Bài đọc 1
Bài đọc 1
Bài đọc 1
12404
CONCEPT ANALYSIS
1
University of Colorado College of Nursing,
Aurora, Colorado Abstract
2
Adult Gerontology Clinical Nurse Specialist Aim: The aim of this concept analysis is to report a synthesis of the extant literature
Program, University of Colorado College of
and define emotional wellbeing in youth as a concept of emerging importance.
Nursing, Aurora, Colorado
3
University of Colorado College of Nursing, Background: Emotional wellbeing is a national research priority in the United States.
Aurora, Colorado It is not well defined nor understood in the context of its ontology, mechanisms,
Correspondence biomarkers, or promotion. As a result, interventional research cannot be adequately
Suzanne E. Courtwright, MSN, RN, PNP, informed.
University of Colorado College of Nursing,
Ed2 North, 13120 E. 19th Avenue, Aurora, Design: A comprehensive review of the literature was conducted to inform the
CO 80045. sample.
Email: suzanne.courtwright@cuanschutz.edu
Data Source: The scientific databases PubMed, Cochrane Library, Ovid Medline,
PsycINFO, NCBI, Allied and Complementary Medicine, EMBASE, EBSCO, JAMAevi-
dence, CINAHL, Joanna Briggs Institute, and Reporter were queried.
Review Methods: The Walker and Avant method was utilized to analyze the resultant
sample for common themes of antecedents, attributes, and consequences of
emotional wellbeing.
Results: Seventeen scientific research studies were included in the final sample.
Conclusion: Attributes of emotional wellbeing in youth include overall positive
emotions, positive self‐esteem, and resilience. Antecedents are safe and stable
nurturing relationships; family and social connectedness, hope, and positive body‐
image. The consequences of emotional wellbeing in youth include self‐efficacy, self‐
actualization, the presence of positive health behaviors, and the absence of high‐risk
behaviors.
KEYWORDS
concept analysis, health promotion, pediatric, research, wellness programs
1 | INTRODUCTION youth in the US under age of 17 years face at least one adverse
childhood experience (ACE), such as abuse, maltreatment, violence,
In October 2018, five institutes and centers at the United States (US) and living with chronic disease.2-4 Empirical studies in adults
National Institutes of Health (NIH) named emotional wellbeing (EW) demonstrate a causal relationship between higher levels of emotional
a concept of national importance, a valid population health outcome wellbeing and overall better health, longevity and improved
and a high research priority.1 Anxiety and depressive disorders in morbidity and mortality; as well as decreased risk of disease, illness,
youth worldwide are at an unprecedented high and nearly half of all and injury.5-9 Nevertheless, the fundamental elements of emotional
wellbeing, particularly in youth, and interventions promoting emo- in youth ages 3 to 24 years to better inform strategies that can
10
tional wellbeing across the lifespan, are not yet well understood. improve emotional wellbeing in this population.
Importantly, interventional research to improve emotional wellbeing
in this vulnerable population cannot be adequately informed without
a standardized conceptualization. 3 | METHODS
A conceptual definition accepted by the scientific community is
necessary to establish a body of science to address this emerging priority. The Walker and Avant19 method guided this systematic analysis of
A concept analysis on emotional wellbeing in youth has not been the extant literature. The following steps informed the process: (a) all
published as of the writing of this analysis. It is a concept of significance uses of the concept are described; (b) defining attributes are
to nurses who, by the very nature of our profession, provide healthcare determined; (c) examples of the model and contrary cases are
from a unique disciplinary perspective that encompasses the patient, offered; (d) antecedents and consequences are explained; and (e)
nurse, environment and health in a holistic approach toward disease empirical referents are defined. Most importantly, a standardized
prevention and health promotion.11 Nurse scientists have an opportunity conceptualization and operational definition of emotional wellbeing
to contribute to the body of knowledge of emotional wellbeing from this in youth is established as a product of the synthesized literature and
position and impact public health and health policy. will inform future research on this developing public health outcome.
