Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

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ISSN: 2177-5281 (Online)

Vol. 15 nº 3 - Jul/Sep - 2018

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Páginas 7 a 14


Resilience and quality of life: a correlational study in young people and adolescents

Resiliencia y calidad de vida: un estudio correlacional en jóvenes y adolescentes

Resiliência e qualidade de vida: um estudo correlacional em jovens e adolescentes

Autores: Cynthia de Freitas Melo1; José Eurico de Vasconcelos Filho2; Marina Braga Teófilo3; Icaro Moreira Costa4; Camila Maria de Oliveira Ramos5; Ronaldo Almeida de Freitas Filho6

1. Doutora in Psychology from the Federal University of Rio Grande do Norte (UFRN). Professor of the Postgraduate Program in Psychology at the University of Fortaleza (UNIFOR). Fortaleza, CE, Brazil
2. Doctor in Computer Science (IHC) from the Pontifical Catholic University of Rio de Janeiro (PUC-Rio). Professor of Computer Engineering and the Professional Master in Technology and Innovation in Nursing at the University of Fortaleza (UNIFOR). Fortaleza, CE, Brazil
3. Psycologist formed by the University of Fortaleza (UNIFOR). Multiprofessional Resident in Oncological Care at the University Hospital of Brasilia (HUB-UNB). Brasilia, DF, Brazil
4. Graduated in Psychology from the University of Fortaleza (UNIFOR). Master's degree in Psychology from UNIFOR. Fortaleza, CE, Brazil
5. Psychologist formed by the University of Fortaleza (UNIFOR). Master's degree in Psychology from UNIFOR. Fortaleza, CE, Brazil
6. Graduated in Computer Engineering from the University of Fortaleza (UNIFOR). Volunteer researcher - IT Department - UNIFOR. Fortaleza, CE, Brazil

Cynthia de Freitas Melo Lins
Universidade de Fortaleza, Programa de Pós-Graduação em Psicologia
Avenida Washington Soares, nº 1321, Bloco N, Sala N13, Edson Queiroz
Fortaleza, CE, Brasil. CEP: 60811-341
(cf.melo@yahoo.com.br)

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Keywords: Resilience, Psychological, quality of life, homeless youth, adolescent.
Palabra Clave: Resiliencia psicológica, calidad de vida, adulto joven, adolescente.
Descritores: Resiliência psicológica, qualidade de vida, adulto jovem, adolescente.

Abstract:
OBJECTIVE: Verify the extent to which the resilience capacity is related to the level of life quality in young people and adolescents.
METHODS: Through a national online survey, a non-probabilistic sample composed of 6,755 participants between 14 and 24 years of age answered the Wagnild and Young (1993) Resilience Scale, the Quality of Life Scale developed by the WHOQOL -bref, (2000) and a sociodemographic questionnaire. The data were analyzed through descriptive and correlational statistics using statistical software SPSS (Statistical Package for Social Science) for Windows version 22.
RESULTS: Resilience capacity correlates positively and significantly with life quality.
CONCLUSION: As higher the resilience indices, higher will be the indices of perception about the quality of life and health of young people and adolescents.

Resumen:
OBJETIVO: Verificar en qué medida la capacidad de resiliencia se relaciona con el nivel de calidad de vida en jóvenes y adolescentes.
MÉTODOS: A través de un estudio nacional en línea, una muestra no probabilística compuesta por 6.755 participantes entre 14 y 24 años respondió a la Escala de Resiliencia desarrollada por Wagnild y Young (1993), la Escala de Calidad de Vida desarrollada por la Organización Mundial de la Salud - WHOQOL-bref, (2000) y un cuestionario sociodemográfico. Los datos fueron analizados por medio de estadística descriptiva y correlacional con ayuda del software estadístico SPSS (Statistical Package for Social Science) para Windows versión 22.
RESULTADOS: La capacidad de resiliencia se correlaciona positiva y significativamente con la calidad de vida.
CONCLUSIÓN: Cuanto mayor los índices de resiliencia, mayores serán los índices de percepción sobre la calidad de vida y salud de jóvenes y adolescentes.

