Aim: The aim of this study is to explore and describe adolescents' own perceptions of quality of life; what it is and what matters.
Background: Quality of life has become an important concept in evaluating health care, in both child and adult populations. As nurses concerned with quality of life and well-being, it is important for us to identify the main factors that contribute to the promotion and sustenance of young people's well-being.
Design: A qualitative hermeneutic design was chosen.
Method: The method was in-depth interviews with 31 healthy adolescents (14-15 years) in the school health service. The interviews were taped, transcribed and analysed as text according to Kvale's three contexts of interpretation: self-understanding, critical common sense and theory.
Results: According to the adolescents, quality of life is about the positive cycles of life. Feeling good, being satisfied with oneself and having an overall positive attitude are in most cases described as the starting points of a positive cycle. To get into and stay in the positive cycle, a positive self-image, good friends and good family relations are important. Consequently, adolescents' quality of life is threatened when these factors are negative. Friends seem to be the most significant factor. It is extremely difficult to be without friends and none of the adolescents would admit that they were, not even to themselves, although it was rather obvious in some cases. Self-image and popularity are factors associated with the ability to get friends.
Conclusions: Understanding the adolescents' view of quality of life emphasises the importance of focusing on their psychosocial health and in particular their peer relations, to promote and sustain their quality of life.
Relevance to clinical practice: Knowledge about the factors most significant to adolescents' quality of life is applicable to all clinical settings where nurses meet adolescents; i.e., hospitals, outpatient clinics and school health services.