Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model

Bruno D Zumbo,Pamela A Ratner,Joy L Johnson,Jacek A Kopec,Richard Sawatzky

doi:10.1186/1477-7525-8-17

Abstract

BackgroundWe examined adolescents' differentiation of their self-reported physical and mental health status, the relative importance of these variables and five important life domains (satisfaction with family, friends, living environment, school and self) with respect to adolescents' global quality of life (QOL), and the extent to which the five life domains mediate the relationships between self-reported physical and mental health status and global QOL.MethodsThe data were obtained via a cross-sectional health survey of 8,225 adolescents in 49 schools in British Columbia, Canada. Structural equation modeling was applied to test the implied latent variable mediation model. The Pratt index (d) was used to evaluate variable importance.ResultsRelative to one another, self-reported mental health status was found to be more strongly associated with depressive symptoms, and self-reported physical health status more strongly associated with physical activity. Self-reported physical and mental health status and the five life domains explained 76% of the variance in global QOL. Relatively poorer mental health and physical health were significantly associated with lower satisfaction in each of the life domains. Global QOL was predominantly explained by three of the variables: mental health status (d = 30%), satisfaction with self (d = 42%), and satisfaction with family (d = 20%). Satisfaction with self and family were the predominant mediators of mental health and global QOL (45% total mediation), and of physical health and global QOL (68% total mediation).ConclusionsThis study provides support for the validity and relevance of differentiating self-reported physical and mental health status in adolescent health surveys. Self-reported mental health status and, to a lesser extent, self-reported physical health status were associated with significant differences in the adolescents' satisfaction with their family, friends, living environment, school experiences, self, and their global QOL. Questions about adolescents' self-reported physical and mental health status and their experiences with these life domains require more research attention so as to target appropriate supportive services, particularly for adolescents with mental or physical health challenges.

Highlights

We examined adolescents’ differentiation of their self-reported physical and mental health status, the relative importance of these variables and five important life domains with respect to adolescents’ global quality of life (QOL), and the extent to which the five life domains mediate the relationships between self-reported physical and mental health status and global QOL
To validate adolescents’ differentiation of their physical and mental health status, we examined the relative importance of these variables with respect to depressive symptoms and the frequency of physical activities
The mode of the QOL-ladder responses was at level 6 of 8 rungs (36.7%), with 11.9% of the adolescents reporting the best possible life, and 14.0% providing a rating at or below the middle of the scale (≤ 4) (n = 7,675)

Summary

Introduction

We examined adolescents’ differentiation of their self-reported physical and mental health status, the relative importance of these variables and five important life domains (satisfaction with family, friends, living environment, school and self) with respect to adolescents’ global quality of life (QOL), and the extent to which the five life domains mediate the relationships between self-reported physical and mental health status and global QOL. Several conceptual models have been developed to describe the relationships between health and QOL in adults [15,16,17,18,19,20,21,22] Most of these models emphasize assessing QOL from the perspective of the individual, and are based on the general proposition that alterations in health status affect other conditions in life (life domains), such as physical and psychological functioning, and social and environmental conditions, that are relevant to a person’s QOL [e.g., [15,20,21,22]]. The relationship between self-reported health status and QOL is not expounded in the model; in particular, it is not clear how self-reported health status relates to other life domains relevant to QOL

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Conclusion