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Console K, Cozzi G, Caiffa G, Romano S, Gortani G, Clarici A, Barbi E, Magni E. School Absenteeism Longer Than Two Weeks Is a Red Flag of Somatic Symptom and Related Disorders in Hospitalised Children and Adolescents: A Matched Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:613. [PMID: 38929193 PMCID: PMC11202215 DOI: 10.3390/children11060613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/16/2024] [Accepted: 05/18/2024] [Indexed: 06/28/2024]
Abstract
Chronic school absenteeism is a common problem in childhood and adolescence, and it is frequently observed in patients with somatic symptom and related disorders (SSRDs). This study aimed to determine whether and to what extent the presence of school absenteeism may be a risk factor for the diagnosis of SSRDs in hospitalised patients. This matched cohort study included children and adolescents aged between 8 and 17 years, admitted to the paediatric ward of the IRCCS Burlo Garofolo in Trieste from 2021 to 2023, who were divided into two groups, the first including children with at least 15 days of absence from school for medical reasons and the second including children with regular school attendance, matched to the former group by age and sex. We consecutively enrolled 70 patients, 35 in the absentee group and 35 in the control group. In the absentee group, 30/35 (85.7%) patients were diagnosed with an SSRD, while in the control group, 1/35 (2.9%) was diagnosed with an SSRD. The absentee group had a 30-fold higher risk of being diagnosed with SSRDs than the control group (RR = 30 [95% CI = 4.3-208]; p < 0.001). This study shows that in hospitalised children, a history of school absenteeism of more than two weeks is an important risk factor for the diagnosis of SSRDs.
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Affiliation(s)
- Karen Console
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy (E.B.)
| | - Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Giada Caiffa
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy (E.B.)
| | - Sara Romano
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy (E.B.)
| | - Giulia Gortani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Andrea Clarici
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy (E.B.)
| | - Egidio Barbi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy (E.B.)
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Elena Magni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy
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Zhang Y, Huang C, Yang M. Family Resilience Progress from the Perspective of Parents of Adolescents with Depression: An Interpretative Phenomenological Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2564. [PMID: 36767927 PMCID: PMC9914939 DOI: 10.3390/ijerph20032564] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
Family resilience plays an important role in the healthy family development of adolescents with depression, but few studies have explored the specific process of family resilience. This study aims to explore the dynamic processes of family resilience from parents of adolescents with depression. Data were collected from 14 Chinese parents of adolescents with depression by interpretative phenomenological analysis method. Four themes and 12 sub-themes emerged: (1) decompensation phase: (i) misinterpretations of illness, (ii) heavy psychological burden, (iii) chaotic rhythms in family; (2) launch phase: (i) potential influences of labeling, (ii) we must cure my child anyway, (iii) begin adjusting to family roles; (3) recovery phase: (i) family reflection, (ii) subsequent reorganization of family resources, (iii) ultimately establishing a new balance; (4) normality phase: (i) adaption for medical seeking process, (ii) actively lower expectations, (iii) concerns of future needs. Mental health professionals could provide targeted suggestions to help the parents achieve family resilience by assessing its different phases.