Resumo:
OBJETIVO: Verificar em que medida a capacidade de resiliência se relaciona com o nível de qualidade de vida em jovens e adolescentes.
MÉTODOS: Por meio de um levantamento nacional online, uma amostra não probabilística composta por 6.755 participantes entre 14 e 24 anos respondeu a Escala de Resiliência desenvolvida por Wagnild e Young (1993), a Escala de Qualidade de Vida desenvolvida pela Organização Mundial de Saúde - WHOQOL-bref, (2000) e um questionário sociodemográfico. Os dados foram analisados por meio de estatística descritiva e correlacional com auxílio do software estatístico SPSS (Statistical Package for Social Science) para Windows versão 22.
RESULTADOS: A capacidade de resiliência se correlaciona positiva e significativamente com a qualidade de vida.
CONCLUSÃO: Quanto maior os índices de resiliência, maiores serão os índices de percepção sobre a qualidade de vida e saúde de jovens e adolescentes.

INTRODUCTION

The concept of resilience is complex, but can be defined as the ability of a person or group to go through an adverse situation and overcome it through adaptation or control, and leave it strengthened1-4. It is a dynamic characteristic that reciprocally relates the individual resources, the life history and the environment in the process of adaptation and recommences in the face of adversities. That is to say, the experience of resilience can vary in the course of the life trajectory of the subject, pondering that each phase of human development presents its characteristics and particularities. In this way, resilience isn´t a permanent protective shield, but rather something punctual, so that each event will awaken different reactions of resilience. That is why we are talking about being resilient, and not stay resilient5.

Consequently, at different times individuals may appear vulnerable to one situation and resilient to the other, depending on how they interact with the environment, highlighting the existing risk and protection factors. In this context, resilience is crossed by a dynamism that admits in the construction of its concept three different levels that can be evaluated: social support, individual skills and internal strength6.

From the interaction between these factors, where the way of life of the individuals is considered, the impact of the classification of the quality of life on the capacity of a person to be more or less resilient is questioned, since it is defined from the perception of the individual about his position in life, contextualized with the culture and its value system, as well as in relation to its objectives, expectations and standards5; 7. In addition, the quality of life encompasses a multidimensional understanding, in which the need to insert in its understanding the physical aspects, social interactions, affective and emotional behavior, and mental health, factors that vary from the current capacity of resilience3; 8. They are, therefore, two constructs treated in the literature in isolation, but that walk in parallel, or even intertwined.

The quality of life doesn´t demand a pattern, since it is a variable concept for each person, and it appropriates co-responsibility for its physical, social, psychic and spiritual rehabilitation. The similar perception can be made in terms of resilience, which isn´t presented as a characteristic of the individual, but goes back to the ability to find a way to face adverse situations, mobilizing individual resources and their social network, which can , even minimally, go through aspects of their quality of life3; 5; 9.

When dealing with the relationship of double resilience and quality of life in young people and adolescents, it is necessary to contemplate that these groups present health preservation needs that may vary according to the interaction between the biological, psychological and social spheres, and that they are positively and negatively impacted by the environment where they are inserted. For example, they may experience a situation of poverty, loss of important people, a weakened social and affective support network, or ruptures in the family structure that may compromise their healthy biopsychosocial development-11.

In addition, the literature of this age group emphasizes that health care must be more efficient, broad and creative, since the deprivation of possibilities and positive expectations to face problems and challenges that may influence the quality of life, harming the strengthening of the resilience processes12.

It is related, however, that the literature lacks research linking these two constructs. In an attempt to fill this gap, the present investigation aims to verify the extent to which resilience capacity is related to the level of quality of life in young people and adolescents of the Brazilian population. It is intended, in this way, to contribute to a better understanding of the healthy development of these groups.


