Introduction
Methods
Sample and data collection
Instruments
Demographic variables
Questionnaires
Factors | Instruments | Number of items | αª |
---|---|---|---|
HRQOL | KIDSCREEN-27 | ||
Physical well-being | 5 | 0.81 | |
Psychological well-being | 7 | 0.87 | |
Autonomy and parent relations | 7 | 0.77 | |
Social support and peers | 4 | 0.78 | |
School environment | 4 | 0.80 | |
Self-efficacy | Generalized Self‐Efficacy Scale (GSE) | 10 | 0.87 |
Self-esteem | Rosenberg Self-Esteem scale (RSES) | 4 | 0.79 |
Pain | Brief Pain Inventory (BPI) | ||
Having pain today | 1 | ||
Pain on average | 1 | ||
Pain interference with activity | 3 | 0.81 | |
Pain interference with emotions | 4 | 0.90 | |
Lübeck Pain-Screening Questionnaire (LPQ) | |||
Pain duration | 1 | ||
Pain frequency | 1 | ||
OTC analgesic questions (derived from SUS) | |||
Intake of OTC analgesics during the last 4 weeks | 1 | ||
Frequency of OTC analgesics intake | 1 | ||
Sleep | School Sleep Habits Survey | ||
Problems with sleepiness | 1 | ||
Frequency of enough sleep | 1 | ||
Loneliness | UCLA Loneliness Scale (ULS-8) | 8 | 0.80 |
Stress | Perceived Stress Questionnaire (PSQ) | 30 | 0.93 |
Data analyses
Results
Characteristics of the sample
Variable | Total (696) | Boys (n = 296) | Girls (n = 400) | P value |
---|---|---|---|---|
Age, mean (SD) | 14.09 (0.33) | 14.08 (0.36) | 14.09 (0.30) | 0.905 |
Adult members of the household, N (%) | 0.185 | |||
Both parents | 508 (73.0) | 224 (75.7) | 284 (71.0) | |
Alternates between two parents | 100 (14.4) | 45 (15.2) | 55 (13.8) | |
One parent and one stepparent | 20 (2.9) | 6 (2.0) | 14 (3.5) | |
One parent | 55 (7.9) | 16 (5.4) | 39 (9.8) | |
Other caregivers | 13 (1.9) | 5(1.7) | 8 (2.0) | |
Parents’ marital status, N (%)a | 0.642 | |||
Two parent family | 492 (70.7) | 212 (71.6) | 280 (70.0) | |
Single/divorced parent family | 204 (29.3) | 84 (28.4) | 120 (30.0) | |
Parents’ birthplace, N (%) | 0.267 | |||
Both parents born in Norway | 551 (79.2) | 241 (81.4) | 310 (77.5) | |
One parent born in Norway | 87 (12.5) | 30 (10.1) | 57 (14.2) | |
Both parents born in another country | 58 (8.3) | 25 (8.4) | 33 (8.3) | |
Parents’ work status, N (%) | 0.013 | |||
Both parents working | 547 (78.6) | 247 (83.4) | 300 (75.0) | |
One parent working | 133 (19.1) | 46 (15.5) | 87 (21.8) | |
No parent working | 16 (2.3) | 3 (1.0) | 13 (3.3) | |
Number of siblings, N (%)b | 0.730 | |||
None | 30 (4.3) | 11 (3.7) | 19 (4.8) | |
1 | 263 (37.8) | 107 (36.1) | 156 (39.0) | |
2 | 244 (35.1) | 109 (36.8) | 135 (33.8) | |
≥ 3 | 159 (22.8) | 69 (36.8) | 90 (22.5) | |
Moved during the previous 5 years, N (%)c | 0.027 | |||
No | 474 (68.1) | 215 (72.6) | 259 (64.8) | |
Yes | 222 (31.9) | 81 (27.4) | 141 (35.3) | |