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Affiliation(s)
- Yinying Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Chongmei Huang
- Xiang Ya Nursing School, Central South University, Changsha 410017, China
| | - Min Yang
- Xiang Ya Nursing School, Central South University, Changsha 410017, China
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Melander K, Kortteisto T, Hermanson E, Kaltiala R, Mäki-Kokkila K, Kaila M, Kosola S. The perceptions of different professionals on school absenteeism and the role of school health care: A focus group study conducted in Finland. PLoS One 2022; 17:e0264259. [PMID: 35226678 PMCID: PMC8884500 DOI: 10.1371/journal.pone.0264259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose of the study School absenteeism and school dropout jeopardize the future health and wellbeing of students. Reports on the participation of school health care in absenteeism reduction are infrequent, although physical and mental health problems are the most common causes of school absenteeism. Our aim was to explore what reasons different professionals working in schools recognize for absenteeism and which factors either promote or inhibit the inclusion of school health care in absenteeism reduction. Materials and methods Data for this qualitative study was gathered from ten focus groups conducted in two municipalities in southern Finland. The groups included (vice) principals, special education/resource/subject teachers, guidance counselors, school social workers, school psychologists, school nurses, school doctors, and social workers working in child protective services. Data analysis was predominantly inductive but the categorization of our results was based on existing literature. Results Study participants identified student-, family-, and school-related reasons for absenteeism but societal reasons went unmentioned. A number of reasons promoting the inclusion of school health care in absenteeism reduction arose, such as expertise in health-related issues and the confidentiality associated with health care. Inclusion of school health care was hindered by differences in work culture and differing perceptions regarding the aims of school health care. Conclusion Professionals working in schools were knowledgeable about the different causes of school absenteeism. Clarifying both the aims of school health care and the work culture of different professionals could facilitate the inclusion of school health care in absenteeism reduction.
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Affiliation(s)
| | | | - Elina Hermanson
- Pikkujätti Medical Center for Children and Youth, Helsinki, Finland
| | | | | | - Minna Kaila
- University of Helsinki /Public Health Medicine, Helsinki, Finland
| | - Silja Kosola
- Pediatric Research Center, New Children’s Hospital, Helsinki University Hospital and University of Helsinki, Finland
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Henzan H, Takeuchi R, Njenga SM, Gregorio ER, Ichinose Y, Nonaka D, Kobayashi J. Factors influencing school re-entry among adolescents in Kenya. Pediatr Int 2022; 64:e14866. [PMID: 34062044 PMCID: PMC9299618 DOI: 10.1111/ped.14866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND The number of out-of-school children and adolescents has been increasing globally. In sub-Saharan Africa, an estimated 23 million adolescents leave school due to poverty, teenage pregnancy, and unspecified illnesses. The reasons for absenteeism are well-known but the factors involved in the decision to return to school have not been analyzed. This study aimed to identify the factors that promote primary school re-entry among chronic adolescent absentees in rural sub-Saharan Africa. METHODS Qualitative data were gathered through participant observation, in-depth interviews, and focus group discussions involving nine pupils who returned to school after chronic absenteeism and 140 adult stakeholders in Mbita sub-county, Kenya. Data were analyzed using thematic analysis. RESULTS The thematic analysis results showed that four factors promoted school re-entry, namely: (1) social norms: "school for a better life"; (2) linkage of community and school; (3) supportive environment; and (4) using discipline to make adolescents serious about their education. CONCLUSIONS School re-entry among chronic absentees in Mbita sub-county is promoted by both community and school factors. It was observed that social norms regarded an education as a "passport to a better life." Adolescents, teachers, and community leaders view education as a means of improving one's socio-economic status. Two essential elements of health-promoting schools, a supportive environment and a linkage with community, effectively promoted returning to the school among adolescents. The introduction of health-promoting schools was recommended to implement a school re-entry policy in Kenya effectively.
