Sølvi Helseth

Aim.  The aim of this study is to explore and describe adolescents’ own perceptions of quality of life; what it is and what matters.Background.  Quality of life has become an important concept in evaluating health care, in both child and adult populations. As nurses concerned with quality of life and well‐being, it is important for us to identify the main factors that contribute to the promotion and sustenance of young people’s well‐being.Design.  A qualitative hermeneutic design was chosen.Method.  The method was in‐depth interviews with 31 healthy adolescents (14–15 years) in the school health service. The interviews were taped, transcribed and analysed as text according to Kvale’s three contexts of interpretation: self‐understanding, critical common sense and theory.Results.  According to the adolescents, quality of life is about the positive cycles of life. Feeling good, being satisfied with oneself and having an overall positive attitude are in most cases described as the starting points of a positive cycle. To get into and stay in the positive cycle, a positive self‐image, good friends and good family relations are important. Consequently, adolescents’ quality of life is threatened when these factors are negative. Friends seem to be the most significant factor. It is extremely difficult to be without friends and none of the adolescents would admit that they were, not even to themselves, although it was rather obvious in some cases. Self‐image and popularity are factors associated with the ability to get friends.Conclusions.  Understanding the adolescents’ view of quality of life emphasises the importance of focusing on their psychosocial health and in particular their peer relations, to promote and sustain their quality of life.Relevance to clinical practice.  Knowledge about the factors most significant to adolescents’ quality of life is applicable to all clinical settings where nurses meet adolescents; i.e., hospitals, outpatient clinics and school health services.

While research on school children's health has mainly focused on risk factors and illness, few studies have examined aspects of health promotion. Thus, this study focuses on health promotional factors including general self-efficacy (GSE) and health-related quality of life (HRQOL). GSE refers to a global confidence in coping ability across a wide range of demanding situations, and is related to health. The purpose of this study was to examine associations between GSE and HRQOL, and associations between HRQOL and socio-demographic characteristics. Knowledge of these associations in healthy school children is currently lacking.

Adolescents' use of over-the-counter (OTC) analgesics is increasing. However, our knowledge on their patterns of use and their attitudes towards such analgesics is limited and the aim of this study is to increase our understanding of adolescents' use of OTC-analgesics by focusing on their knowledge of –, their experiences with — and their attitudes to use OTC-analgesics. Data were collected through focus group interviews with 29 adolescents from Oslo and analysed using qualitative content analysis. Indications for use of OTC-analgesics vary across a wide continuum, from treatment to prevention of different kinds of pain and discomfort. OTC-analgesics are judged by the adolescents as safe to use and with few side effects. The threshold for use is relatively low, especially among girls and the analgesics are easy to access. Adolescents' understanding of the effects and side effects of OTC-analgesics is incomplete. Their consumption of such analgesics indicates an attitude that tablets make an easy solution to a variety of problems, pain and discomfort, especially among girls.

The study presented in this paper is part of a larger Norwegian investigation among adolescents, where the overall aim is to develop methods to promote their quality of life, to discover risk factors or threats to adolescents' well-being, and finally to prevent the negative effects of such factors. The purpose of this article is to describe the health-related quality of life (HR-QOL) of a group of healthy, Norwegian adolescents, and to discuss possible implications for further research and clinical work. HR-QOL was measured with Child Health Questionnaire Child Form (CHQ-CF87), and in addition demographic data were collected. The results indicate that HR-QOL among this group of Norwegian adolescents is relatively high on the average. However, the findings also reveal areas of quality of life where the average measures are somewhat lower, and where the adolescents seem to be more vulnerable, ie mental health, self-esteem and bodily pain. There are also significant gender differences, with girls scoring lower than boys, in the following scales; bodily pain, mental health, self-esteem and behaviour.