School absence for the previous 3 months, N (%)d | 0.812 | |||
0–4 days | 595 (85.5) | 255 (86.1) | 340 (85.0) | |
5–10 days | 84 (12.1) | 35 (11.8) | 49 (12.3) | |
> 10 days | 17 (2.4) | 8 (2.0) | 11 (2.8) |
Variable | Total (n = 696) | Boys (n = 296) | Girls (n = 400) | P value |
---|---|---|---|---|
Physical well-being, mean (SD)a,b | 47.1 (9.3) | 49.6 (9.6) | 45.2 (8.6) | < 0.001* |
Psychological well-being, mean (SD)a,b | 46.6 (8.4) | 49.5 (8.1) | 44.4 (8.0) | < 0.001* |
Autonomy and parent relations, mean (SD)a,b | 52.6 (8.7) | 53.4 (9.1) | 51.9 (8.5) | 0.027 |
Social support and peers, mean (SD)a,b | 48.4 (8.5) | 49.0 (8.5) | 48.0 (8.4) | 0.130 |
School environment, mean (SD)a,b | 48.0 (8.6) | 49.6 (9.1) | 46.8 (7.9) | < 0.001* |
Self-efficacy, mean (SD)c | 3.1 (0.4) | 3.2 (0.4) | 3.0 (0.4) | < 0.001* |
Self-esteem, mean (SD)d | 3.1 (0.7) | 3.3 (0.6) | 2.9 (0.7) | < 0.001* |
Having pain today, N (%) | < 0.001* | |||
Yes | 200 (28.7) | 56 (18.9) | 144 (36.0) | |
No | 496 (71.3) | 240 (81.1) | 256 (64) | |
Pain on average, mean (SD)e | 2.2 (1.9) | 1.6 (1.7) | 2.6 (1.9) | < 0.001* |
Pain interference with activity, median (min, max)f, g | 1.3 (0.0, 10.0) | 1.0 (0.0, 10.0) | 1.3 (0.0, 9.7) | 0.372 |
Pain interference with emotions, median (min, max)f, g | 1.2 (0.0, 9.7) | 0.7 (0.0, 9.2) | 1.2 (0.0, 9.7) | < 0.001* |
Pain duration, N (%)f, h | 0.069 | |||
Pain ≤ 3 months | 335 (63.6) | 133 (68.6) | 202 (60.3) | |
Pain > 3 months | 192 (36.4) | 61 (31.4) | 131 (39.3) | |
Pain frequency, N (%)f, i | 0.146 | |||
Seldom | 221 (41.9) | 92 (47.4) | 129 (38.7) | |
Sometimes | 123 (23.2) | 42 (21.6) | 81 (24.3) | |
Often | 183 (34.7) | 60 (30.9) | 123 (36.9) | |
OTC analgesic intake during the last 4 weeks, N (%) | < 0.001* | |||
Yes | 342 (49.2) | 103 (34.8) | 239 (59.9) | |
No | 353 (50.8) | 193 (65.2) | 160 (40.1) | |
Frequency of OTC analgesic intake, N (%)j | 0.043 | |||
Daily | 20 (5.8) | 10 (9.7) | 10 (4.2) | |
Every week, but not daily | 52 (15.2) | 10 (9.7) | 42 (17.6) | |
Less often than every week | 243 (71.1) | 72 (69.9) | 171 (71.5) | |
No intake during the last 4 weeks | 27 (7.9) | 11 (10.7) | 16 (6.7) | |
Problems with sleepiness, N (%) | < 0.001* | |||
No problem at all | 280 (40.3) | 151 (51.0) | 129 (32.3) | |
A slight problem | 311 (44.7) | 120 (40.5) | 191 (47.9) | |
More than a slight problem | 68 (9.8) | 17 (5.7) | 51 (12.8) | |
A big problem | 26 (3.7) | 7 (2.4) | 19 (4.8) | |
A very big problem | 10 (1.4) | 1 (0.3) | 9 (2.3) | |
Frequency of enough sleep, N (%) | 0.002* | |||
Always | 59 (8.5) | 34 (11.5) | 25 (3.6) | |
Usually | 387 (55.7) | 175 (59.1) | 212 (53.1) | |
Sometimes | 177 (25.5) | 69 (23.3) | 108 (27.1) | |
Rarely | 63 (9.1) | 15 (5.1) | 48 (6.9) | |