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Affiliation(s)
- Hanae Henzan
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Nakagami-gun, Japan
| | - Rie Takeuchi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Nakagami-gun, Japan.,Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki City, Japan.,Japanese Consortium for Global school Health and Research, Nakazu-gun, Japan
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ernesto R Gregorio
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Yoshio Ichinose
- Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki City, Japan
| | - Daisuke Nonaka
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Nakagami-gun, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, Nakagami-gun, Japan.,Japanese Consortium for Global school Health and Research, Nakazu-gun, Japan
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Hoogsteder MHH, Douma LN, Eskens CGA, Berendsen RL, Vanneste YTM, Schaafsma FG. Professionals' and Students' Perceived Needs for an Online Supportive Application for Reducing School Absence and Stimulating Reintegration: Concept Mapping Study. JMIR Form Res 2021; 5:e24659. [PMID: 34152275 PMCID: PMC8277345 DOI: 10.2196/24659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 01/30/2023] Open
Abstract
Background To limit students’ medical absenteeism and premature school dropout in the Netherlands, the Medical Advice for Sick-reported Students (MASS) intervention was developed to enhance collaboration between students, parents, school, and health care professionals. MASS reduces medical absenteeism. However, it does not yet optimally support professionals in monitoring students nor automatically stimulating students’ autonomy regarding their situation. Objective This study aimed to identify professionals’ and students’ perceived need for an online supportive application to monitor and reduce absenteeism and stimulate student autonomy and school reintegration. Methods Concept mapping sessions were held with professionals (n=23) and secondary school students (n=27) in group meetings or online to identify their perspectives and needs. Multidimensional scaling and hierarchical clustering were done with Ariadne 3.0 software. The resulting concept maps were reclustered and interpreted by 4 researchers. Results Three heterogeneous groups of professionals generated 17 clusters (135 unique statements), with a mean importance rating ranging from 2.9 to 4.6 on a Likert scale with scores ranging from 1 to 5. Three heterogeneous groups of secondary school students generated 18 clusters (95 unique statements), with a mean importance rating ranging from 3.2 to 4.6. Professionals considered as most important the following: easily accessible contact with students; supporting, motivating, and rewarding students; monitoring absent students; providing information to students and their parents; exchanging information between professionals. Students considered as most important the following: better teacher-student communication and respect; communication between school professionals on the one hand and parents, other professionals, and students on the other hand; guidance in missed learning materials and tests. Students perceived an online format for support as the obvious option. Conclusions Both professionals and students were positive about an online application to support students in dealing with medical absenteeism, especially considering the need for better and easily accessible contact between students and professionals. An eHealth or mobile health (mHealth) application addressing these aspects could stimulate student autonomy and have positive effects on medical absenteeism.
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Affiliation(s)
- Mariette H H Hoogsteder
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Linda N Douma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,GGD (Public Health Service) Flevoland, Almere, Netherlands
| | | | | | - Yvonne T M Vanneste
- Dutch Knowledge and Innovation Centre Youth and Health (NCJ), Utrecht, Netherlands
| | - Frederieke G Schaafsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (UMC), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Cozzi G, Barbi E. Chronic school absenteeism as a diagnostic clue for paediatricians. J Paediatr Child Health 2020; 56:191-193. [PMID: 31705771 DOI: 10.1111/jpc.14689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 01/12/2023]
Abstract
Chronic school absenteeism is a relatively common problem in childhood and adolescence, and paediatricians should be aware of the causes, implications, and possible consequences of this behaviour. Most children, who consistently miss school, remain at home with the awareness of their parents, reporting some medical causes for their behaviour. Therefore, paediatricians should learn to use chronic school absenteeism as a diagnostic clue, to appropriately address children and adolescents with this behaviour and their families.
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Affiliation(s)
- Giorgio Cozzi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.,University of Trieste, Trieste, Italy
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Maeda T, Oniki K, Miike T. Sleep education in primary school prevents future school refusal behavior. Pediatr Int 2019; 61:1036-1042. [PMID: 31325196 DOI: 10.1111/ped.13976] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/10/2019] [Accepted: 06/03/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sleep disorders, along with extreme difficulty in awakening, are one of the main causes of school refusal. The accumulation of chronic sleep deprivation accompanied by a late-night lifestyle is considered the basic inciting factor. METHODS From 2007, we initiated a sleep education program (Min-Iku) in Fukui, Japan, with the aim of improving pupil lifestyle and preventing future school refusal. All grade 1-6 Miyake-primary school (M-PS) pupils participated in this program and gave their informed consent. The Min-Iku included (i) implementation of a "daily life rhythm survey" by recording the sleep-wake rhythm in a table for 14 days; (ii) evaluation of the sleep table according to the classifications A-D; (iii) interviews of stage D children and their guardians; (iv) lectures on the importance of daily life rhythms for parents and teachers; and (v) 45 min classwork for all participating pupils. RESULTS In 2007, 10% of M-PS graduates developed school refusal behavior after entering Kaminaka junior high school (K-JHS). The incidence of school refusal, however, decreased each year after the implementation of the Min-Iku program and finally reached 0 by 2012. The sleep onset time of pupils improved each year, with the most common sleep time reaching 9:30 p.m. on both weekdays and holidays. With an earlier sleep time, the night-time sleep duration was significantly extended (P < 0.001 vs 2007 data). CONCLUSION The Min-Iku program for primary school pupils successfully achieved a more routine night-time sleep pattern and a regular life rhythm, which prevented school refusal during the subsequent JHS years.
