Health-related quality of life is strongly associated with self-efficacy, self-esteem, loneliness, and stress in 14–15-year-old adolescents: a cross-sectional study

Abstract

Background To enhance and better understand health-related quality of life (HRQOL) in adolescents, it is important to study factors associated with HRQOL. The present study aimed to assess possible associations between sociodemographic variables, self-efficacy, self-esteem, pain, sleep, loneliness, stress and HRQOL in 14 to 15-year-old adolescents. Methods A cross-sectional study was performed among 696 adolescents (14–15 years) in a school-based setting. Sociodemographic variables, self-efficacy, self-esteem, pain, sleep, loneliness and stress were analyzed. The variables were all assessed with well-validated instruments. HRQOL was analyzed using KIDSCREEN 27. Analyses included Chi-square, independent t-tests, Mann–Whitney U tests, linear regression analyses and hierarchical regression analyses. The results from linear regression models were expressed as standardized beta. Results The adolescents generally reported high levels of HRQOL. However, girls scored significantly worse on HRQOL, self-efficacy, self-esteem, pain, sleep, loneliness and stress compared to boys. Using hierarchical regression analyses we found that Self-efficacy (beta = 0.11–0.24), Self-esteem: (beta = 0.12–0.21), Loneliness: (beta = − 0.24 to − 0.45) and Stress: (beta = − 0.26 to − 0.34) revealed the strongest associations with the HRQOL dimensions. Sociodemographic-, pain- and sleep related covariates were all significantly associated with some of the KIDSCREEN subscales, however their effect on the outcome was smaller than for the psychosocial variables listed above. Being a girl, not living with both parents, not having both parents working, being absent from school more than 4 days, having pain and having lack of enough sleep were all independently negatively associated with HRQOL. Conclusions HRQOL is strongly associated with self-efficacy, self-esteem, loneliness and stress in 14 to 15-year-old adolescents. Our findings indicate that positive psychosocial factors such as self-efficacy and self-esteem might play a buffer role for negative psychosocial factors (e.g. stress) in adolescents. Further, our results show that girls score significantly worse on factors that are associated to HRQOL compared to boys. To improve HRQOL in school-based populations of adolescents, we suggest that future interventions should aim to strengthen self-efficacy and self-esteem. We recommend gender specific interventions.

Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis

“…Specifically, both resilience and mental health were indirectly associated with QoL via the mediation of momentary mood. These results are in contrast with our preliminary model, which predicted direct and strong associations between these two predictors and QoL, and to several previous studies involving populations of young recruits to a military service ( 2 , 16 , 55 ) or young adults under stress ( 84 ), which did find a direct association between these contributors and QoL. Another study, conducted in a sample of 149 medical students, found that anxiety and depression were associated with significantly poorer QOL.…”

“…Therefore, in our model, we refer to self-efficacy as part of the global concept of psychological resilience. In addition, there may be gender differences related to the two constructs: while female adolescents were found to report lower self-efficacy under stress compared to their male counterparts ( 55 , 56 ), others report higher levels of challenges among newly-recruited females soldiers ( 24 ).…”

Well‐being and COVID‐19‐related worries of German children and adolescents: A longitudinal study from pre‐COVID to the end of lockdown in Spring 2020

“…(2020) found evidence of increased mental health problems, especially related to loneliness and social isolation in children and adolescents. Loneliness is associated with lower quality of life and higher perceived stress (Mikkelsen et al., 2020), higher prevalence of depression (Goosby et al., 2013; C. H. Liu, Zhang et al., 2020), anxiety (C. H. Liu, Zhang et al., 2020), suicidality (Shovestul et al., 2020), and somatic symptoms (C. H. Liu, Zhang et al., 2020; S. Liu, Liu et al., 2020). Moreover, Shovestul et al.…”

Stress, Pain, and Work Affiliation Are Strongly Associated With Health-related Quality of Life in Parents of 14–15-year-old Adolescents

“…This cross-sectional study was a part of the "Start Young -quality of life and pain in generations" study conducted in two regions in Southern-and Eastern Norway, which has about 1.6 million inhabitants (30% of the total Norwegian population) and an adolescent population (aged 14-15 years) of about 37,000 [17]. Schools that include grade 9 (aged 14-15 years) in elementary school were strati ed according to region, rural or urban district, and school size.…”

“…Schools that include grade 9 (aged 14-15 years) in elementary school were strati ed according to region, rural or urban district, and school size. Details have been reported previously [17]. The schools varied in size and location from city to suburb and admitted adolescents from different sociocultural and economic backgrounds.…”