Never | 9 (1.3) | 3 (1.0) | 6 (1.5) | |
Loneliness, median (min, max)k | 13.0 (8.0, 32.0) | 12.0 (8.0, 27.0) | 13.0 (8.0, 32.0) | < 0.001* |
Stress, mean (SD)l | 0.29 (0.15) | 0.24 (0.13) | 0.33 (0.16) | < 0.001* |
Crude associations between sociodemographic variables, self-efficacy, self-esteem, pain, sleep, loneliness, stress, and HRQOL examined by linear regression analyses
Physical well-being | Psychological well-being | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
B1 | B2 | B3 | B4 | B5 | B6 | B7 | B1 | B2 | B3 | B4 | B5 | B6 | B7 | |
Gender (ref = boy) | − 0.21* | − 0.27* | ||||||||||||
Adult members of the household (ref = both parents) | ||||||||||||||
Part-time with each parent | − 0.07 | − 0.09 | ||||||||||||
One parent and one stepparent | − 0.06 | − 0.06 | ||||||||||||
One parent | − 0.08 | − 0.12* | ||||||||||||
Other caregivers | − 0.02 | − 0.08 | ||||||||||||
Parents’ work status (ref = both parents working) | ||||||||||||||
One parent working | − 0.10* | − 0.11* | ||||||||||||
No parent working | − 0.08 | − 0.00 | ||||||||||||
School absence (ref = 0–4 days)d | ||||||||||||||
5–10 days | − 0.14* | − 0.13* | ||||||||||||
> 10 days | − 0.09 | − 0.08 | ||||||||||||
Self-efficacy | 0.43* | 0.53* | ||||||||||||
Self-esteem | 0.44* | 0.67* | ||||||||||||
Pain on average | − 0.29* | − 0.41* | ||||||||||||
Frequency of enough sleep (ref = always) | ||||||||||||||
Usually | − 0.23* | − 0.30* | ||||||||||||
Sometimes | − 0.27* | − 0.39* | ||||||||||||
Rarely | − 0.31* | − 0.38* | ||||||||||||
Never | − 0.18* | − 0.24* | ||||||||||||
Loneliness | − 0.37* | − 0.62* | ||||||||||||
Stress | − 0.43* | − 0.72* | ||||||||||||
R2 adj | 0.106 | 0.186 | 0.192 | 0.086 | 0.083 | 0.133 | 0.187 | 0.150 | 0.276 | 0.449 | 0.171 | 0.112 | 0.390 | 0.518 |
Autonomy and parent relations | Social support and peers | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
B1 | B2 | B3 | B4 | B5 | B6 | B7 | B1 | B2 | B3 | B4 | B5 | B6 | B7 | |
Gender (ref = boy) | − 0.06 | − 0.05 | ||||||||||||
Adult members of the household (ref = both parents) | ||||||||||||||
Part-time with each parent | − 0.06 | − 0.01 | ||||||||||||
One parent and one stepparent | − 0.07 | − 0.08 | ||||||||||||
One parent | − 0.13* | − 0.05 | ||||||||||||
Other caregivers | − 0.11* | − 0.03 | ||||||||||||
Parents’ work status (ref = both parents working) | ||||||||||||||
One parent working | − 0.06 | − 0.03 | ||||||||||||
No parent working | − 0.07 | 0.05 | ||||||||||||
School absence (ref = 0–4 days)d | ||||||||||||||
5–10 days | − 0.06 | − 0.06 | ||||||||||||
> 10 days | − 0.02 | − 0.05 | ||||||||||||
Self-efficacy | 0.38* | 0.32* | ||||||||||||
Self-esteem | 0.43* | 0.35* | ||||||||||||
