Quality of Life and School Absenteeism in Children With Chronic Illness

Abstract

Objective Children and adolescents with a chronic illness (CI) tend to demonstrate diminished physical and social functioning, which contribute to school attendance issues. We investigated the role of social and physical functioning in reducing school absenteeism in children participating in Mastering Each New Direction (MEND), a family-based psychosocial intervention for youths with CI. Methods Forty-eight children and adolescents with a CI (70.8% female, Mage = 14.922, SD = 2.143) and their parent(s) completed a health-related quality of life (HRQOL) measure pre- and postintervention. Using multiple mediation, we examined whether parent- and child-rated physical and social HRQOL mediated the relationship between school attendance before and after MEND. Once the mediational model was not supported, we investigated whether HRQOL moderated the relationship between missed school days pre- and postintervention. Results Neither physical nor social functioning mediated or moderated the relationship between missed school days pre- and postintervention. Instead, higher parent-rated physical functioning directly predicted decreased number of missed school days, while lower parent-rated social and child-rated physical functioning predicted increased missed school days. Conclusions Parent-perceived HRQOL may have a direct effect on health-related behaviors such as school attendance. Future research should determine whether gains in parent-rated QOL are maintained in the long term and whether these continue to impact markers of functional well-being.

Prospective Pilot Study of the Mastering Each New Direction Psychosocial Family Systems Program for Pediatric Chronic Illness

“…In other words, did certain CI groups change at a greater or lesser rate? This hypothesis is somewhat born out of other literature which shows a positive relationship between self-concept and HRQL (Armstrong et al, 2011;Emerson et al, 2015). In this case, depression, self-concept, and HRQL are interconnected.…”

“…In other words, placing different CIs adolescents together in peer groups helps the adolescent create a differentiated self, inclusive of but not limited by their disease. This likely helps build the adolescent's self‐efficacy, which has been shown to be a significant factor in later life self‐management and HRQL (Armstrong et al., ; Emerson et al, ). To this end, this study also shows that the MEND approach did increase the adolescent's self‐concept, a similar construct to self‐efficacy.…”

“…It specifically evaluates the overall HRQL of the child in a more global fashion than other measures in this study. This measure was also used in previous MEND studies (Distelberg et al, 2014;Emerson et al, 2015) and has consistently showed positive pre-to post-HRL improvements for the program. We chose to use the parent report of child Physical Functioning (a = .82), Emotional Functioning (a = .77), Social Functioning (a = .79), and School Functioning (a = .73) as it has been shown to have a greater degree of reliability than adolescent self-reports, which tend to minimize psychosocial difficulties (Emerson et al 2015).…”

Chronic school absenteeism as a diagnostic clue for paediatricians

“…In the same way, adverse experiences in childhood, such as the death or incarceration of a parent or financial hardship, familial substance use or neighbourhood violence increase the risk of making it chronic . Thus, in the evaluation of children with chronic school absenteeism, paediatricians should explore the home atmosphere and involve general practitioners to have a complete picture of the entire family behaviours, illnesses, and social conditions . In some cases, we should take into consideration the fact that these individuals may also be victim of an overt maltreatment.…”

Schools and Health: An Essential Partnership for the Effective Care of Children with Chronic Conditions

“…A child's ability to attend and perform well in school is directly related to health, thus children with chronic conditions are at increased risk for educational disadvantage and have lower levels of academic, physical, and social functioning as opposed to their healthy classmates . Furthermore, roughly half of children suffering from chronic conditions are absent from school for lengthy amounts of time, which diminishes their educational outcomes . Likewise, lower educational attainment is strongly associated with elevated health risks and poorer health status into adulthood …”