We had the opportunity to conduct a

We had the opportunity to conduct a quantitative study of the spiritual health of adolescents through our involvement in the cross-national Health Behaviour in School-aged Children study, or HBSC (Freeman et al., 2011). This longstanding study involves researchers in some 43 countries or regions and seeks to understand adolescent health and its contextual determinants. In its most recent bcl-xl inhibitor (2013–2014), a series of spiritual health measures were available to countries as a new optional set of items. We used this opportunity in order to: (1) describe aspects of perceptions of the importance of spiritual health of young people by developmental stage within genders and across the six countries; (2) conduct similar analyses but within four specific domains of spiritual health; (3) relate perceptions of the importance of adolescent spiritual health to self-perceived personal health status. Our intentions were to explore the assessment of spiritual health within a general adolescent health survey context, to evaluate the consistency of suspected developmental and gender-based patterns of adolescent spiritual health experiences inferred from existing theories (Fisher, 2011; Hay & Nye, 1998), and to provide evidence that might inform the eventual planning and targeting of spiritual health interventions applied to adolescents within a diversity of health, educational and home settings.
Methods
Results Table 1 profiles the samples available for study. Some country teams asked the spiritual health items of all HBSC ages, while others limited their questioning to older age groups. The perceptions of young people in terms of how often they viewed each of the eight spiritual health items as “important” are presented in Table 2. Across the six countries, declines in the median proportions of young people reporting such perceptions of importance were observed as children aged. This pattern was observed consistently in both boys and in girls, but less consistently at the country level (N.B., in 3/6 countries; the Czech Republic, Poland, and Scotland, these and subsequent age-related trends were based upon responses from 13 to 15 year-olds, only). Comparisons across the four domains suggest that “connections with others” and “connections with self” were important to strong majorities of young people, irrespective of their age or gender. Similar declines in the perceived importance of the eight spiritual health items were reflected in our multivariable log-binomial regressions, presented here per 2-year age interval (Table 3). The largest declines were observed in the four items describing the last two domains (connections with nature and to the transcendent). There were also some apparent national and perhaps cultural differences in responses observed across the countries under study; for example Israel appeared to be anomalous to the other countries in the last two domains (N.B., endochondral ossification may in part be attributable to its use of only 4 vs. 5 possible response items, which varied from the other 5 countries). Table 4 summarizes results according to the multidimensional spiritual health score, presented here for exploratory purposes only. These findings demonstrate strong and statistically significant declines in the reported perceptions of spiritual health as being “important” as children aged. Similar to the analyses at the item and domain levels, this pattern was observed consistently by gender within all countries, with the exception of girls from Israel. In addition, in every age group and country, girls scored higher on this composite score than did boys. Percentages of young people within each age/gender grouping reporting the importance of spiritual health to be in the “not important” range were small and these values remained relatively consistent by age group. Finally, Fig. 1 shows the proportion of respondents reporting excellent self-perceived health status in relation to their overall multidimensional spiritual health score. Relations were strong and consistent among both boys and girls in each of the six countries. Israel again stood out from all other countries because more young people rated their health as excellent; however, the relationship between the multidimensional spiritual health measure and self-perceived health status was consistent with that observed in other countries.