Abstract
BackgroundDespite extensive use of self-rated health questions in youth studies, little is known about what such questions capture among adolescents. Hence, the aim of this study was to explore how adolescents interpret and reason when answering a question about self-rated health.MethodsA qualitative study using think-aloud interviews explored the question, “How do you feel most of the time?”, using five response options (“Very good”, “Rather good”, “Neither good, nor bad”, “Rather bad”, and “Very bad”). The study involved 58 adolescents (29 boys and 29 girls) in lower secondary school (7th grade) and upper secondary school (12th grade) in Sweden.ResultsRespondents’ interpretations of the question about how they felt included social, mental, and physical aspects. Gender differences were found primarily in that girls emphasized stressors, while age differences were reflected mainly in the older respondents’ inclusion of a wider variety of influences on their assessments. The five response options all demonstrated differences in self-rated health, and the respondents’ understanding of the middle option, “Neither good, nor bad”, varied widely. In the answering of potential sensitive survey questions, rationales for providing honest or biased answers were described.ConclusionsThe use of a self-rated health question including the word ‘feel’ captured a holistic view of health among adolescents. Differences amongst response options should be acknowledged when analyzing self-rated health questions. If anonymity is not feasible when answering questions on self-rated health, a high level of privacy is recommended to increase the likelihood of reliability.
Highlights
Despite extensive use of self-rated health questions in youth studies, little is known about what such questions capture among adolescents
In this study, we found that the use of the word ‘feel’ in a self-rated health question captured a holistic health construct in adolescents that included social, mental, and physical aspects
Our results indicate that the response options represent differences in subjective health and that participants’ level of honesty in providing potentially sensitive survey answers varies
Summary
Despite extensive use of self-rated health questions in youth studies, little is known about what such questions capture among adolescents. The aim of this study was to explore how adolescents interpret and reason when answering a question about self-rated health. There is widespread agreement in the literature that self-rated health measured as a single-item general health question is an important health indicator and a strong predictor for future outcomes such as morbidity and mortality [1,2,3,4]. Several different concepts are in use, such as self-rated health, subjective health, self-perceived health, and self-assessed health. Despite the different wording of self-rated health questions, they all seem to reliably predict future health outcomes [1, 8]. Self-rated health decreases with age, but boys report good health to a greater extent than girls [7]. In Sweden, 47 % of 11-year-old boys and 42 % of 11-year-old girls report “very good” health, while among 15-year-olds these figures decline to 37 % among
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