Identification
PubMed n=285
EMBASE n=99
OVID MEDLINE R (1946-present),
PsycINFO, Medline, CINAHL,
Joanna Briggs, AMED n= 940
Duplicates removed
(n=255)
Screening
Wellbeing n=1
Documents included in
Full-text articles assessed
analysis
for eligibility
(n= 27)
(n= 27)
studies, to lower‐level evidentiary review articles, books, and reports. feeling.”22 Various other definitions are proposed throughout the
Only scientific studies were included in the final sample of 17 studies. scientific literature, and the Centers for Disease Control and
The sample is representative of studies from five continents and Prevention (CDC) reports this lack of consensus as a barrier to
across multiple disciplines including psychology, medicine, sociology, conducting research on this concept so that interventional research
philosophy, and nursing. Half of the studies are qualitative, and all may be better informed.10 The CDC, NIH Emotional Wellness
qualitative studies explored emotional wellbeing in youth living with Toolkit, the NIH Emotional Wellbeing High Priority Research
chronic disease. One‐third of the studies are US based and, of those, Network, and the National Center for Complementary and Integra-
four are published in the last 5 years indicating the emerging topic of tive Health all offer varying definitions of emotional wellbeing (see
priority. Participants’ ages ranged from 3 to 24 years. Table 1 Table 2).
demonstrates the resultant sample. A definition of emotional wellbeing in youth has not yet been
defined as of the writing of this analysis. One is proposed as a result
of the synthesis of the scientific literature. Emotional wellbeing in
4.1 | Definition and uses of the concept youth can operationally be defined as an overall positive state of
The dictionary definition of emotional wellbeing was limited to a emotions, self‐esteem, and resilience that leads to self‐actualization,
definition of wellness without the qualifier of “emotional,” and is self‐efficacy, and health‐promoting behaviors. This definition cap-
defined as “the state of being happy, healthy, or prosperous.” 22 tures the core essence of the concept as described throughout
Emotional was defined with its root word “emotion” as “a state of history.1,10,13,17,18,24-26,30,31,37,38,40
T A B L E 1 Current literature on emotional wellbeing in youth
Age range,
Author(s)/date Country Title y Methods Antecedents Attributes Consequences Funding
COURTWRIGHT
Amato and Keith26 US Parental divorce and the Preschool‐ Meta‐analysis of 92 Family connectedness Resilience Self‐ University of Nebraska—
wellbeing of children: a college quantitative studies Self‐esteem actualization Lincoln Research Council
ET AL.
(Continues)
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
110
TABLE 1 (Continued)
|
Age range,
Author(s)/date Country Title y Methods Antecedents Attributes Consequences Funding
31
Feller et al. US Emotional well‐being and 18‐24 Review + Self‐esteem Rapid Research Advances for
public health: proposal Progress in Disparities
for a model initiative. Mental Health Award from
the CA State Behavioral
Center of Excellence; UCLA
Clinical Translational
Science Institute
Giannakopoulos Greece Adolescents’ wellbeing 11‐18 Quantitative Social connectedness + Self‐ Self‐efficacy
et al.32 and functioning: exploratory Family connectedness esteem + emotions Self‐
relationships with descriptive and actualization
parents’ subjective multivariate
general physical and analysis
mental health.
Glozah33 UK Exploring Ghanaian Average Qualitative Social + Self‐esteem Self‐efficacy
adolescents’ meaning of age 16.8 Interpretive connectedness + body‐ Absence of high‐
health and wellbeing: a phenomenology image risk behaviors
psychosocial Family connectedness
perspective
Herrmann et al.34 Germany Factors associated with 3‐12 Quantitative Family connectedness
the emotional health of
children: high family
income as a protective
factor
Kirk35 UK How children and young 8‐19 Qualitative grounded Social Self‐ Department of Health/
people construct and theory connectedness + body‐ actualization Health Foundation Primary
negotiate living with image Care Post‐doctoral
medical technology. Fellowship
Lynch36 New A qualitative study of 16‐21 Qualitative Hope
Zealand youth living with Crohn interpretive
disease phenomenology
McCaffrey37 Australia Major stressors and their 5‐15 Qualitative Social + Self‐esteem
effects on the well‐being interpretive connectedness + body‐
of children with cancer. phenomenology image
Mutumba et al Uganda Psychosocial challenges 12‐19 Qualitative Social connectedness University of Michigan
(2015) and strategies for coping interpretive
with HIV among phenomenology
adolescents in Uganda: a
qualitative study.
(Continues)
COURTWRIGHT
ET AL.
