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Quality of Life Among Adolescents

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Principal Investigators Dennis Raphael
Co-Investigators Ellen Rukholm, Ivan Brown, Emily Donato, Pat Hill-Bailey, Rebecca Renwick
Dates 1994 - 1996
Funded by Collaboration between Centre for Health Promotion, University of Toronto, and the School of Nursing, Laurentian University, Sudbury, Ontario

Adolescent health has become an increasingly important focus for governments, foundations, and behavioural researchers. In contrast to other age groups, mortality and morbidity rates for 10-25 year olds in Western countries have been increasing the past few decades and there is increasing evidence that the health status of adolescents is not as high as was the case for their parents.

Why a Quality of Life Perspective?

Examining adolescent health and its determinants within a quality of life perspective achieves various aims that go beyond most other approaches.

A quality of life approach

  • considers a broad range of determinants, including both psychological and societal aspects, thus identifying determinants of adolescent health which may not have been considered to date
  • draws attention to determinants of health at a range of levels; specifically, personal factors such as attitudes and beliefs; community factors such as family, peers, employment, and schools; and structural factors such as income distribution, and educational and employment opportunities. Usually, research into the health of adolescents is limited to only one or two of these levels without considering level interrelationships.
  • allows for consideration of multiple perspectives, in this case the views of adolescents, their parents, service providers, and government analysts among others, concerned with adolescent health. Consideration of the views of adolescents and those close to them helps put a human face on the determinants of health and healthy behaviour during adolescence.
  • can be linked to health promotion and rehabilitation perspectives suggesting means of promoting positive health and healthy behaviours among adolescents.

The Centre for Health Promotion in cooperation with the School of Nursing, Laurentian University, Sudbury, Ontario, Canada identified quality of life issues through direct dialogue with adolescents. Based on focus groups with Ontario adolescents, the literature on adolescent concerns and the quality of life framework presented earlier, a 54 item Quality of Life Profile - Adolescents' Version was developed and validated in the Spring of 1995.

The study found that Quality of Life scores were related to adolescent drinking and smoking as well as to adolescent perceptions of their current happiness and future opportunities*. Specific areas of adolescent concerns were identified, and information concerning the psychometric integrity of the instruments was obtained.

Items in the Quality of Life Profile: Adolescent Version

Each Domain Item is rated for Importance and Satisfaction. The listed items are a sampling of those contained in the questionnaire.

being belonging becoming

Physical Being

  • My appearance - how I look
  • Making healthy choices - alcohol, drugs, smoking

Physical Belonging

  • The earth and its environment
  • Feeling safe at school, in the neighbourhood and when I go out

Practical Becoming

  • Looking after myself and my appearance
  • The work I do at a job while still a student

Psychological Being

  • Being independent
  • Knowing where I am going

Social Belonging

  • Being appreciated by others
  • The friends I have

Leisure Becoming

  • Participating sports and recreation activities
  • Visiting and spending time with others

Spiritual Being

  • Having hope for the future
  • Feeling that life has meaning

Community Belonging

  • Being able to access medical/social services on my own
  • Having things to do in my community in my spare time

Growth Becoming

  • Planning for a job or career
  • Solving my problems

*Results of the Quality of Life Among Adolescents project were published in:

Raphael, D., Rukholm, E., Brown, I., Hill-Bailey, P., & Donato, E. (1996). The quality of life profile-Adolescent version: Background, description, and initial validation. Journal of Adolescent Health, 19(5), 366-375.

A reprint of this article is also available from the Quality of Life Research Unit (see the Publications page).



Quality of Life Research Unit
Department of Occupational Therapy
University of Toronto
160-500 University Ave
Toronto, Ontario
M5G 1V7