Time-trends in Nordic adolescents’ communication with their parents

Adolescence is an important developmental period toward greater independence. However, the family is still very important in the life of young people. The aim of this study was to analyse changes over time in easy communication between adolescents and their parents in the Nordic countries. The study used the Nordic part of Health Behaviour in School-aged Children, carried out in four waves from 2002–2014. It included 109,446 adolescents. The adolescents were asked how easy it was to communicate with their mother or father about things that really bothered them. The results were analysed using descriptive statistics and binomial logistic regression. In all Nordic countries, the prevalence of easy communication between adolescents and their parents increased from 2002 to 2014. Although the positive change in parental communication was more pronounced among Nordic fathers, the data showed that mothers had markedly better communication with their adolescents than fathers did. In 2014, around three out of four adolescents found it easy to talk with their fathers, while four out of five found it easy to talk with their mothers. The results indicate that policies in the Nordic countries to support the role of both mothers and fathers in caring for their children are warranted.publishedVersio

Trends in high life satisfaction among adolescents in five Nordic countries 2002–2014

Life satisfaction is an important indicator when assessing positive mental health aspects in populations, including among adolescents. The aim of this study was to investigate trends over time in prevalence of high life satisfaction among adolescents from five Nordic countries: Denmark, Iceland, Finland, Norway and Sweden. We used data from four waves of the Health Behaviour in School-Aged Children study from 2002, 2006, 2010 and 2014 (n=109,847). HBSC is a school-based study examining social circumstances, health and health behaviour among 11-, 13- and 15-years olds every four years in many European and North American countries. The Cantril Ladder, an 11-step visual analogue scale, was used as the measure of life satisfaction, and was dichotomised into two groups: high life satisfaction (scoring 9 or 10 on the scale) and medium/low life satisfaction (scoring <9). Over the 12-year period studied, between 28.6 and 44.8% of adolescents in the five countries rated their life satisfaction as high. Relatively large changes in prevalence levels occurred at the country level over the period. Denmark and Finland showed a steady, significant decline in the prevalence of high life satisfaction over the years. Iceland showed the highest prevalence in 2010. Norway and Sweden showed similar development until 2010, followed by a clear increase for Norway and a sharp decline in adolescent high life satisfaction for Sweden up until 2014. In all countries, high life satisfaction was most prevalent in 11-year- olds and least prevalent in almost all surveys among 15-year-old girls.peerReviewe

Translation and validation of the Alberta Context Tool for use in Norwegian nursing homes

Purpose: Organizational context is recognized as important for facilitating evidence-based practice and improving patient outcomes. Organizational context is a complex construct to measure and appropriate instruments that can quantify and measure context are needed. The aim of this study was to translate and cross-culturally adapt the Alberta Context Tool (ACT) to Norwegian, and to test the reliability and structural validity among registered nurses (RNs) and licenced practice nurses (LPNs) working in nursing homes. Methods: This study was a validation study utilizing a cross-sectional design. The sample consisted of n = 956 healthcare personnel from 28 nursing homes from a municipality in Norway. In the first stage, the ACT was translated before being administered in 28 nursing homes. In the second stage, internal consistency and structural validity were explored using Cronbach’s alpha and confirmatory factor analysis. Results: A rigorous forward-and-back translation process was performed including a team of academics, experts, professional translators and the copyright holders, before an acceptable version of the ACT was piloted and finalized. The Norwegian version of the ACT showed good internal consistency with Chronbachs alpha above .75 for all concepts except for Formal interactions where the alpha was .69. Structural validity was acceptable for both RNs and LPNs with factors loadings more than .4 for most items. Conclusions: The Norwegian version of the ACT is a valid measure of organizational context in Norwegian nursing homes among RNs and LPNs.publishedVersio

Trends in excellent self-rated health among adolescents: A comparative Nordic study

Background: Excellent self-rated health (SRH) can be seen as an important component of positive health among adolescents. The aim of this paper is to examine time trends of excellent health among adolescents in five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 2002 and 2014, including differences between countries, gender and age. Methods: Nordic data from the Health Behaviour in School-aged Children (HBSC) survey (including 11-, 13- and 15-year-olds) from 2002 (n = 19,009), 2006 (n = 29,656), 2010 (n = 33,232) and 2014 (n = 31,540) were analysed by design-adjusted binomial logistic regression models. Results: The trend analysis of excellent SRH for Nordic adolescents indicates a small improvement between 2002 and 2006 but a stable trend in the following periods up until 2014. The time trends do, however, depend on the specific country. In general, a smaller proportion of girls compared to boys were found to rate their health as excellent. Over time, however, the proportion of boys rating their health as excellent decreased, while girls’ ratings improved. Conclusions: From a public health perspective, indications of a changing trend in adolescent health coinciding with the 2007–2008 global recession warrant further attention from researchers and policy-makers and should be closely monitored in the future.</p

Building knowledge of adolescent mental health in the Nordic countries

Adolescence is an important developmental period. Young people face many pressures and challenges, including growing academic expectations, changing social relationships with family and peers, and the physical and emotional changes associated with maturation. Mental health is a broad concept, including positive mental health, mental health problems and psychiatric diseases. This introductory paper addresses the issue of positive mental health, and how existing data from the Health Behaviour in School-aged Children study (HBSC) may be used to deepen our knowledge of developments in mental health among adolescents in the Nordic countries.   The Health Behaviour in School-Aged Children study is a WHO collaborative cross-national study that now includes 48 countries, collecting data every four years from 1984 to 2018 on health, well-being, health behaviour and social environments. Data collection is carried out in school classes via self-completion of questionnaires. An asset of the study is that the HBSC focuses on understanding young people’s health in their social context at family, peer, school, neighbourhood, and country levels. The investment in the HBSC study gives unique opportunities for high-quality research and monitoring in the Nordic countries.   The on-going Nordic research collaboration on positive mental health among adolescents uses the HBSC study as the research infrastructure for analysing trends as well as collecting new data on positive mental health. This special issue reports on trends when positive perspectives have been guiding the analysis of available data. The present research explores the potential of Nordic collaboration and comparative studies of school-aged children in the Nordic countries.</p