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
COURTWRIGHT ET AL. | 111
Columbia
Funding
Self‐efficacy adult literature and the pediatric and adolescent literature describe
positive emotions as a central attribute to emotional wellbeing.
Positive emotions refer to the expression of feelings of happiness,
optimism, and general satisfaction with oneʼs life, the majority of
the time as opposed to the expression of negative emotions the
majority of the time, such as worry, fear, anger, and overall
dissatisfaction.1,5,7,10,13,14,17,38,41
+ Emotions
Attributes
Hope
Abbreviations: RCT, randomized controlled trial; SSNR, safe and stable nurturing relationship.
Quantitative
Quantitative
descriptive
descriptive
and “being happy with who you are.”29 Another study demonstrated
Methods
13‐17
emotionally well.
y
challenges of parents
and their children in
4.5 | Resilience
The effects of a
competence.
conditions.
T A B L E 2 Definitions of emotional wellbeing in the current scientific literature; all refer to the general population; none exist for youth
Definition Source
“There is no universally accepted “definition” of mental wellbeing. Promotion of Mental Well‐being, World Health Organization23
Mental wellbeing includes cognitive, emotional and behavioral
responses”
“Overall positive state of oneʼs emotions, life satisfaction, sense of Emotional Wellbeing High Priority Research Network, Sabri, and
meaning and purpose, and ability to pursue self‐defined goals.” Clark,1 (p. 1); and The National Center for Complementary and
Integrative Health24
“The ability to successfully handle lifeʼs stresses and adapt to change and National Institutes of Health Educational Wellness Toolkit,25 (p. 1)
difficult times.”
“There is no consensus around a single definition of wellbeing, but there Centers for Disease Control and Prevention10
is general agreement that at minimum, wellbeing includes the presence
of positive emotions and moods (eg, contentment, happiness), the
absence of negative emotions (eg, depression, anxiety), satisfaction
with life, fulfillment and positive functioning.”
4.11 | Self‐efficacy
4.8 | Hope
The directional relationship between self‐esteem and self‐efficacy is
50
Several researchers, including Seligmanʼs seminal work on positive described in the literature. In two examples, researchers describe
psychology, established hope as an essential protective factor and self‐efficacy as encompassing high self‐esteem and positive beliefs
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
COURTWRIGHT ET AL. | 113
about the ability to change a situation and succeed29,54 (p. 28). expresses genuine happiness when her friends come to visit (SSNRs:
Researchers measure self‐efficacy as a marker of emotional well- social connectedness, positive emotions). Even though she shares her
being in youth.30 A consequence of emotional regression is parental extreme disappointment in missing the dance she worked so hard for,
dependence, suggesting the opposite of emotional wellbeing.37 she expresses to you that she has learned from previous asthma
attacks that melting down emotionally worsens her symptoms, and
she is focused on remaining calm to not exacerbate her symptoms
4.12 | Self‐actualization
(resilience). She expresses gratitude (positive emotions) for not being
Self‐actualization is described in the literature as visualizing and admitted to the intensive care unit, as in her last hospitalization. She
striving to achieve oneʼs potential.2,26,30,33 In his seminal work, attributes her lesser severity of the illness to valuing her own health,
55
Erikson concluded that adolescents, developmentally, are chal- believing that her actions can impact her asthma outcomes,
lenged with establishing an identity independent from parents and monitoring her symptoms, and taking her medications regularly
caregivers, and school‐aged children are challenged to establish a now (positive self‐esteem, self‐efficacy, presence of health promotion
sense of competence in what is commonly known as industry versus behaviors, and self‐actualization). Although Jasmine has arguments
inferiority. Teens who experience emotional wellbeing have been with her girlfriends at times and wishes she was 10 pounds lighter,
demonstrated to have hopes and dreams for career aspirations, and she indicates she is overall happy with her body and these concerns
demonstrate the beginnings of self‐actualization.30,33 Children in the do not keep her from sleeping or engaging in behaviors that are
National Survey of Childrenʼs Health described as flourishing harmful, such as purging (positive body‐image, absence of high‐risk
demonstrated the ability to make a plan and follow through with it, behaviors). She denies any drug use, unprotected sex, or suicidal
thereby exhibiting self‐actualization and emotional wellbeing.2 These ideation (absence of high‐risk behaviors). She offers that she
consequences have important implications for population health as considers her aunts, uncles, teachers, and coach to be close safe
this population grows into adults. and stable adults with who she can talk with about her concerns
(SSNRs: family connectedness). Jasmine is an honors student and
hopes to achieve a scholarship to college so she can move her mom
4.13 | Presence of health promotion behaviors and
and siblings to a safer home than one she grew up in (hope, self‐
absence of high‐risk behaviors
actualization).
