估的。然而,事实证明这些措施并不充分,现在很明显有必要更加关注生活质量,而不仅仅是寿命长短。本文关注的问题是,从现有的针对“患病”青少年的工具改编而来的、与健康相关的生活质量测量工具,是否能够构成一个新的指标,用以评估青少年健康需求这一未知领域。作者通过给出生活质量的几个定义来阐述测量生活质量的概念,同时指出其测量中的困难和不足。作者还疑惑为何众多关注青少年健康的专业人士尚未想到采用一种参与式方法来制定这些测量工具,即一种让青少年自身参与的方法。作者提议让青少年参与评估工具的开发将确保满足青少年表达和被倾听的需求。作者还坚持认为,无论是健康方面还是一般意义上的教育,都应使个人能够理解自身积极的一面,并充分发展这些方面。它不应将行为模式强加于个人或群体。如果在为年轻人制定生活质量指标时采用这种方法,就可以形成一种积极的促进青少年健康的方法。