Measuring mental wellness among adolescents living with a physical chronic condition: a systematic review of the mental health and mental well-being instruments

Abstract

Background Globally, promoting mental health and well-being among adolescents has become a public health priority, especially for adolescents living with a physical chronic condition (CC), as research suggests they may be more at risk of developing mental health co-morbidities. Valid and reliable instruments are needed to measure and better understand mental health and mental well-being among adolescents living with a CC. To this end, we reviewed studies reporting on mental health and well-being instruments used in adolescent populations living with a chronic physical condition/disease globally. Methods We used a systematic review method guided by PRISMA to identify assess mental health and mental well-being instruments used in adolescents living with a CC. In this instance, mental health instruments were defined as those representing negative domains of mental health (i.e. depression and anxiety) while mental well-being instruments included positive aspects of mental health (i.e. self-concept and resilience). Results We identified 22 articles, which included 31 instruments that were used to measure either mental health (n = 8) or mental well-being (n = 15) or both (n = 8) in adolescents living with a CC. Of these, thirteen studies used a Health-Related Quality of Life (HRQoL) scale to measure mental health and/or mental well-being. The KIDSCREEN questionnaires and the Strengths and Difficulties Questionnaire were identified as being frequently used across the 22 studies. Additionally, 7 out of the 31 instruments were disease specific, with 3 focusing on adolescents with diabetes. All the instruments were developed in high income countries and adapted for use in lower- and middle-income countries (LMICs). Adolescents with Type 1 Diabetes (n = 7) and HIV (n = 4) were researched in 11 out of 22 studies. Only eight studies were conducted in LMIC, of which four were in Africa. Conclusions HRQoL instruments are useful in measuring mental health and well-being in adolescents living with a CC. However, relatively few valid measures of mental health and mental well-being for adolescents living with a CC exist, which accentuates the paucity of research on mental health and mental well-being of adolescents who are living with a CC. Specific measures need to be developed in and for LMICs where cultural contexts affect mental well-being in unique ways. Systematic review registration: PROSPERO CRD42020186707.

Rethinking mental health wellness among adolescents living with HIV in the African context: An integrative review of mental wellness components

“…To answer the abovementioned questions, we conducted a systematic review of all instruments used to measure mental wellness in adolescents (Orth et al, 2022 ). The sub-analysis of instruments used among adolescents living with a chronic condition (Orth and van Wyk, 2021a ) revealed that Health-Related Quality of Life (HRQoL) instruments were frequently used to measure physical and psychosocial wellbeing among adolescents living with a physical chronic condition. However, these HRQoL instruments often include mental illness and mental wellness indicators which raises the question—to what degree is the absence of mental disorder symptoms equal to a high degree of mental wellness?…”

“…However, these HRQoL instruments often include mental illness and mental wellness indicators which raises the question—to what degree is the absence of mental disorder symptoms equal to a high degree of mental wellness? As such, we argued that more instruments need to be developed in LMICs to give insight into which constructs of mental wellness are important to improving overall mental wellbeing for adolescents living in these contexts (Orth and van Wyk, 2021a ; Orth et al, 2022 ). Though there was a lack of clear definition of mental health, we identified 13 mental wellness concepts from 79 instruments, namely: life satisfaction, mental wellbeing [general], resilience, self-efficacy, self-esteem, connectedness, coping, self- control, mindfulness/spiritual, hope, sense of coherence, happiness, and life purpose (Orth et al, 2022 ).…”

Discourses of Mental Wellness Among Adolescents Living with HIV in Cape Town, South Africa

“…As an analytical approach, DA is aimed at analysing language in relation to the social context, focusing on how meaning is created in different social contexts. 21 Therefore, this analytic process allowed us to interrogate and explore how mental wellness was discussed, positioned, and constructed by adolescent participants who were living with HIV and on treatment. Two researchers (the authors) were involved in the data analysis process.…”

“…This helped us to develop a preliminary framework of mental wellness concepts. 21 , 22 We also familiarised ourselves with the context of the healthcare facilities by conducting interviews with key healthcare workers. 19 This allowed us to develop an understanding of the real-life context of the discourse which emerged from the photovoice groups.…”

Content validation of a Mental Wellness Measuring instrument for Adolescents Living with HIV: A modified Delphi Study

“…Before setting out to develop a new instrument, it is necessary to determine if one is needed or if existing instruments may be used [1,2]. To this end, we conducted a systematic review of mental health instruments used in research with adolescents [25,26]. A key nding from the systematic review, highlighted that there is a lack of consensus around de nitions of mental wellness for adolescent.…”