Youth not having achieved self‐efficacy and emotional wellbeing have Jasmine meets the criteria for being a child at risk; however, she
been described as having higher levels of risky behaviors such as also describes many protective factors that serve as antecedents for
alcohol and substance use and risky sexual activity.30 Children with emotional wellbeings, such as family and social connectedness, hope,
chronic illness not having achieved self‐efficacy and emotional and positive body image. You assess that she exhibits the attributes
wellbeing may regress behaviorally, such as not being able to be of emotional wellbeings, such as resilience, positive self‐esteem, and
37
alone or sleep alone, thumb sucking and needing a security blanket. overall positive emotions; and the consequences of her emotional
Youth with high levels of self‐esteem, resilience, self‐efficacy, and wellbeing, such as self‐efficacy, self‐actualization, absence of high‐
emotional wellbeing demonstrate a determination to overcome risk behaviors, and presence of health promotion. This model case
challenges in the face of adversity and attain personal demonstrates an adolescent at risk who is exhibiting emotional
goals.29,30,33,37,39,40 wellbeing as a result of protective factors serving as antecedents, and
who is also reaping the benefits or consequences of emotional well‐
being.
4.14 | Diagram
A diagram of the antecedents, attributes, and consequences of the
4.16 | Contrary case
concept of emotional wellbeing in youth is provided in Figure 2.
The following scenario provides a contrary case of youth exhibiting
emotional wellbeing. Jasmine is a 16‐year‐old female with chronic
4.15 | Model case
persistent asthma (ACE) admitted to your unit and upon history, you
Jasmine is a 16‐year‐old adolescent who has witnessed interpersonal identify that she has witnessed interpersonal violence for many years
violence (ACE) at home for many years. She lost her brother to gang and her father is not in her life due to a restraining order (ACE). She
violence and her father is restrained from her home due to domestic has lost her brother to gang violence (ACE). Jasmineʼs family history
violence. She lives in a low socioeconomic neighborhood in a single‐ reveals that she moved to this city recently and has no family in the
family home with many cousins, aunts, and uncles close by, who she area (potential for lack of SSNR: family connectedness). She is having
describes as a very close‐knit family (SSNR: family connectedness). difficulty making friends in her school (potential for lack of SSNR:
Jasmine has chronic persistent asthma (ACE) and has been social connectedness). She admits that she feels overweight (altered
hospitalized several times. She is currently your patient on the body‐image) and does not feel worthy to join the popular girls on the
inpatient unit. During your history and physical, she expresses dance troop (altered self‐esteem). She expresses missing her old
sadness that she is missing her most recent dance recital but school terribly and tells you she feels hopeless in ever finding friends
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
114 | COURTWRIGHT ET AL.
F I G U R E 2 Conceptual model of
emotional wellbeing in youth
or happiness in this new city (absence of hope). She admits to feeling The KIDSCREEN 52, a health‐related quality of life questionnaire
depressed and having suicidal ideation. She wants to go back home for children and adolescents, measured the most elements with ten
and admits to not taking her asthma medications because she does dimensions as follows: physical wellbeing, psychological wellbeing,
not feel life is worth living. moods and emotions, self‐perception and autonomy, parent relation
This contrary case demonstrates an adolescent at high‐risk, and home life, financial resources, peer and social support, school
having experienced two ACEs without protective factors as environment, and bullying.56 Developed and tested in 13 European
antecedents to emotional wellbeings, such as a strong sense of countries, it was found to have acceptable levels of reliability and
family and social connectedness, a positive self‐image and hope for validity. Internal consistency of the dimensions screened was tested
her future. As such, Jasmine is not exhibiting the attributes of using Cronbachʼs α where coefficients above 0.7 were considered
emotional wellbeing, such as resilience, positive self‐esteem, or acceptable, and results ranged from 0.77 to 0.89. Because the toolʼs
positive emotions nor she is enjoying the consequences of emotional limitation is the population on which it was developed, convergent
wellbeings, such as self‐actualization, self‐efficacy, the absence of validity was determined using Pearson correlation coefficients to
high‐risk behaviors, and the presence of health‐promoting behaviors. compare the tool to other common assessments used to measure the
pediatric quality of life. Correlation coefficients were moderate
ranging between 0.3 and 0.5 when comparing the KIDSCREEN 52
4.17 | Empirical referents and the Pediatric Quality of Life Inventory, the Child Health and
Empirical referents can help facilitate the identification of a concept Illness Profile‐Adolescent Edition, and Youth Quality of Life Instru-
occurring, by measuring associated phenomena. 19
Across studies, ment Scales with statistical significance at P < .01.56 The latter scales
mostly qualitative methods informed the conceptualization of mentioned assess similar constructs; however, do not assess for
emotional wellbeing in youth. Less than half used quantitative positive emotions which is an attribute of emotional wellbeing.
