The Measurement of Quality of Life and its Relationship with Perceived Health Status in Adolescents
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Several assumptions of the indirect reflective model of the Multidimensional Students’ Life Satisfaction Scale (MSLSS) were tested to assess its validity as a measure of adolescents’ satisfaction with life generally and with five important life domains (family, friends, living environment, school, and self perception). We also examined whether adolescents’ perceived mental and physical health status significantly explained their global quality of life (QOL) and whether these relationships were mediated by their satisfaction with the five life domains. The data were taken from a cross-sectional health survey of 8,225 adolescents in 49 schools in British Columbia, Canada. Global QOL was measured using Cantril’s ladder and a single-item rating of the adolescents’ satisfaction with their QOL. Confirmatory factor and factor mixture analyses were used to examine the measurement assumptions of the MSLSS, and structural equation modeling was applied to test the hypothesized mediation model. The Pratt index (d) was used to evaluate variable importance. The adolescents did not respond to all MSLSS items in a consistent manner. An abridged 18-item version of the MSLSS was therefore developed by selecting items that were most invariant in the sample. Good model fit was obtained when the abridged MSLSS was used to test the hypothesized mediation model, which 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 the adolescents’ mental health status (d = 30%) and by their satisfaction with self (d = 42%) and family (d = 20%). Self and family satisfactionwere the predominant mediating variables of the relationships between mental health (45% total mediation) and physical health (68% total mediation) and global QOL.Satisfaction with life domains and perceived physical and mental health can be viewed as conditions that potentially contribute to adolescents’ global QOL. Questions about adolescents’ experiences with important life domains require more attention in population health research so as to target appropriate supportive services for adolescents, particularly those with mental or physical health challenges.