title: Adolescents' health-related quality of life (HRQoL) changes over time: a three year longitudinal study.
abstract: BACKGROUND
  Adolescence is a significant developmental stage marked by physical, psychological and social changes. While adolescents are generally perceived to be healthy, this stage of development is also associated with an emergence of risk factors that may have long-term consequences for their wellbeing. The aim of this study was to assess health related quality of life (HRQoL), and possible gender and age differences, in a sample of secondary school-aged adolescents over a three-year time period.
  
  
  METHODS
  Australian adolescents (n = 403, aged 12-15 at baseline) across six New South Wales high schools completed the KIDSCREEN-27 Questionnaire at three time points. The KIDSCREEN-27 measures five HRQoL domains (physical wellbeing, psychological wellbeing, autonomy and parents relations, social support and peers, and school environment). Mixed-between-within-subjects ANOVA analyses were employed to examine HRQoL over time and across age and gender.
  
  
  RESULTS
  HRQoL rates were comparable to the European-based KIDSCREEN norms with the exception of psychological wellbeing, which was considerably lower in this study's sample. Over time, for the total sample, there were significant changes on only one of the five dimensions (social support and peers). However, gender differences were found to be significant across three dimensions (physical wellbeing, psychological wellbeing, and autonomy and parents relations), with females reporting lower scores than males (i.e. lower HRQoL). Females' scores also declined over the three time points across two of the five HRQoL dimensions (social support and peers, and school environment), indicating reductions in HRQoL over time. Age differences were found across all but one dimension (autonomy and parents relations).
  
  
  CONCLUSIONS
  Although statistically significant, the changes in HRQoL may not be clinically significant, as the effect sizes were small and therefore those changes would not be readily noticeable. Those changes, however, suggest that, while HRQoL is predominantly stable over time, fluctuations and declines, such as those found for females, may be early indicators of physical and psychological vulnerabilities. If such vulnerabilities are detected timely; they may be addressed with preventative measures or appropriate interventions.
authors.affiliation: School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. t.meade@westernsydney.edu.au.
authors.forename: Tanya
authors.initials: T
authors.lastname: Meade
authors.affiliation: School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. e.dowswell@westernsydney.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dowswell
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D009517:New South Wales; D010290:Parents / Q000523:psychology*; D010379:Peer Group; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012574:Schools; D012737:Sex Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors
references.citation: Arch Dis Child. 2015 Aug;100(8):779-83
references.pmid: 26038309
references.citation: Expert Rev Pharmacoecon Outcomes Res. 2005 Jun;5(3):353-64
references.pmid: 19807604
references.citation: Aust N Z J Psychiatry. 2010 Aug;44(8):729-35
references.pmid: 20636194
references.citation: Int J Public Health. 2014 Feb;59(1):95-105
references.pmid: 23793782
references.citation: Qual Life Res. 2008 Sep;17(7):997-1008
references.pmid: 18633730
references.citation: Br J Psychiatry. 2012 Sep;201(3):199-206
references.pmid: 22790680
references.citation: BMC Public Health. 2014 Sep 01;14:898
references.pmid: 25183192
references.citation: J Am Acad Child Adolesc Psychiatry. 1999 Dec;38(12):1569-79
references.pmid: 10596258
references.citation: Qual Life Res. 2009 Nov;18(9):1147-57
references.pmid: 19774493
references.citation: Behav Res Methods. 2007 May;39(2):175-91
references.pmid: 17695343
references.citation: Issues Ment Health Nurs. 2011;32(9):589-97
references.pmid: 21859410
references.citation: Arch Pediatr Adolesc Med. 2006 Mar;160(3):285-91
references.pmid: 16520448
references.citation: Eur Child Adolesc Psychiatry. 2004;13 Suppl 2:II17-24
references.pmid: 15243782
references.citation: Lancet. 2011 Jun 18;377(9783):2093-102
references.pmid: 21652063
references.citation: Qual Life Res. 2008 Dec;17(10):1207-15
references.pmid: 18931941
references.citation: Soc Sci Med. 2006 Feb;62(4):815-27
references.pmid: 16098649
references.citation: Prev Med. 2005 Jun;40(6):735-9
references.pmid: 15850873
references.citation: J Adolesc Health. 2006 Jul;39(1):14-9
references.pmid: 16781956
references.citation: Health Qual Life Outcomes. 2005 May 16;3:34
references.pmid: 15904527
references.citation: Qual Life Res. 2014 Aug;23(6):1895-905
references.pmid: 24473990
references.citation: Lancet. 2011 Oct 22;378(9801):1515-25
references.pmid: 22008427
references.citation: Eur J Pediatr. 2007 Jul;166(7):701-8
references.pmid: 17120041
references.citation: Lancet. 2007 Sep 8;370(9590):859-77
references.pmid: 17804063
references.citation: Am J Prev Med. 2013 Oct;45(4):407-15
references.pmid: 24050416
references.citation: Aust N Z J Psychiatry. 2010 Jun;44(6):551-9
references.pmid: 20482414
references.citation: Lancet. 2015 Feb 21;385(9969):705-16
references.pmid: 25301503
references.citation: J Adolesc Health. 2008 Sep;43(3):260-7
references.pmid: 18710681
references.citation: Health Qual Life Outcomes. 2013 Jun 20;11:101
references.pmid: 23786901
references.citation: Lancet. 2007 Mar 31;369(9567):1130-9
references.pmid: 17398312
references.citation: J Adolesc Health. 2010 Nov;47(5):427-32
references.pmid: 20970076
references.citation: Soz Praventivmed. 2005;50(5):281-91
references.pmid: 16300172