The health-related quality of life (HR-QOL) of children and adolescents is increasingly considered a relevant topic for research. Instruments to assess quality of life in children and adolescents of a generic as well as disease- or condition-specific nature are being developed and applied in epidemiological surveys, clinical studies, quality assurance and health economics. This paper attempts to give an overview on the state of the art of HR-QOL assessment in children as it relates to methodological and conceptual challenges. Instruments available in international or cross-cultural research to assess HR-QOL in generic terms were identified and described according to psychometric data provided and the width of application. In an initial literature search, several challenges in the assessment of child and adolescent HR-QOL were identified, ranging from conceptual and methodological to practical aspects. Seven specific major issues were considered: (i) What are the dimensions of HR-QOL relevant for children and adolescents, and do suitable instruments for their measurement exist? (ii) Can these dimensions be collected in a cross-culturally comparable way? (iii) What advantages and disadvantages do self-rated versus externally evaluated HR-QOL measurements of children and adolescents have? (iv) How can HR-QOL be assessed in an age-appropriate way? (v) What are the advantages and disadvantages of disease-specific and generic data collection? (vi) What advantages and disadvantages do profile and index instruments have? (vii) How can HR-QOL be connected with utility- preference values? In a second literature search we identified nine generic HR-QOL instruments and four utility health state classification systems that complied with the prespecified inclusion criteria. It was concluded that (i) HR-QOL instruments are available to assess the dimensions of the construct relevant to children and adolescents; (ii) provided that an instrument was constructed in an appropriate way, the dimensions of HR-QOL can be measured in an interculturally comparable manner; (iii) the HR-QOL of children and adolescents can and should be ascertained by self-rating; (iv) the measurement instruments used have to consider maturity and cognitive development; (v) only generic quality-of-life instruments allow for an assessment of HR-QOL in both healthy and chronically ill children and adolescents; (vi) the representation of HR-QOL achieved through a singular index value is connected to strict psychometric conditions: the index instrument has to be tailored to these psychometric conditions; (vii) how far utility measures are employable with children and adolescents has to be investigated in further studies. The problem aspects identified indicate the necessity for further research. Nevertheless, instruments for assessing the HR-QOL of children and adolescents can be identified that meet the requirements mentioned above.
Risikoverhalten und Lebensqualität von Jugendlichen in Europa <span class="fett">Fragestellung:</span> Das Zusammenspiel von sozioökonomischem Status (SES), Alkohol- und Tabakkonsum sowie subjektiver Lebensqualität und psychischer Gesundheit bei europäischen Jugendlichen wurde untersucht. </p><p> <span class="fett">Methodik:</span> Eine Stichprobe von 12.494 Jugendlichen (12–18 Jahre) wurde mit Hilfe von logistischen Regressionsanalysen, Varianzanalysen und linearen Strukturgleichungsmodellen analysiert. </p><p> <span class="fett">Ergebnisse:</span> Regelmäßig rauchende Jugendliche sowie regelmäßig Alkohol trinkende Mädchen berichten häufiger psychische Probleme und eine geringere Lebensqualität (Effektstärke d < 0.53). Ein geringerer SES ist mit höherem Tabak- (Odds Ratio 1.5/1.3 [Jungen/Mädchen]), jedoch nicht mit höherem Alkoholkonsum assoziiert. Die Beziehung zwischen niedrigem SES, Risikoverhalten und Geschlecht variiert zwischen den einzelnen Ländern. </p><p> <span class="fett">Schlussfolgerung:</span> Die Ergebnisse zeigen die Notwendigkeit geschlechts-, kultur- und substanzspezifischer Präventions- und Interventionsmaßnahmen.
The present study extends the research on user trust in ecommerce to the area of e-recruitment, focusing specifically on the importance of perceived privacy to evoke user trust and self-disclosure. Two websites of a fictitious online recruitment site were compared, which differed only in their level of perceived privacy. It was found that an interface conveying a high level of privacy significantly increased user trust. Although users with high trust scores also disclosed more and more sensitive information than users with low trust scores, this could not be attributed solely to the perceived privacy of the online job bank.
This investigation highlights the role of on-farm stores on the rural-urban fringe near Abbotsford, British Columbia, Canada. Farming near a large urban centre was found to create opportunities for higher returns such as marketing of local food and agritourism. However existence of farming near urban areas depends on higher returns and a supportive public. Longitudinal case study of four farm stores operating nearly year round within the Agricultural Land Reserve revealed that the farm stores catered to a rural idyll that reflects cultural conceptions of farm life. We suggest the multifunctional landscape of the farm store provides economic and cultural benefits, and should be considered as sustaining agriculture. However operators must shape their offerings according to a dialectic with the non-farming public who have strong expectations of the farm experience. The study revealed that farm store operators in particular share the rural idyll of urban consumers, though agritourism operators are more consciously including rural elements in their operations. Though multifunctionality was a choice, it was influenced by the customer base and created its own challenges and costs.
Zusammenfassung. Bevölkerungsbezogene Untersuchungen des Wohlbefindens von Kindern und Jugendlichen ermöglichen die Identifikation von Risikofaktoren und Risikogruppen für ein beeinträchtigtes Wohlbefinden und gesundheitliche Belastungen. In dieser Arbeit wird am Beispiel dreier internationaler bzw. nationaler bevölkerungsbezogener Studien aufgezeigt, wie sich die komplexen Beziehungen zwischen Wohlbefinden und für das Wohlbefinden relevanten Aspekten unter Verwendung komplexer statistischer Modellierungsansätze untersuchen lassen. Die im Modul „Seelisches Wohlbefinden und Verhalten” des Kinder- und Jugendgesundheitssurveys (BELLA-Studie; n = 1700), der Health Behaviour in School-aged Children (HBSC; n = 7000) und der KIDSCREEN Studie (n = 8000) an 11 bis 18jährigen Kindern und Jugendlichen erhobenen Daten zu ihrem Wohlbefinden, psychischen Problemen, personalen familiären und sozialen Ressourcen, schulischer Umgebung sowie Tabak- und Alkoholkonsum werden dazu ausgewertet. Über die Daten jeder der drei Studien wurde je eine lineare Strukturgleichungsmodellanalyse mit Lisrel durchgeführt. Die drei unterschiedlichen nach theoretischen Vorüberlegungen spezifizierten Lisrel Modelle weisen eine akzeptable Datenanpassung auf. Personale, familiäre und soziale Ressourcen, psychische Probleme und schulische Anpassung erweisen sich als bedeutende Prädiktoren des Wohlbefindens. Es finden sich Hinweise auf eine komplexe und reziproke Natur der Beziehung zwischen Wohlbefinden und Tabak- bzw. Alkoholkonsum. Die Überprüfung der spezifizierten komplexen Einflussfaktorenmodelle mit LISREL bestätigt die Ergebnisse bisheriger Untersuchungen detaillierter Aspekte der Korrelate des Wohlbefindens. Die Ergebnisse sind mit theoretischen Arbeiten zum Wohlbefinden vereinbar.
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