methods, and of those, researchers used a wide variety of Although not aimed specifically to screen for emotional wellbeing,
instruments, such as the New General Self‐Efficacy Scale, the the KIDSCREEN‐52 assesses all the antecedents necessary for
Strengths and Difficulties Questionnaire, the Positive and Negative emotional wellbeing. Further study with this tool is indicated to
Affect Scale, the Minnesota Adolescent Health Survey, and the determine reliability and validity as related to emotional wellbeing.
KIDSCREEN 52 Instrument. 30,32,34,38,40
Not one instrument in the The authors of the study indicate that additional research is needed
sample comprehensively measures all the attributes of emotional to assess longitudinal validity.56
wellbeing in youth as defined by this analysis, highlighting the need Importantly, researchers recently proposed an item bank for
for conceptual standardization and further instrument development inclusion in the NIH patient‐reported outcomes measurement
for this important concept. information system (PROMIS) to measure childrenʼs eudaimonic
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
COURTWRIGHT ET AL. | 115
wellbeing as part of a trio measuring pediatric subjective wellbeing esteem, as well as the strong correlation between SSNRs and
57
(SWB) (p. 212). While determining items for inclusion, the authors resilience—a critical element to emotional wellbeing in
acknowledge adapting concepts from the adult literature “starting youth.18,26-29,32,33,35,37,39,40
with a systematic review of candidate item concepts and extant Importantly, the results of this synthesis of the scientific
instruments for measuring SWB,”57 (p. 216). Ultimately, the concepts literature and concept analysis, particularly the small resultant
chosen for the pediatric SWB item banks are exactly the same used sample size and dates of publication, reflect the call for more
to measure adult psychological wellbeing, ie, (a) life satisfaction, (b) research on this emerging topic for youth across the globe. An
positive affect and (c) meaning/purpose.58 The authors acknowledge: operational definition is proposed and future theoretical and
empirical research may be better informed. Notably, this definition
“There has been very little attention given to the distinguishes the concept of EW in youth from the many definitions
developmental origins of SWB, whether these concepts that currently exist for the general population as a whole.
are relevant to children’s life experiences, health and The Academic Pediatric Association and many pediatric providers
coping with the disease and how to best measure SWB in are calling for a paradigm shift from a medical model of healthcare
pediatric populations”57 (p. 208). delivery to one embracing emotional wellbeing for youth.31 The
results of this study reflect the critical nature of the need to further
The 10 international content experts consulted in the study develop this area of science.
knowledge generation. This analysis provides clear implications 8. Kok BE, Coffey KA, Cohn MA. How positive emotions build physical
toward that end; however, opposing views may consider this health: perceived positive social connections account for the upward
spiral between positive emotions and vagal tone. Psychol Sci.
method as a limitation of this study for that reason. Another
2013;24(7):1123‐1132.
critique of the methodology is the lack of equation to absolute 9. Ong DA. Pathways linking positive emotion and health in later life.
truth in a reductionist approach. The approach used for this Current Directions Psychol Sci. 2010;19(6):358‐362.
analysis does not subscribe to the inflexibility of the positivistic 10. Centers for Disease Control and Prevention. Well‐being concepts.