Trends in high life satisfaction among adolescents in five Nordic countries 2002–2014

Life satisfaction is an important indicator when assessing positive mental health aspects in populations, including among adolescents. The aim of this study was to investigate trends over time in prevalence of high life satisfaction among adolescents from five Nordic countries: Denmark, Iceland, Finland, Norway and Sweden.   We used data from four waves of the Health Behaviour in School-Aged Children study from 2002, 2006, 2010 and 2014 (n=109,847). HBSC is a school-based study examining social circumstances, health and health behaviour among 11-, 13- and 15-years olds every four years in many European and North American countries. The Cantril Ladder, an 11-step visual analogue scale, was used as the measure of life satisfaction, and was dichotomised into two groups: high life satisfaction (scoring 9 or 10 on the scale) and medium/low life satisfaction (scoring    Over the 12-year period studied, between 28.6 and 44.8% of adolescents in the five countries rated their life satisfaction as high. Relatively large changes in prevalence levels occurred at the country level over the period. Denmark and Finland showed a steady, significant decline in the prevalence of high life satisfaction over the years. Iceland showed the highest prevalence in 2010. Norway and Sweden showed similar development until 2010, followed by a clear increase for Norway and a sharp decline in adolescent high life satisfaction for Sweden up until 2014. In all countries, high life satisfaction was most prevalent in 11-year- olds and least prevalent in almost all surveys among 15-year-old girls.</p

Temporal trends in psychological distress and healthcare utilization among young people

Background: Young people are generally considered to be healthy, as severe illness and mortality is uncommon during this developmental stage. However, there are increasing concerns that psychological distress may be increasing in recent generations of youth, which will generate greater healthcare needs. Overall aims: The overall aims of this thesis were to investigate the temporal trends of psychological distress (also referred to as psychosomatic health complaints) among the general youth population and to investigate the association between the utilization of the youth primary healthcare service and psychological distress. Material and methods: The first paper used the Joanna Briggs Institute framework to conduct a systematic review and meta-analysis of prevalence studies, systematically identifying, selecting and critically appraising all the global evidence on psychosomatic health complaints among young people. The primary databases searched were MEDLINE, Embase and PsycINFO. Studies were included if they were of a repeated cross-sectional design and contained the self-reported data of 1019-year-olds. Inclusion criteria and study quality were assessed by two independent reviewers. The second paper was a repeated cross-sectional study investigating temporal trends of psychosomatic health complaints among 11-16-year-olds in Norway between 1994 and 2014. The data were drawn from the Norwegian HBSC study (n = 27,476). The third paper was a repeated cross-sectional study investigating the temporal trends of psychological distress and its relationship to youth primary healthcare utilization among 13-19-year-olds in Norway, between 2014 and 2018 (n = 368,579). The data were drawn from the Norwegian “Ungdata” study. Results: Paper I: The systematic search of the literature yielded 8,338 potentially relevant articles. Twenty-one studies met the inclusion criteria and were included in the study. In total, this study represents over seven million young respondents from 36 countries, mainly in Europe and North America, covering the time period between 1982 and 2013. Overall, the results indicated a minor increasing trend of psychosomatic health complaints among young people. However, the increase was mainly found in Northern Europe, while other geographical regions had more stable trends. Paper II: In Norway, psychosomatic health complaints increased between 1994 and 2014 among young people. There were indications that psychological and somatic health complaints might follow different trajectories. For psychological health complaints, there was a three-way interaction between age, gender and time, indicating that older teenage girls experience a greater increase in psychosomatic health complaints over time relative to boys and younger adolescent girls. In terms of somatic health complaints, older teenage girls also had the greatest increase over time, but this difference was constant and did not diverge from the other groups over time. Paper III: Psychological distress and primary healthcare utilization increased between 2014 and 2018 among young people in Norway. Psychological distress was associated with primary healthcare utilization, and young people with high levels of psychological distress used services twice as often as their peers. Psychological distress could account for a substantial amount of the change in utilization of youth primary healthcare. However, the absolute increase in primary healthcare utilization was mainly driven by those with low levels of psychological distress, as opposed to young people with high levels of distress. This suggests that primary healthcare utilization among young people with high and low levels of distress is converging, which could indicate overuse among less distressed youths and underuse among more distressed youth. Conclusion and implications for practice: The prevalence of psychological distress (psychosomatic health complaints) among young people from 36 different countries in Europe and North America appeared to remain stable in large parts of Europe and North America between 1980 and 2013. However, Northern Europe stood out in terms of displaying an increasing trend of psychological distress among young people, suggesting that increasing psychological distress among this age group is primarily a Northern European phenomenon. In Norway, psychological distress among young people appear to have been systematically increasing between 1994 and 2018, especially among older teenage girls. Furthermore, since psychological distress is associated with primary healthcare utilization, one would expect that part of the increase could be explained by a growing population of psychologically distressed young people. However, this does not appear to be the case, as the greatest increase identified in the utilization of youth primary healthcare, occurs primarily among the less distressed. This raises questions about the expected need for healthcare and actual healthcare utilization, on the pathways from distress to care and the effectiveness of youth primary healthcare. School-based interventions tailored to reduce psychological distress symptoms or psychosomatic health complaints should be tailored to address the needs of older teenage girls, who tend to be more distressed. Intervention strategies should also be developed to improve health literacy among young people to enable them to identify and seek help for psychological distress