Relações entre qualidade de vida relacionada à saúde e autoconceitos e conceitos de outros significativos de adolescentes por meio da modelagem de equações estruturais

Abstract

From data collected in the adolescent population of four Brazilian capitals (Belém, Brasília, Fortaleza and Porto Alegre), test the validity of theoretical model that investigates the relationship between the variables involved in the constructs of the familiar identifying patterns obtained with the Identification Test Family (FIT) and those of health-related quality of life questionnaire obtained using the generic KIDSCREEN-27, by applying the structural equation modeling (SEM). 1,082 adolescents selected, constituted three groups: one of the attending health care services in outpatient mental health (CG), a student group of the public sector (GP) and a student group of the private sector (GPr). The three groups were investigated with the KIDSCREEN-27 in five dimensions of quality of life related to health (HRQoL) and the FIT (the Family Identification Test) in their patterns of family identifications. The instruments were analyzed in its psychometric properties, scores of HRQoL were obtained, self-concepts and family identifications that allowed us to compare the three groups with descriptive and inferential statistics (MANOVA, MANCOVA and Discriminante Analysis); and, in a second step, were analyzed the repercussions of identification patterns in HRQoL by structural equation modeling. The mean age of the adolescents in the general sample was from 15.30 (SD = 1.60) years old; 54.1% female; lower scores were found in adolescents with mental illness in four of five dimensions of KIDSCREEN-27, with an effect size ranging from 0.25 to physical well-being 0.46 for Autonomy & Parents. In FIT analysis, was obtained a statistically significant effect with MANOVA that indicated differences in the family identification patterns. Adolescents from PrG had higher scores than PG adolescents in self-congruence, identifications actual and ideal with the father and ideal identification with grandparents; and also showed differences with the CG in actual and ideal identification with the father. The results differentiated adolescents from different backgrounds. In the last analysis stage, was conducted a factorial structure study of the KIDSCREEN-27 and the FIT and after that was conducted a Multivariate Regression Model and it was observed that the actual self-concept predicts the quality of life in its five dimensions; the perceived image of the mother, father and grandfather / grandmother predicts the quality of life mainly in the aspect of quality of life related to Autonomy & Relationship with Parents. The study provides relevant and valuable information on the measurement of HRQoL and Identifications Patterns in Brazilian adolescents groups from different backgrounds. The finding that adolescents from public schools and clinical group show fewer desires to look like their parents can point to a lower family cohesion or more pronounced feelings of rejection with father figure. Additionally, aspects highlighted by the perception of self-concepts and other's concepts can be predictors of higher scores of Health-Related Quality of Life. Both instruments, therefore, are useful tools in assessing the mental health and well-being of adolescents.