METHOD

Sample of participants

It is a descriptive and exploratory investigation, generated from a survey conducted via the internet for all of Brazil. There was a non-probabilistic convenience sample composed of 5,884 young Brazilians, with inclusion criteria being Brazilian, with ages between 14 and 24 years. The sample was divided into two groups: adolescents (14-17 years) and young adults (18-24 years), with different biodemographic characteristics (Table 1).




Instruments

For the measurement of quality of life, the short Portuguese version of the WHOQOL-bref13 was used, which has 26 articles and a response scale type Likert that varies from 1 to 5. The first two questions are related to the perception of quality of life ( WHOQOL-1) and satisfaction with health (WHOQOL-2). The remaining 24 elements are presented distributed in four domains: physical (7 items), psychological (6 items), social relationships (3 items) and environment (8 items).

To assess resilience, the Brazilian version of the Resilience Scale14 was used, which is considered one of the few instruments used to measure levels of positive psychosocial adaptation to important events in life. The scale has 25 positively described items with a Likert type response that varies from 1 to 7, which varies from 1 to 7, in which the scores range from 25 to 175 points, with high values indicating high resilience. It consists of three factors: Factor 1 - Resolution of actions and values (14 items); Factor 2 - Independence and determination (6 items); and Factor 3 - Self-confidence and ability to adapt to situations (5 items).

Procedures

The research was approved by the Commission of Ethics in Research of the University of Fortaleza, under Opinion No. 1,356,319, based on the ethical aspects related to research involving human beings. Subsequently, the instrument was set up on the Internet together with the Free Informed Consent Term - TCLE, by means of a specific webpage and private domain, the information being recorded and maintained by the institution. The disclosure was made through the publication on social networks, televised reports, magazines and digital portals of general interest groups. It is important to highlight that the ethical aspects demanded by Resolution 466/12 of the National Health Council were respected.

Data analysis

The data analyzes were carried out through the statistical package SPSS (Statistical Package for Social Science) for Windows version 22, carried out in four stages. First, the profile of the sample was verified through descriptive statistics. In the second stage, the quality of life indexes were analyzed: from the items WHOQOL-1 and WHOQOL-2 (results that vary from 1 to 5) and from each of the four domains (results that vary from 0 to 100). Subsequently, those domains were interpreted in quartiles: 0 to 24 - very dissatisfied; 25 to 49 - dissatisfied; 50 to 74 - satisfied; and 75 to 100 - very satisfied.

In the third stage, the results of the resilience scale were analyzed: summations were made of the scores of the total resilience scale (results ranging from 26 to 182) and of each scale factor (results ranging from 14 to 98 - factor 1, 6 to 42 - factor 2, and 5 to 35 - factor 3). For interpretation, it is considered that resilience can´t be measured, but to verify the tendency of a subject to be more or less resilient and to investigate its potential for resilience and, therefore, the number of individuals remaining in the mean and below the average score. Finally, the fourth stage consisted of correlation analyzes between the general resilience index and the quality of life indexes.


RESULTS AND DISCUSSION

The results found in the score of the first two items of the quality of life scale and their domains are presented in this section. Below are the results on the total resilience score and its factors. Finally, the correlation indexes between the two constructs will be presented.

Quality of Life Indices

The self-perception of the quality of life (WHOQOL-1) of the participants obtained an average of 3.51 (SD = 0.89); and satisfaction with health (WHOQOL-2) obtained an average of 3.15 (SD = 1.05). It is revealed, in this way, that the young Brazilians investigated have a "good" assessment of their quality of life and satisfaction with health.

The Physical Domain presented an average of 61.69 (DP = 17.36), indicating that young Brazilians are "satisfied" with their physical condition. As the Psychological domain presented average 50.97 (DP = 19.54), the Social Relations domain presented mean 54.29 (DP = 19.90), and the Environment domain presented mean 50.62 (DP = 16.84). ), all classified as "satisfied".

