Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model
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RESEARCH
Open Access
Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model Richard Sawatzky1*, Pamela A Ratner2, Joy L Johnson2, Jacek A Kopec3, Bruno D Zumbo4
Abstract Background: 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. Methods: The 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. Results: Relative 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. Selfreported 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). Conclusions: This 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, selfreported 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.
Background Health researchers and providers increasingly recognize the importance of obtaining information about adolescents’ perspectives of their quality of life (QOL) [1-10]. Several instruments have been developed for the measurement of adolescents’ QOL to examine the impact of health care interventions, supportive services, and health * Correspondence: [email protected] 1 School of Nursing, Trinity Western University, 7600 Glover Road, Langley, British Columbia (BC) V2Y 1Y1, Canada
promotion initiatives [e.g., [3,8,11,12]
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