Background
Methods
Study design
The self-rated health question
Setting and sample
Lower secondary, n = 23 | Upper secondary, n = 35 | |
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Gender | ||
Boys | 10 | 19 |
Girls | 13 | 16 |
Country of birth | ||
Born in Sweden | 22 | 30 |
Born outside of Europe | 1 | 5 |
Self-rated health | ||
Very good | 9 | 14 |
Rather good | 13 | 19 |
Neither good, nor bad | 1 | 1 |
Rather bad | - | 1 |
Very bad | - | - |
Data collection
Data analysis
Ethical considerations
Results
The interpretation and essence of the question
The concept of ‘feel’
My family have not felt so good lately, both financially and relation wise. Like when you come home, you can almost always expect that there will be nagging. It is just like ahhhh. Sometimes we even start to shout at each other.
The whole society as it looks… a lot of what you think is wrong and strange… if you see a woman in town, it is assumed that she should enjoy wearing make-up, she’s supposed to clean, she should do this and that. When you meet a guy, you should assume that he thinks it is really fun to build houses and drink beer and do macho stuff. We have expectations of things and I think it can be hard sometimes.
Contrasting ‘feel’ and ‘health’
No, then I would have responded “Rather good.” I watch what I eat and I work out. But then I use snus [Swedish moist snuff]. And I’m like… I drink maybe a bit too much during the weekends. I know it is not possible to do so all my life. But my health is still very good, I think at least. I eat a lot of vegetables and get everything I need. I exercise and get fresh air… Health for me, it’s more about how I take care of my body and everything like that… purely chemical. Just how the body feels, but not how I feel as a person.
If I had to describe it in short, I guess I would say that health is more physical and how you feel is more mental. That is to say, health is how you feel in your body. And how you feel, it’s more… I mean they are intertwined. If you don’t feel good mentally, then your health gets worse and then it will be a bad circle. And the same goes the other way, if you are less healthy you feel worse. If I had to choose, I would rather have slightly worse health but feel very good than the other way around. (Boy, 7th grade, answered “Rather good”)
Strategies for determining a response
In my former class, it was very much so that the girls were supposed to be girly, and the guys were supposed to be macho. And then I didn’t fit in…So then I was bullied a bit, so now I feel like almost everything is better than back then.
In reality it is very good. I go to a very good school. I have very nice classmates. I have good teachers, only good teachers. And then I also have a very good relationship with my mother. I have very good relationships with my roommates and so on. But it is also very stressful in school. The schedule is packed. We have a lot of homework. And it feels like there is no time. What should I say I feel… how does one do if it feels pretty good, but also pretty bad… I’ll circle this one [“Neither good, nor bad”].
Choosing a response
Finding an appropriate response option
Attitudes toward providing an honest answer
No… I would not like to admit it in writing, so that it sticks. Because even if you look down on yourself… you do not want to admit you are at the bottom, it’s like to confirming that it’s like that. (Girl, 7th grade, answered “Rather good”)
Discussion
A holistic health construct
Gender and age differences
The response options
Honest and biased answers
Methodological considerations
Conclusions
Recommendations |
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1. Carefully consider the focus of the study before choosing the wording of a question. The word “feel” seems to capture a holistic construct, whilst “health” may imply emphasis on physical aspects. |
2. Acknowledge differences between response options when analyzing a self-rated health question. If dichotomization is necessary, thoughtful consideration of the grouping of variables is encouraged. |
3. To enhance the reliability of a self-rated health question, appropriate precautions should be taken to ensure privacy. |