Association between loneliness, self-esteem and outcome of life satisfaction in Norwegian adolescents aged 15-21.

AIMS: Adolescence is an important developmental stage for understanding the role of perceived loneliness and self-esteem on life satisfaction. This study investigated the association between loneliness, self-esteem and the outcome of life satisfaction, as well as potential interaction effects in association with life satisfaction, in a sample of Norwegian adolescents. METHODS: The study was based on a cross-sectional sample of 1816 adolescents aged 15-21 years. Data were collected in September 2016. The participants reported scores on the five-item Satisfaction with Life Scale, the 10-item Rosenberg Self-Esteem Scale and one item assessing loneliness. Control variables included sex, age, perceived family economy, parents' education, place of birth and perceived bullying. The data were analysed with descriptive and multiple linear regression analysis. RESULTS: A significant negative and moderately strong association was found between loneliness and life satisfaction, where the association was stronger for girls than for boys. Self-esteem showed a significant positive and strong association with life satisfaction; however, no significant interaction effect was found. CONCLUSIONS: The findings show the significant role of both loneliness and self-esteem in association with adolescents' perception of life satisfaction. The findings support promoting self-esteem, belongingness and social integration in all daily life contexts for adolescents to support their life satisfaction.

Life satisfaction in association with self-efficacy and stressor experience in adolescents - self-efficacy as a potential moderator.

AIM: This paper reports associations among socio-demographic variables, stressor experience, self-efficacy and life satisfaction among Norwegian adolescents aged 15-21 years and the potential moderating role of self-efficacy on the association between stressor experience and life satisfaction. METHODS: The cross-sectional school-based survey study involved 1816 upper-secondary school students from Mid-Norway. Data were analysed with independent samples t test, Pearson's product moment correlation and multiple linear regression analysis. RESULTS: Bivariate results showed that boys scored higher than girls on life satisfaction and self-efficacy, whereas girls scored higher than boys on all stressor domains. Multiple linear regression analysis showed that life satisfaction declined weakly with age, whereas stronger family economy and having parents who work full-time associated with higher life satisfaction. Stress with teacher interaction, peer pressure, home life, school attendance, school-leisure conflict and school performance were all negatively associated with life satisfaction, whereas self-efficacy associated positively and strongly with life satisfaction. Self-efficacy moderated the association between both interpersonal and school-related stressors and life satisfaction. CONCLUSION: The results provide support for the unique role of stressor experience and self-efficacy in association with adolescents' life satisfaction as well as self-efficacy as a stress moderator in relation to life satisfaction.

Spirituality and religious coping are related to cancer-bereaved siblings' long-term grief.

OBJECTIVE: Many bereaved siblings have still not come to terms with their grief many years after the loss, but few studies have focused on what can help. The aims of this study were to identify cancer-bereaved adolescents' and young adults' ways of coping with grief after loss of a sibling, and examine whether these ways of coping were related to their experience of having worked through their grief. METHOD: This nationwide survey of 174 cancer-bereaved siblings (73% participation rate) is based on one open-ended question about coping with grief ("What has helped you to cope with your grief after your sibling's death?") and one closed-ended question about siblings' long-term grief ("Do you think you have worked through your grief over your sibling's death?"). The open-ended question was analyzed with content analysis; descriptive statistics and Fisher's exact test were used to examine the relation between type of coping and siblings' long-term grief. RESULT: The siblings described four ways of coping: (1) thinking of their dead brother/sister and feeling and expressing their grief; (2) distracting or occupying themselves; (3) engaging in spiritual and religious beliefs/activities; and (4) waiting for time to pass. One of these categories of coping with grief, namely, engaging in spiritual and religious beliefs and activities, was associated with siblings' experience of having worked through their grief two to nine years after the loss (p = 0.016). SIGNIFICANCE OF RESULTS: Those siblings who had used spirituality, religious beliefs, and activities to cope were more likely to have worked through their grief than those who had not.

The Relationship Between Positive Mental Health Literacy and Mental Well-Being Among Adolescents: Implications for School Health Services.

Mental health education is a central part of school nurses' practice. Mental health literacy is an asset for health that educational initiatives can strengthen, and a significant determinant of mental health. This study was intended to examine the relationship between positive mental health literacy (PMeHL) and mental well-being to discuss its implications for school health services' mental health education. The relationship was assessed using a multiple linear regression model controlling for relevant covariates. Data were derived from a cross-sectional school-based survey including 1,888 adolescents aged 15-21 years (response rate 97.3%). A weak gender difference was found in PMeHL. The regression model accounted for 41% of the variance in adolescents' mental well-being; PMeHL was a significant explanatory variable of mental well-being. Accordingly, the current study found support for including PMeHL, or knowledge of how to obtain and maintain good mental health, as an integral component of school health services' mental health education among adolescents.