2018. https://www.cdc.gov/hrqol/wellbeing.htm#three. Accessed
worldview, and therefore this analysis may be viewed as limited for
February 1, 2019.
that reason. Another limitation to this analysis is the relatively 11. Fawcett J. The metaparadigm of nursing: present status and future
small sample size from which to gain consensus on the concept refinements. J Nurs Scholarsh. 1984;16(3):84‐87.
elements. This finding was expected given the call for this concept 12. National Prevention Council. Mental and emotional wellbeing. 2014.
https://www.surgeongeneral.gov/priorities/prevention/strategy/
as a national research priority, yet remains a limitation for
mental‐emotional‐well‐being.pdf. Accessed February 12, 2019.
generalizability. 13. Amadio J, Kenny A. Aristotle. 2019. Encyclopaedia Britannica:
https://www.britannica.com/biography/Aristotle/Philosophy‐of‐
mind#ref254722. Accessed February 12, 2019.
8 | CONC LU SION 14. Rackham H. Aristotle: The Athenian Constitution, The Eudemian Ethics
on Virtues and Vices with an English Translation. Cambridge, MA:
Harvard University Press; 1935.
This concept analysis provides the foundational step to inform the 15. Robinson D. Aristotleʼs Psychology. New York, NY: Columbia Uni-
generation of new knowledge and strategies to enhance emotional versity Press; 1989.
wellbeing in youth. Future research can now be conducted with a 16. Bobonich C. Socrates and Eudaimonia. Cambridge: Cambridge Uni-
versity Press; 2010.
clear definition and standardized conceptualization, generated from
17. Bradburn NM. The Structure of Psychological Wellbeing. Chicago, CHI:
rigorous scientific methods. This study offers a common language for Aldine Publishing Company; 1969.
scientists and clinicians to launch from to further develop and test 18. Bethell CD, Solloway MR, Guinosso S, et al. Prioritizing possibilities
screening tools assessing antecedents of emotional wellbeing in for child and family health: an agenda to address adverse childhood
experiences and foster the social and emotional roots of wellbeing in
youth. Innovating novel interventions to promote safe and stable
pediatrics. Academic Pediatrics. 2017;17(7S):S36‐S50.
nurturing relationships, hope, and positive body image in youth with 19. Walker LO, Avant KC. Strategies for Theory Construction in Nursing. 6th
individualized precision will help youth realize the beneficial ed. Boston: Pearson Prentice Hall; 2019.
consequences of emotional wellbeing. 20. National Child Health Survey. Data query from the child and adolescent
health measurement initiative. 2017. Data Resour Cent Child Adolesc
Health. www.childhealthdata.org. Accessed February 18, 2019.
OR CID 21. United Nations. World youth report. 2018. http://www.un.org/
development/desa/youth/world‐youth‐report‐wyr2018.html. Accessed
Suzanne E. Courtwright http://orcid.org/0000-0003-2911-360X July 22, 2019.
22. Merriam‐Webster. Well‐being. 2019. Merriam‐Webster: https://
www.merriam‐webster.com/dictionary/well‐being. Accessed Febru-
REFERENC ES ary 12, 2019.
23. World Health Organization. Promotion of mental wellbeing. 2019.
1. Sabri M, Clark D. Emotional well‐being: high priority research http://www.searo.who.int/entity/mental_health/promotion‐of‐
networks. 2018. https://nccih.nih.gov/grants/concepts/consider/ mental‐well‐being/en/. Accessed July 28, 2019.
Emotional‐Well‐Being‐High‐Priority‐Research‐Networks. Accessed 24. National Center for Complementary and Integrative Health. Emo-
February 12, 2019. tional Wellbeing: Emerging Insights and Questions for Future Research.
2. National Survey of Childrenʼs Health. Data query from the child and Bethesda, MD: National Institutes of Health; 2018.
adolescent health measurement initiative. 2012. www. 25. National Institutes of Health. National institutes of health emotional
childhealthdata.org. Accessed February 18, 2019. wellness toolkits. 2018. https://www.nih.gov/sites/default/files/health‐
3. Polanxczyk GV, Salem GA, Sugaya LS, Caye A, Rohde LA. Annual info/wellness‐toolkits/emotional‐wellness‐checklist.pdf. Accessed Feb-
research review: a meta‐analysis of the worldwide prevalence of ruary 13, 2019.
mental disorders in children and adolescents. J Child Psychol Psychiatr. 26. Amato PR, Keith B. Parental divorce and the wellbeing of children: a
2015;56(3):345‐365. meta‐analysis. Psychol Bull. 1991;110(1):26‐46.