The quality of life indicates the importance of considering, in a comprehensive manner, the various aspects existing in the composition of the individual's life, being physical, social, behavioral, emotional and psychological. These factors can influence the quality of life composition process3; 8. It is understood that young Brazilian participants in the sample demonstrate a position of satisfaction in all areas, which show content such as pain and discomfort, activities of daily life, positive feelings, spirituality/religion/personal beliefs, personal relationships, support (support ) social, physical security and protection and environment in the home, among others. What result directly in the satisfaction of their quality of life, ratified by the studies of Libório et al.12.

Resilience Indexes

The Total Resilience score of the young people presented an average of 119.20 (DP = 23.46). It was observed that 2,783 (47.30%) young people presented score below the average and 3,101 (52.70%) presented above the average.

Resilience is the way a person or group behaves in the presence of a problem, and that result in overcoming it1-4. In addition, it reveals individual characteristics, personal and collective experiences and the environment that influence the functioning of the individual in the adverse situation5. In this way, the results of Total Resilience corroborate that individuals have different ways of reacting to adversity, not being a standard behavior.

(Campos et al. Claim that ... life). This data corroborates with the results of the present study that show that the participants consider themselves satisfied with their quality of life and resilience. This phenomenon can be better understood in the research of Campos et al.11, when he states that young people considered satisfied with their lives are more favorable to thinking about a positive perspective in relation to their health and, consequently, obtain more skills to deal with the different situations of life.

Factor 1 - Resolution of actions and values - presented an average of 67.78 (DP = 14.63). It was observed that 2.661 (45.20%) young people were marked below the average and 3.223 (54.80%) were verified above it. Factor 1 deal with an operative subject, energetic and rational in the cycle that surrounds it, in which it acts in a way to solve any problem, in addition to knowing itself and valuing its interpersonal relationships. In this way, it isn´ted that most of the participants deal with the problems in an efficient and active way, looking for decisive means to solve them, in addition to having a present social support, even considering an unfavorable environment for their development, Studies by Hack et al.9

In Factor 2 - Independence and determination, the average presented was 25.57 (DP = 5.88). It was found that 2,820 (47,90%) subjects are below the average and 3,064 (52,10%) are presented above. From that, it is inferred that young people present themselves as capable of giving continuity to the interest in things, which manage to solve conflicts individually and which are persistent. These aspects are fundamental to consider a good resilience index, since even recognizing the need to have a good support network for the healthy development of a young person or adolescent, the ability to transpose difficulties in a self-dependent manner is also considered essential, as well as reported in the research by Rozemberg et al.4

Factor 3 - Self-confidence and ability to adapt to situations, scored 24.03 (DP = 5.49). It was observed that 2,962 (50.30%) subjects present below the mean and 2,922 (49.70%) are above the mean. This result is important because it shows that the individuals analyzed aren´t considered capable enough to solve some problems, they can´t withstand adverse situations at the same time and they don´t perceive themselves as capable of facing challenges.

It is emphasized, however, that only Factor 3 had an index below the average, and the difference between the groups above and below the average was small. This result can evidence the fact that resilience is considered to be something specific and dynamic and that it belongs to the set of variables existing in the daily lives of these young people, as presented in the research by Conzatti and Mosmann6.

The relationship between Quality of Life and Resilience

Through the Pearson correlation coefficient, a positive, moderate and significant correlation was found between Total Resilience and Question 1 (how would you evaluate your quality of life?) (R = 0.381, p <0.01) the Total Resilience Index and Question 2 (how satisfied are you with your health?), in that you obtained a positive, moderate and significant correlation (r = 0.318, p <0.01). It is understood, then, that the higher the total resilience index, the higher the self-perception indexes about quality of life and satisfaction with health (Table 2).