Validation of the brief instrument "Health Literacy for School-Aged Children" (HLSAC) among Norwegian adolescents.

Health literacy (HL) has been identified as an important and modifiable determinant of health. To succeed in promoting HL, it is crucial to evaluate interventions addressing HL using validated instruments. However, HL measurement is an under-researched area among adolescents. The Health Literacy for School-Aged Children (HLSAC) scale is developed in Finland to measure the subjective HL levels of school-aged children. The HLSAC has been used and validated across Europe. No validated instrument for measuring HL among Norwegian adolescents has been identified. Therefore, the aim of this study was to assess the psychometric properties of the HLSAC among Norwegian adolescents in upper secondary schools. Cross-sectional data were collected in 2017 from 1 054 adolescents with a response rate of 93.5%. The participants were students aged 16-21 (mean = 17.3) years from four upper secondary schools in an urban area in Mid-Norway. Confirmatory factor analysis (CFA) was utilized to investigate the underlying dimensionality of the data together with composite reliability based on Raykov's reliability coefficient and certain aspects of construct validity. The original ten-item one-dimensional version of the HLSAC revealed a poor fit. A one-dimensional version including six of the original ten items presented the best fit to our data, demonstrating good reliability and construct validity. This validation study suggests a one-dimensional solution of the HLSAC scale including six of the original ten items, i.e., the HLSAC-6 as a statistical valid and reliable measure for HL among adolescents in upper secondary schools. However, the modifications of the instrument indicate the need for further investigation of the HLSAC in this age group, i.e. by conducting cognitive interviews and focus-group discussions on the concept of HL among adolescents. Testing the wording of the HLSAC prior to additional psychometric evaluations of both the original HLSAC and the suggested HLSAC-6 is recommended. Finally, developing more age-appropriate items for the measurement of HL in this age-group is suggested.

Psychosocial health in children and adolescents surviving cancer.

AIM: To explore psychosocial health in children and adolescents surviving cancer three years after diagnosis compared with healthy controls, as assessed by adolescents themselves, their parents and teacher. MATERIAL AND METHODS: Case-control study included 50 children and adolescents diagnosed with cancer between 1 January 1993 and 1 January 2003 and treated at the Paediatric Department St. Olav's University Hospital, Trondheim, Norway. Data were collected using the Strengths and Difficulties Questionnaire (self-report, parent report and teacher report), as well as the Achenbach System of Empirically Based Assessment questionnaire (teacher report). RESULTS: Children surviving cancer had more emotional symptoms, higher total problem scores and poorer academic performance than their peers. Emotional problems were consistently reported by parents, teachers and adolescents themselves, in particular in children with brain tumours and among survivors with late effects. CONCLUSION: Our study shows that children surviving cancer are at higher risk for emotional problems when compared with their friends, even after several years following diagnosis and treatment. We conclude that when planning long-term follow-up care, rehabilitation of children and adolescents with cancer, especially for survivors with brain tumours and late effects, should particularly take into account their psychological problems and psychosocial functioning.

Protective and risk factors associated with psychological distress in cancer-bereaved parents: A cross-sectional study.

PURPOSE: Research shows that knowledge about mental health status, both protective and risk factors, is limited in cancer-bereaved parents. The study aimed to investigate (1) the extent of psychological distress in bereaved parents 2-8 years after the loss of a child to cancer compared to non-bereaved parents, and (2) psychological distress in association with resilience, the extent of having coped with the grief, time since the loss, and past psychological distress in cancer-bereaved parents. DESIGN: Retrospective, cross-sectional study. METHODS: A Norwegian nationwide study-specific questionnaire was completed by 162 parents who had lost a child to cancer, and 77 matched non-bereaved parents. We used the Cohort Norway-Mental Health Index and Resilience Scale for Adults to measure psychological distress and resilience, respectively. The extent of having coped with grief was also measured. RESULTS: Bereaved parents experienced significantly more symptoms of psychological distress, albeit not clinical psychological distress, compared to non-bereaved parents. The bereaved parents who have coped with their grief or had higher resilience reported lower psychological distress. Positive "Perception of self" and well "Planned future" were the strongest predictors of psychological distress in both bereaved fathers and mothers. CONCLUSION: Both fathers and mothers experience more psychological distress symptoms 2-8 years after losing a child to cancer than non-bereaved parents. The findings also highlight the need for long-term support to bereaved parents in order to help to improve their resilience and to better cope with their grief.