4. Centers for Injury Prevention and Control (2017). 10 leading causes 27. Berntsson L, Berg M, Brydolf M, Hellstrom AL. Adolescents’
of death by age group, United States—2017. In: National Center for experiences of well‐being when living with a long‐term illness or
Injury Prevention and Control, CDC. disability. Scand J Caring Sci. 2007;21:419‐425.
5. Chida Y, Steptoe A. Positive psychological well‐being and mortality: a 28. Bluth K, Roberson PN, Girdler SG. Adolescent sex differenes in
quantitative review of prospective observational studies. Psychosom response to a mindfullness intervention: a call for research. J Child
Med. 2008;70(7):741‐756. Fam Stud. 2017;26:1900‐1914.
6. Cohen R, Bavishi C, Rozanski A. Purpose in life and its relationship to 29. Coverdale GE, Long AF. Emotional well‐being and mental health: an
all‐cause mortality and cardioavascular events: a meta‐analysis. exploration into health promotion in young people and families.
Psychosom Med. 2016;78(2):122‐133. Perspect Public Health. 2015;135(1):27‐36.
7. Diener E, Chan MY. Happy people live longer: subjective well‐being 30. Dudovitz RN, Chung PJ, Nelson BB, Wong MD. What do you want to
contributes to health and longevity. Appl Psychol Health Wellbeing. be when you grow up? career aspirations as a marker for adolescent
2011;3(1):1‐43. wellbeing. Academic Pediatrics. 2017;17(2):153‐160.
17446198, 2020, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/nuf.12404 by Victoria University Of Welling, Wiley Online Library on [03/10/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
COURTWRIGHT ET AL. | 117
31. Feller SC, Castillo EG, Greenberg JM, Abascal P, Van Horn R, Wells 52. Choi I, Choi E. The associations between body dissatisfaction, body
KB, University of California, Los Angeles Community Translational figure, self‐esteem, and depressed mood in adolescents in the United
Science Team. Emotional wellbeing and public health: proposal for a States and Korea: a moderated mediation analysis. J Adolesc.
model national initiative. Public Health Rep. 2018;133(2):136‐141. 2016;53:249‐259.
32. Giannakopoulos G, Dimitrakaki C, Pedeli X, et al. Adolescents’ 53. Duchesne AP. Body dissatisfaction and psychological distress in
wellbeing and functioning: relationships with parents’ subjective adolescents: is self‐esteem a mediator? J Health Psychol. 2016;
general physical and mental health. Health and Quality Outcomes. 22(12):1563‐1569.
2009;7:100‐109. 54. Adi Y, Kiloran A, Janmohamed K, Stewart‐Brown S. Systematic
33. Glozah FN. Exploring Ghanaian adolescents’ meaning of health and review of the effectiveness of interventions to promote mental
wellbeing: a psychological perspective. Int J Qual Stud Health Well‐ wellbeing in primary schools. Report 1: universal approaches which
Being. 2015;10:263‐270. do not focus on violence or bullying. Warwick: University of Warwick;
34. Herrmann J, Vogel M, Pietzner D, et al. Factors associated with 2007.
emotional health of children: high family income as a protective 55. Erikson EH. Childhood and Society. New York, NY: Norton & Company;
factor. Eur Child Adolesc Psychiatry. 2018;27:319‐328. 1963.
35. Kirk S. How children and young people construct and negotiate living 56. Ravens‐Sieberer U, Gosch A, Rajmil L, et al. The KIDSCREEN‐52
with medical technology. Soc Sci Med. 2010;71:1796‐1803. quality of life measure for children adn adolescents: psychometric
36. Lynch T, Spense D. A qualitative study of youth living with Crohn results from a cross‐cultural survey in 13 European countries. Value
disease. Gastroenterol Nurs. 2007;31(3):224‐230. Health. 2008;11(4):645‐657.