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Affiliation(s)
| | - Kentaro Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruhisa Miike
- Children's Sleep and Development Medical Research Center, Kobe, Hyogo, Japan
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Allison MA, Attisha E, Lerner M, De Pinto CD, Beers NS, Gibson EJ, Gorski P, Kjolhede C, O’Leary SC, Schumacher H, Weiss-Harrison A. The Link Between School Attendance and Good Health. Pediatrics 2019; 143:peds.2018-3648. [PMID: 30835245 DOI: 10.1542/peds.2018-3648] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
More than 6.5 million children in the United States, approximately 13% of all students, miss 15 or more days of school each year. The rates of chronic absenteeism vary between states, communities, and schools, with significant disparities based on income, race, and ethnicity. Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes. Pediatricians and their colleagues caring for children in the medical setting have opportunities at the individual patient and/or family, practice, and population levels to promote school attendance and reduce chronic absenteeism and resulting health disparities. Although this policy statement is primarily focused on absenteeism related to students' physical and mental health, pediatricians may play a role in addressing absenteeism attributable to a wide range of factors through individual interactions with patients and their parents and through community-, state-, and federal-level advocacy.
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Affiliation(s)
- Mandy A. Allison
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado, and Children’s Hospital Colorado, Aurora, Colorado; and
| | - Elliott Attisha
- Detroit Public Schools Community District, Detroit, Michigan
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10
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Kato T, Fujiwara T, Kawachi I. Associations between mothers' active engagement with infants at 6 months and children's adjustment to school life at ages 5.5 and 11 years. Child Care Health Dev 2017; 43:406-414. [PMID: 27991690 DOI: 10.1111/cch.12432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 11/12/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND In Japan, students' poor adjustment to school life such as school refusals has been recognized as a nation-wide problem. In this study, we examined the link between the absence of mothers' active engagement with their infants at 6 months and children's risks of poor adjustment toward elementary school life at the ages of 5.5 and 11. METHODS We used a Japanese national longitudinal survey (n = 43 132) with 11 years of follow-up. Because of social patterning in how mothers engage with their infants, we employed propensity score matching analyses to control for confounding by socio-economic and other factors. We matched mothers with active engagement and those without on various social and parental characteristics such as educational attainment and household income. RESULTS AND CONCLUSIONS Among matched pairs, we observed higher risks of poor adjustment to school life at both 5.5 and 11 years among Japanese children who lacked mothers' active engagement at 6 months. For example, the relative risk was 1.46 [95% confidence interval: 1.10, 1.94] for inability to get along with others in a group setting at the age of 5.5 years and 1.29 [1.10, 1.51] for inability to get along with teachers at the age of 11 years. Our findings corroborate previous findings, which emphasize the importance of providing an enriched environment for infants' social development and may indicate the need for an intervention for caregivers who lack appropriate nurturing skills.