Pain on average | − 0.29* | − 0.14* | ||||||||||||
Frequency of enough sleep (ref = always) | ||||||||||||||
Usually | − 0.15 | − 0.22* | ||||||||||||
Sometimes | − 0.26* | − 0.24* | ||||||||||||
Rarely | − 0.24* | − 0.20* | ||||||||||||
Never | − 0.15* | − 0.16* | ||||||||||||
Loneliness | − 0.39* | − 0.55* | ||||||||||||
Stress | − 0.52* | − 0.39* | ||||||||||||
R2 adj | 0.049 | 0.145 | 0.181 | 0.080 | 0.053 | 0.153 | 0.270 | 0.010 | 0.104 | 0.123 | 0.018 | 0.032 | 0.297 | 0.153 |
School environment | |||||||
---|---|---|---|---|---|---|---|
B1 | B2 | B3 | B4 | B5 | B6 | B7 | |
Gender (ref = boy) | − 0.14* | ||||||
Adult members of the household (ref = both parents) | |||||||
Part-time with each parent | − 0.03 | ||||||
One parent and one stepparent | − 0.04 | ||||||
One parent | − 0.05 | ||||||
Other caregivers | − 0.02 | ||||||
Parents’ work status (ref = both parents working) | |||||||
One parent working | − 0.07 | ||||||
No parent working | − 0.05 | ||||||
School absence (ref = 0–4 days)d | |||||||
5–10 days | − 0.12* | ||||||
> 10 days | − 0.06 | ||||||
Self-efficacy | 0.49* | ||||||
Self-esteem | 0.51* | ||||||
Pain on average | − 0.34* | ||||||
Frequency of enough sleep (ref = always) | |||||||
Usually | − 0.23* | ||||||
Sometimes | − 0.37* | ||||||
Rarely | − 0.35* | ||||||
Never | − 0.22* | ||||||
Loneliness | − 0.40* | ||||||
Stress | − 0.56* | ||||||
R2 adj | 0.046 | 0.240 | 0.262 | 0.113 | 0.112 | 0.162 | 0.310 |
Adjusted associations between sociodemographic variables, self-efficacy, self-esteem, pain, sleep, loneliness, stress, and HRQOL examined by hierarchical regression analyses
Physical well-being | Psychological well-being | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M1 | M2 | M3 | M4 | M5 | M6 | M7 | M1 | M2 | M3 | M4 | M5 | M6 | M7 | |
Gender (ref = boy) | − 0.21* | − 0.13* | − 0.09* | − 0.07 | − 0.06 | − 0.07 | − 0.06 | − 0.27* | − 0.18* | − 0.09* | − 0.06 | − 0.06 | − 0.07* | − 0.05 |
Adult members of the household (ref = both parents) | ||||||||||||||
Part-time with each parent | − 0.07 | − 0.05 | − 0.04 | − 0.04 | − 0.04 | − 0.04 | − 0.03 | − 0.09 | − 0.06 | − 0.04 | − 0.04 | − 0.04 | − 0.04 | − 0.02 |
One parent and one stepparent | − 0.06 | − 0.01 | − 0.01 | − 0.01 | − 0.00 | 0.00 | − 0.00 | − 0.06 | − 0.00 | 0.01 | − 0.00 | 0.00 | 0.01 | 0.01 |
One parent | − 0.08 | − 0.05 | − 0.04 | − 0.03 | − 0.02 | − 0.02 | − 0.02 | − 0.12* | − 0.09* | − 0.06 | − 0.05 | − 0.05 | − 0.05 | − 0.04 |
Other caregivers | − 0.02 | − 0.00 | 0.01 | 0.02 | − 0.02 | − 0.03 | 0.03 | − 0.08 | − 0.05 | − 0.03 | − 0.02 | − 0.02 | − 0.01 | − 0.01 |
Parents’ work status (ref = both parents working) | ||||||||||||||