37. McCaffrey CN. Major stressors and their effects on the wellbeing of 57. Forrest CB, Bevans KB, Filus A, et al. Assessing childrenʼs eudaimonic
children with cancer. J Pediatr Nurs. 2006;21(1):59‐66. wellbeing: the PROMIS pediatric meaning and purpose item banks. J
38. Schonert‐Reichl KA. The effects of a mindfulness‐based education Pediatr Psychol. 2019;44(9):1074‐1082. https://doi.org/10.1093/
program on pre‐and early adolescentsʼ wellbeing and social and jpepsy/jsz046
emotional competence. Mindfulness. 2010;1(3):137‐151. 58. Health Measures. Emotion measures. 2019. http://www.
39. Wo SW, Ong LC, Low WY, Lai PS. Exploring the needs and challenges healthmeasures.net/explore‐measurement‐systems/nih‐toolbox/
of parents and their children in childhood epilepsy care: a qualitative intro‐to‐nih‐toolbox/emotion. Accessed July 27, 2019.
study. Epilepsy & Behavior. 2018;88:268‐275.
40. Wolman C, Resnick MD, Harris LJ, Blum RW. Emotional wellbeing
AU TH OR B IO GRA P H IES
among adolescents with and without chronic conditions. J Adolesc
Health. 1994;15:199‐204.
41. National Survey of Child Health. Emotional and mental health. 2012.
Suzanne Courtwright, MSN, RN, PNP, is a nurse leader at a top
http://www.childhealthdata.org/browse/survey/results?q=2480&r=1.
Accessed February 18, 2019. academic children's hospital and PhD student at the University of
42. Centers for Disease Control and Prevention. Essentials for childhood: Colorado College of Nursing in the health systems track. Her
steps to create safe, stable, and nurturing relationships and environ- research interests include children's wellbeing and health
ments for all children. 2014. https://www.cdc.gov/violenceprevention/
systems research.
pdf/essentials_for_childhood_framework.pdf. Accessed February 12,
2019. Mary Beth Flynn Makic, PhD, RN, CCNS, CCRN‐K, FAAN, FANP,
43. Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relation-
CNS, is a professor and specialty director of the Clinical Nurse
ships as a moderator of intergenerational continuity of child
maltreatment: a meta‐analysis. J Adolesc Health. 2013;53(4):S32‐S38. Specialist Program at University of Colorado College of Nursing,
44. Yeung DY, Ho SM, Mak CW. Brief report: attention to positive Aurora. Makic is also a research scientist at a level I trauma
information mediates the relationship between hope and psycholo- center. Her practice and research focus on improving patient
gical well‐being of adolescents. J Adolesc. 2015;42:98‐102.
outcomes through the translation of evidence‐based practice
45. Morris AS, Robinson LR, Hays Grudo J, Claussen AH, Hartwig SA,
Treat AE. Targeting parenting in early childhood: a public health (EBP) in the critical care environment.
approach toimprove outcomes for children living in poverty. Child-
Jacqueline Jones, PhD, RN, FAAN, is a Professor of Nursing at
hood Development. 2017;88:388‐397.
46. National Academies of Sciences, Engineering and Medicine. Parenting the University of Colorado College of Nursing. Her major
Matters: Supporting Parents of Children Ages 0‐8. Washington DC: The research interests are health and wellbeing of older adults and
National Academies Press; 2016. development of person‐centered systems. She is an expert in
47. Taub JF, Boynton‐Jarrett F. Modifiable resilience factors to childhood
qualitative and mixed methods research for over 20 years.
adversity for clincial pediatric practice. Pediatrics. 2017;139:
e20162569.
48. Biglan A, Van Ryzin MJ, Hawkins D. Evolving a more nurturing
society to prevent adverse childhood experiences. Academic Pedia-
trics. 2017;17:S150‐S157.
49. Earvolino‐Ramirez M. Resilience: A concept analysis. Nurs Forum. How to cite this article: Courtwright SE, Makic MBF, Jones J.
2007;42(2):73‐82.
Emotional wellbeing in youth: A concept analysis. Nurs Forum.
50. Seligman PM. Learned Optimism. New York, NY: Pocket Books; 1990.
2020;55:106–117. https://doi.org/10.1111/nuf.12404
51. Kumpfer KL. Factors and Processes Contributing to Resilience: the
Resilience Framework. New York, NY: Kluwer Academic/Plenum; 1999.