The movement between resilience and quality of life occurs jointly. So, if there is health promotion and quality of life, this will reflect in the reinforcement of the mechanisms that sustain resilience12. According to the results of the research, it is possible to infer that as the youth or adolescent is aware of their good quality of life, this will positively reflect on their ability to face adversity. In addition, this data has a proportional influence on the increase in the understanding of young people about their quality of life and health, as reported by et al.4

Confirming this trend, Haack et al.9, in research on the promotion of resilience in adolescents aged 12 to 15 years of the Vale do Paranhana, in Rio Grande do Sul (RS), point out that the relevant biopsychosocial development is associated with factors resilient, but personal characteristics may make it impossible or provide access to prevention programs to social vulnerability. Similarly, Baraldi et al.10, in a study conducted in Brasilia with students aged 18 to 25 years, showed that this group can present physical and emotional fragilities, characterized by negative feelings and dissatisfaction related to sleep, energy of the day and the opportunity for recreation, compromising their ability to resilience and quality of life.

Regarding the other correlations performed, positive, moderate and significant correlation was verified between Total Resilience and: Physical Domain (r = 0.528, p <0.01), Psychological Domain (r = 0.685, p <0.01), Domain (R = 0.438, p <0.01) and Environmental Domain (r = 0.332, p <0.01). These results suggest that the higher the resilience index, the higher the quality of life indexes cited (Table 1).

That is why the importance of undermining the influence of the biological, social, psychological and environmental dimensions on the link between the quality of life and the resilience of young people is highlighted. This, once it is necessary that the perspective on this process be cross-referenced by the dimensions mentioned above, since the individual must be seen integrally10-11. Therefore, it is observed in the results that the positive, moderate and significant correlation between Total Resilience and the physical, psychological, social and environmental domains corroborates the conception that resilience has an intrinsic connection with these dimensions.


CONCLUSION

It was found that the majority of the sample is presented above the average in relation to the analysis of Total Resilience, as well as being shown above the average in factors 1 (Resolution of actions and values) and 2 (Independence and determination) of resilience. In spite of this, when factor 3 was verified (Self-confidence and ability to adapt to situations), young people and adolescents showed below average. In addition, upon confirming the level of satisfaction with quality of life, this sample is satisfied with the self-perception of quality of life (WHOQOL-1) and with satisfaction with health (WHOQOL-2). In addition, the individuals analyzed are also perceived as satisfied in terms of the psychological domains, social, physical and environmental relationships that encompass the concept of quality of life.

It is emphasized that the results indicated that the higher the total resilience index, the higher the self-perception indexes about the quality of life and satisfaction with health. As well as, the higher the resilience index, the higher the quality of life indexes of said domains. These results corroborate with the other indices that go back to the influence of quality of life on resilience and vice versa.

It can be considered as a limiting aspect of this investigation the fact of having been punctual, not being allowed to do a long-term investigation, longitudinally. However, considering that the level of resilience can change over time due to individual and environmental factors, as well as the perception of quality of life and health, it is recommended that new studies be carried out, as well as new research. for other correlations, with the purpose of investigating possible changes and results referring to the Brazilian population of young people and adolescents.

Therefore, the results of this research may contribute to a better understanding of the influence of resilience on the quality of life in young people and adolescents, in order to encourage new strategies of assistance in work in health, as well as to provide to teaching and research the possibility of building new conceptions on the subject and a greater consolidation about the importance of becoming resilient from a good perception about the quality of life.


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2. Juliano MCC, Yunes MAM. Reflexões sobre rede de apoio social como mecanismo de proteção e promoção de resiliência. Ambiente &Sociedade 2014; 17(3): 135-154.

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4. Rozemberg L, Avanci J, Schenker M, Pires T. Resiliência, gênero e família na adolescência. Ciência&SaúdeColetiva 2014;19(3): 673-684.

5. Miguel MEGB. Resiliência e qualidade de vida em docentes de enfermagem. [tese]. São Paulo: Universidade de São Paulo.

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