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Additional file 1. Cronbach’s alpha values for instruments used in this study. Cronbach’s alpha values for KIDSCREEN-10, RAND-36, The Health Literacy in School-Aged Children Questionnaire, The Health Literacy Questionnaire.

Background Increased knowledge about factors that can impact changes in adolescents’ health-related quality of life (HRQOL) is needed. The present study aimed to investigate possible HRQOL changes in adolescents at 14 and 16 years, and assess the impact of sociodemographic factors, gender, pain, self-esteem, self-efficacy, loneliness, and stress on HRQOL changes over time. Further, to assess HRQOL stratified by gender. Methods A longitudinal study involving 211 adolescents was conducted. Sociodemographic variables, pain, self-esteem, self-efficacy, loneliness, and stress were all assessed with well-validated instruments. KIDSCREEN-27 was used to measure HRQOL. Data were analyzed using independent t-tests, paired samples t-tests, and linear mixed models for repeated measures. Results When all variables were added to the linear mixed models, stress, loneliness, and pain were significantly, independently associated with a reduction in HRQOL change scores for four of the five KIDSCREEN subscales. Time was significantly associated with a reduction in physical and psychological well-being. Self-efficacy and self-esteem were significantly associated with an increase in HRQOL change scores for four and two subscales, respectively. Male gender was significantly negatively associated with changes in social support and peers compared to female gender. Conclusion Our results demonstrated a significant decline in adolescents’ HRQOL regarding physical and psychological well-being for the age range 14–16 years. Furthermore, we found that stress, loneliness, and pain have a significant negative impact on HRQOL changes, whereas self-esteem and self-efficacy have a significant positive impact. Our results highlight the importance of increased understanding regarding factors associated with changes in adolescents’ HRQOL to enable accurate and strategic interventions.

Additional file 1. Cronbach’s alpha values for instruments used in this study.

Some adolescents have a high consumption of over-the-counter analgesics. One in ten are daily users, while 25 percent use over-the-counter analgesics weekly. The quality of life for these adolescents is reduced by frequent and persistent pain, sleeping problems and reduced self-esteem. Affecting factors seem to be a stressful childhood and adolescence marked by long-term family conflicts, frequent moves and serious health problems or substance abuse in family or near relations. Many have experienced persistent bullying. These adolescents long for a close and reliable friend. The mother is the primary caregiver, often with little support from the father or other family members. She has significant influence on the youths’ daily activities, and assessment of pain and pain management, including the use of over-the-counter analgesics. The mutual interdependence between mother and child may seem protective, but such a close relationship might impede the development of independence and identity.

Tema: Prosjektets tema er kropp, kroppssyn og psykisk helse hos NEET-jenter. Bakgrunn: Kroppen er lite tematisert i forhold til helse, når det gjelder sammenhengen mellom det psykiske og fysiske. Psykisk helse og kroppssyn er lite tematisert i tilgjengelig litteratur. Kroppen knyttes mest til somatisk helse og fysisk aktivitet. Det er lite forskning på unge jenter utenfor arbeid og skole, og deres håndtering av fysisk og psykisk helse. Formål: Få mer kunnskap om kroppssyn NEET-jenter har, og utdype hvilken betydning dette kroppssynet har for deres opplevelse av helse. Problemstilling: «Kropp, kroppssyn, og psykisk helse blant unge jenter utenfor arbeid og skole – Hvordan er opplevelse av sammenheng mellom kroppssyn og helse?» Metode: Kvalitative individualintervjuer. Fem NEET- jenter i alderen 18-21 år ble intervjuet. Fortolkningen av datamaterialet ble gjort i en fenomenologisk og hermeneutisk fortolkningstradisjon. Det er foretatt en tematisk analyse, inspirert av Malteruds systematiske tekstkondensering. Funn: Oppveksten hadde betydning for relasjonelle bånd og opplevelse av egenverdi. Stress i barndommen påvirket hvordan NEET-jentene håndterte stress, vanskelige livshendelser, skole og jobb senere i livet. Håndtering av stress påvirket også jentenes fysiske og psykiske helse. Stressfaktorene som påvirket dem kom utenifra, fra samfunnet, og innenifra dem selv, i form av krav og forventninger. Det kom til uttrykk blant annet ved skole- og kroppspress. Studien viser at jentene opplevde trening og bevegelse som betydningsfullt og essensielt. Jentene opplevde mestring ved bevegelse. Jentenes stressende livshendelser preget deres opplevelse av å ha det bra, og fikk betydning for om livet ble forståelig, håndterbart og meningsfullt. Funn i studien diskuteres opp mot tidligere forskning i lys av salutogenese. Oppsummering: Studien indikerer at en turbulent barndom skapte stress hos jentene, og deres opplevelse av egenverdi, som igjen påvirket hvordan de håndterte stress senere i livet. Deres livs- og bevegelseserfaringer, og deres samspill med andre, fikk betydning for deres opplevelse av helse, og om livet ble forståelig, håndterbart og meningsfullt. Nøkkelord: Psykomotorisk fysioterapi, kroppssyn, psykisk helse, unge jenter, salutogenese. Theme: The elements of the theme of this project are the body, body views and mental health in NEET females. Background: The body, as a cohesive unit in the mental and physical, is little themed in relation to health. The body is mostly associated with somatic health and physical activity. There is little research among young females who are not studying, working or training and their ability of coping with physical and mental health. Intention: To gain more knowledge of the body views that NEET-females have, and what significance this body view has for their perception of health. Research question: «Body, body views, and mental health among young females who are not participation in education, employment, or training – How is the sense of coherence between body view and health?» Method: Qualitative interviews. Five NEET females aged 18-21 were interviewed. The interpretation of the data material is in a phenomenological and hermeneutic interpretational tradition. A thematic analysis has been made. Findings: Childhood experiences became important for relational ties later in life, and the ability of experiencing intrinsic value.. The study indicates that stress during childhood affected how NEET females handled stress, difficult life events, school, and work later in life. Managing stress also affected their physical and mental health. The stressors that affected them came from the outside, as from society, and from within themselves, in the form of demands and expectations. This was expressed by school and body pressure, and their feelings of being valuable. The study shows that the participants experienced exercise and movement as significant and essential. The young females felt mastery of movements. The sum of their life events became important for their understanding and perception of health. Findings in the study are discussed against previous research in the light of salutogenesis. Summary: The study indicate that a chaotic and turbulent childhood became stressful for the participants. This affected how they dealt with stress later in life. Their life experiences and movement experiences became important for their perception of health.