Aim.  This paper reports a study to increase our understanding of how cancer affects childcare through assessing the parenting experiences of cancer patients and their spouses with young children.Background.  A parent's cancer brings insecurity into the life of a child. It affects their well‐being and increases their needs for comfort and care. However, little research has been conducted to understand how a parent's illness affects parenting and the care of the child. The study was carried out in 2001–2002.Methods.  An explorative design was chosen and data were collected through in‐depth interviews with a convenience sample of 18 parents of 23 children (aged 0–18 years) in 10 families.Findings.  Parents described living in a state of emergency. Cancer was consuming their energy, physically and emotionally. In spite of their difficulties, they were striving to be good parents. Positive aspects of illness reported were a shift of priorities and change of values that often brought family members closer together. The parents would face the challenges of illness by making the best of it, putting the needs of the children in focus and trying to maintain normal family life. The overall aim of parenting would be to protect the children and make the illness situation as secure and normal as possible for them.Conclusion.  Cancer is a challenge and often necessitates changes in parenting roles, responsibilities and goals. In the future, nurses need to approach parents with young children more directly about these extra challenges, and offer them further assistance in dealing with them.

The study presented in this paper is part of a larger Norwegian investigation among adolescents, where the overall aim is to develop methods to promote their quality of life (QoL), to discover risk factors or threats to adolescents’ well‐being, and finally to prevent the negative effects of such factors. An adequate generic health‐related quality of life (HR‐QoL) measure is therefore needed. However, only a limited number of well validated instruments that measure HR‐QoL in adolescents exist, and to date only a few has been translated into Norwegian. The purpose of this study was therefore to examine some psychometric properties of the first Norwegian version of a simple, generic, German HR‐QoL questionnaire for adolescents, KINDL^®. The instrument consists of 24‐items, distributed in six subscales, which correspond to six domains of adolescents’ HR‐QoL. Based on a sample of 239 healthy adolescents, the internal consistency reliability is satisfactory for both the total scale and the subscales of ‘Self‐esteem and Family’, fairly good for the ‘Emotional’ subscale, but lower for the subscales ‘Physical’, ‘Friends’ and ‘School’. Factor analyses, which concerns construct validity, yielded interpretable solutions. The factor solutions at item level were interpreted to be in line with the original subscales, while factor analysis at subscale level indicated that a common QoL core is involved. To conclude, the Norwegian version of KINDL^® appears, in general, to be a psychometrically acceptable method of measuring HR‐QoL in healthy adolescents. However, the α‐values of some of the subscales are not optimal, and these scales should be used with caution in research and profession. Still KINDL^®‐N is considered suitable for screening purposes in the public health area and especially within school‐health care.

In a Norwegian study on how children aged 7-12 years cope during a period of serious illness within the family and on their quality of life at this time, several ethical questions became apparent. These were mainly concerned with the vulnerability of children during research, with their ability to make autonomous decisions, and with considerations regarding how to respect their right to confidentiality during the research process. In this article we approach these questions using our experience from this previous study, discussing them within the framework of theories of ethics and relevant research ethical guidelines. Finally, we discuss our experience in the light of the overall purpose of this article: how to deal with the ethical dilemmas that may appear during research involving young children.

Little research has addressed how a parent's cancer affects young children. The purpose of this study was to explore the well-being and coping of young children during a period of cancer illness in the family. An explorative design was chosen, and data were collected through qualitative in-depth interviews with children (ages, 7-12 years) and their parents. Data were analyzed and interpreted within a phenomenologic-hermeneutic frame of understanding. Four major themes emerged in the findings: illness ruling in the family, reactions over and under the surface, many efforts to manage the situation, and feeling good most of the time. This report discusses how children's reactions and their management of such a difficult life event affect their quality of life. By going "in and out" of the situation, both literally and emotionally, the children cope with the situation and maintain a balance in life. In general, the children reported "feeling good," but they put a lot of effort into it, and their quality of life appeared to be fragile. Their well-being was especially vulnerable at the time of the diagnosis and when the illness situation changed.