One parent working | − 0.10* | − 0.09* | − 0.09* | − 0.08 | − 0.09* | − 0.09* | − 0.08 | − 0.11* | − 0.10* | − 0.10* | − 0.09* | − 0.10* | − 0.08* | − 0.06* |
No parent working | − 0.08 | − 0.09* | − 0.09* | − 0.10* | − 0.11* | − 0.10* | − 0.10* | 0.00 | − 0.01 | 0.01 | − 0.01 | − 0.02 | − 0.02 | − 0.02 |
School absence (ref = 0–4 days)d | ||||||||||||||
5–10 days | − 0.14* | − 0.12* | − 0.10* | − 0.08 | − 0.08 | − 0.07 | − 0.07 | − 0.13* | − 0.11* | − 0.05 | − 0.03 | − 0.03 | − 0.02 | − 0.01 |
> 10 days | − 0.09 | − 0.06 | − 0.05 | − 0.05 | − 0.05 | − 0.04 | − 0.04 | − 0.08 | − 0.04 | − 0.03 | − 0.03 | − 0.03 | − 0.01 | 0.00 |
Self-efficacy | 0.38* | 0.26* | 0.25* | 0.24* | 0.22* | 0.21* | 0.46* | 0.21* | 0.20* | 0.19* | 0.14* | 0.11* | ||
Self-esteem | 0.24* | 0.21* | 0.19* | 0.15* | 0.12* | 0.50* | 0.46* | 0.45* | 0.33* | 0.21* | ||||
Pain on average | − 0.13* | − 0.11* | − 0.10* | − 0.10* | − 0.18* | − 0.17* | − 0.15* | − 0.12* | ||||||
Frequency of enough sleep (ref = always) | ||||||||||||||
Usually | − 0.12 | − 0.12 | − 0.11 | − 0.14* | − 0.13* | − 0.11 | ||||||||
Sometimes | − 0.18* | − 0.18* | − 0.17* | − 0.12* | − 0.11* | − 0.05 | ||||||||
Rarely | − 0.11 | − 0.11 | − 0.10 | − 0.09* | − 0.09* | − 0.03 | ||||||||
Never | − 0.08 | − 0.08 | − 0.07 | − 0.08* | − 0.07* | − 0.02 | ||||||||
Loneliness | − 0.11* | − 0.09 | − 0.32* | − 0.24* | ||||||||||
Stress | − 0.07 | − 0.31* | ||||||||||||
R2 adj | 0.106 | 0.237 | 0.275 | 0.289 | 0.299 | 0.307 | 0.308 | 0.150 | 0.343 | 0.511 | 0.539 | 0.545 | 0.616 | 0.658 |
Autonomy and parent relations | Social support and peers | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M1 | M2 | M3 | M4 | M5 | M6 | M7 | M1 | M2 | M3 | M4 | M5 | M6 | M7 | |
Gender (ref = boy) | − 0.06 | 0.02 | 0.07 | 0.10* | 0.10* | 0.10* | 0.12* | − 0.05 | 0.02 | 0.06 | 0.07 | 0.07 | 0.06 | 0.06 |
Adult members of the household (ref = both parents) | ||||||||||||||
Part-time with each parent | − 0.06 | − 0.03 | − 0.02 | − 0.02 | − 0.02 | − 0.02 | − 0.01 | − 0.01 | 0.01 | 0.02 | 0.02 | 0.02 | 0.02 | 0.03 |
One parent and one stepparent | − 0.07 | − 0.03 | − 0.02 | − 0.03 | − 0.03 | − 0.02 | − 0.03 | − 0.08 | − 0.04 | − 0.04 | − 0.04 | − 0.04 | − 0.02 | − 0.02 |
One parent | − 0.13* | − 0.10* | − 0.09 | − 0.08 | − 0.07 | − 0.07 | − 0.06 | − 0.05 | − 0.03 | − 0.02 | − 0.02 | − 0.02 | − 0.02 | − 0.02 |
Other caregivers | − 0.11* | − 0.08 | − 0.07 | − 0.06 | − 0.06 | − 0.06 | − 0.05 | − 0.03 | − 0.00 | 0.00 | 0.01 | 0.01 | 0.02 | 0.02 |
Parents’ work status (ref = both parents working) | ||||||||||||||
One parent working | − 0.06* | − 0.06 | − 0.06 | − 0.05 | − 0.06 | − 0.04 | − 0.03 | − 0.03 | − 0.03 | − 0.03 | − 0.03 | − 0.03 | − 0.00 | 0.00 |
No parent working | − 0.07* | − 0.08 | − 0.08 | − 0.08 | − 0.09* | − 0.09* | − 0.09* | 0.05 | 0.04 | 0.04 | 0.04 | 0.03 | 0.04 | 0.04 |
