STRUCTURAL EQUATION MODELLING OF PSYCHOSOCIAL FUNCTIONING AND QUALITY OF LIFE OF ADOLESCENTS IN RESOURCE CONSTRAINED SETTING

Abstract

Psychosocial functioning (PSF) is a factor of Quality of life (QoL). The instruments used to assess this latent relationship among adolescents are developed outside Nigeria. Hence, this study examines the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ) and the adapted WHO-QOL BREF (QoL) as an effective, reliable and valid screening instrument in examining the psychosocial functioning (PSF) and quality of life and to describe the latent dimensions that underlie adolescents responses in a resource constrained setting. lt also examined the causal effect of the PSF on the QoL among adolescents with no known health problems in Nigeria. A total of 2,095 secondary school adolescents age 10-19years were administered the Strengths and Difficulties Questionnaire (SDQ) and the adapted WHO-QOL BREF (QoL) to assess their psychosocial functioning and quality of life, most of whom are males (54.8%) and 49.0% of them lives in Urban area. Internal consistency was measured using Cronbach's alpha and Polychoric coefficients. An exploratory factor analyses was performed to extract the underlying factors, confirmatory factor analyses was used to confirm the theoretical and hypothesized factors, and structural equation modelling was used to model the impact of psychosocial functioning on quality of life of healthy adolescents in Nigeria. Analyses were performed at 5% significance level using IBM SPSS statistics version 20, R package and AMOS version 21. The study findings show that Cronbach's alpha deflates the reliability estimates when compared with Polychoric alpha. The theoretical 5-factors SDQ and 4-factors of WHO-QOL BREF were not confirmed. Only items that were meant to assess the Prosocial Scale (PSS) are confirmed for SDQ, the three negatively worded questions on the QoL formed a component. The final hypothesized models yielded a 20-item 3-factors SDQ and 23-item 2- factors QoL that provided the best fit to the observed data. Their relative x2 yielded x2/df<3 = 2.67 and x2 /df < 3 = 2.98 and SFM shows that poor psychosocial functioning of adolescent's results in poor quality of life with x2 /df < 3 = 2.91 while other fit indices were in the acceptable range. The present result however suggest that the domains published and validated in other countries may not be appropriate in a sample of healthy Nigerian adolescents. The components identified and confirmed in this study will provide a better measure of the underlying structure of these instrument in a resource constraint setting.