School absence (ref = 0–4 days)d | ||||||||||||||
5–10 days | − 0.06 | − 0.05 | − 0.01 | 0.00 | 0.01 | 0.01 | 0.02 | − 0.06 | − 0.05 | − 0.02 | − 0.01 | − 0.01 | 0.00 | 0.00 |
> 10 days | − 0.02 | 0.01 | 0.02 | 0.02 | 0.02 | 0.03 | 0.04 | − 0.05 | − 0.02 | − 0.01 | − 0.01 | − 0.02 | 0.02 | 0.02 |
Self-efficacy | 0.36* | 0.21* | 0.20* | 0.20* | 0.17* | 0.14* | 0.31* | 0.19* | 0.19* | 0.17* | 0.10 | 0.09 | ||
Self-esteem | 0.31* | 0.27* | 0.26* | 0.19* | 0.06 | 0.26* | 0.25* | 0.25* | 0.06 | 0.03 | ||||
Pain on average | − 0.16* | − 0.15* | − 0.13* | − 0.11* | − 0.03 | − 0.03 | 0.02 | 0.02 | ||||||
Frequency of enough sleep (ref = always) | ||||||||||||||
Usually | − 0.05 | − 0.04 | − 0.01 | − 0.13 | − 0.12 | − 0.11 | ||||||||
Sometimes | − 0.08 | − 0.08 | − 0.01 | − 0.10 | − 0.08 | − 0.07 | ||||||||
Rarely | − 0.06 | − 0.06 | 0.00 | − 0.05 | − 0.07 | − 0.05 | ||||||||
Never | − 0.05 | − 0.04 | 0.01 | − 0.08 | − 0.06 | − 0.04 | ||||||||
Loneliness | − 0.18* | − 0.09 | − 0.48* | − 0.45* | ||||||||||
Stress | − 0.34* | − 0.10 | ||||||||||||
R2 adj | 0.049 | 0.170 | 0.233 | 0.255 | 0.254 | 0.276 | 0.324 | 0.010 | 0.101 | 0.144 | 0.144 | 0.146 | 0.306 | 0.309 |
School environment | |||||||
---|---|---|---|---|---|---|---|
M1 | M2 | M3 | M4 | M5 | M6 | M7 | |
Gender (ref = boy) | − 0.14* | − 0.04 | 0.02 | 0.04 | 0.05 | 0.04 | 0.06 |
Adult members of the household (ref = both parents) | |||||||
Part-time with each parent | − 0.03 | − 0.01 | 0.00 | 0.01 | 0.01 | 0.01 | 0.02 |
One parent and one stepparent | − 0.04 | 0.02 | 0.03 | 0.01 | 0.03 | 0.03 | 0.03 |
One parent | − 0.05 | − 0.02 | − 0.00 | 0.01 | 0.02 | 0.02 | 0.03 |
Other caregivers | − 0.02 | 0.01 | 0.03 | 0.03 | 0.04 | 0.04 | 0.05 |
Parents’ work status (ref = both parents working) | |||||||
One parent working | − 0.07 | − 0.06 | − 0.07 | − 0.06 | − 0.07 | − 0.06 | − 0.05 |
No parent working | − 0.05 | − 0.06 | − 0.06 | − 0.06 | − 0.07 | − 0.07 | − 0.07 |
School absence (ref = 0–4 days)d | |||||||
5–10 days | − 0.12* | − 0.10* | − 0.06 | − 0.04 | − 0.03 | − 0.03 | − 0.02 |
> 10 days | − 0.06 | − 0.02 | − 0.01 | − 0.01 | − 0.01 | − 0.00 | 0.01 |
Self-efficacy | 0.47* | 0.30* | 0.30* | 0.28* | 0.26* | 0.24* | |
Self-esteem | 0.34* | 0.30* | 0.27* | 0.23* | 0.13* | ||
Pain on average | − 0.18* | − 0.16* | − 0.15* | − 0.13* | |||
Frequency of enough sleep (ref = always) | |||||||
Usually | − 0.10 | − 0.09 | − 0.07 | ||||
Sometimes | − 0.16* | − 0.16* | − 0.11 | ||||
Rarely | − 0.13* | − 0.14* | − 0.09 | ||||
Never | − 0.11* | − 0.10* | − 0.06 | ||||
Loneliness | − 0.11* | − 0.04 | |||||
Stress | − 0.26* | ||||||
R2 adj | 0.046 | 0.250 | 0.327 | 0.355 | 0.369 | 0.377 | 0.404 |