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Affiliation(s)
- T Kato
- The Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - T Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - I Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Vanneste YTM, Mathijssen JJP, van de Goor IAM, Rots-de Vries CMC, Feron FJM. Addressing medical absenteeism in pre-vocational secondary students: effectiveness of a public health intervention, using a quasi-experimental design. BMC Public Health 2016; 16:1107. [PMID: 27769205 PMCID: PMC5073934 DOI: 10.1186/s12889-016-3718-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Students' health and school absenteeism affect educational level, with adverse effects on their future health. This interdependence is reflected in medical absenteeism. In the Netherlands, a public health intervention has been developed to address medical absenteeism in pre-vocational secondary education. This study aims to investigate the effectiveness of this intervention on students' medical absenteeism, compared to "medical absenteeism policy as usual". METHODS A quasi-experimental design with an intervention group (493 students) and a control group (445 students) was applied. Multilevel analysis was used to study differences in the development of the level of a student's medical absence over time (after 3 and 12 months). RESULTS In the intervention group, the level of absenteeism decreased from 8.5 days reported sick in 12 school weeks to 5.7 days after 3 months, and to 4.9 days after 12 months. The number of absence periods fell from 3.9 in 12 school weeks to 2.5 after 3 months, and to 2.2 after 12 months. In the control group, the absence days initially decreased from 9.9 days reported sick in 12 school weeks to 8.4 days after 3 months, after which an increase to 8.9 days was measured. The number of absence periods initially decreased from 4.5 in 12 school weeks to 3.5, after which an increase to 3.7 was measured. The number of absence days per period remained about the same in both groups. CONCLUSIONS The study provides first indications for the intervention to be effective for Dutch pre-vocational secondary students with increased medical absence rates. The intervention, which consists of personalised management of medical absenteeism by systematic identification of students with extensive medical absenteeism and consistent referral to youth health care physicians, appears to reduce the absence rates more effectively than "medical absenteeism policy as usual". The effectiveness of the intervention is shown primarily by a decrease in the number of periods reported sick.
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Affiliation(s)
- Yvonne T M Vanneste
- Regional Public Health Service West Brabant, PO Box 3024, 5003 DA, Tilburg, The Netherlands. .,Faculty of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands. .,Faculty of Health, Medicine and Life Sciences (FHML), CAPHRI, Department of Social Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jolanda J P Mathijssen
- Faculty of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Ien A M van de Goor
- Faculty of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Carin M C Rots-de Vries
- Regional Public Health Service West Brabant, PO Box 3024, 5003 DA, Tilburg, The Netherlands.,Faculty of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Frans J M Feron
- Faculty of Health, Medicine and Life Sciences (FHML), CAPHRI, Department of Social Medicine, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
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Vanneste Y, van de Loo M, Feron F, Rots – de Vries C, van de Goor I. Attitudes towards Addressing Medical Absenteeism of Students: A Qualitative Study among Principals and Special Education Needs Coordinators in Dutch Secondary Schools. PLoS One 2016; 11:e0148427. [PMID: 26845688 PMCID: PMC4742281 DOI: 10.1371/journal.pone.0148427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/18/2016] [Indexed: 11/19/2022] Open
Abstract
Background Reducing school absenteeism benefits the health and educational opportunities of young people. The Dutch intervention Medical Advice for Sick-reported Students (abbreviated as MASS) was developed to address school absenteeism due to sickness reporting, also called medical absenteeism. This study is part of a research project on the effectiveness of MASS and explores factors that influence the implementation and dissemination of the intervention, from schools’ perspectives. The research questions include reasons schools have to implement MASS, their experiences in the implementation of MASS and their views on what is needed to ensure sustainable implementation. Methods A qualitative research method was used. Semi-structured interviews were held with nine principals and eight special education needs coordinators, working in nine secondary schools that apply MASS. Inductive content analysis was carried out. Findings The main reasons for schools to address medical absenteeism were their concerns about students’ well-being and future prospects and their wish to share these concerns with students’ parents. Participants also mentioned the wish to raise the threshold for reporting sick. According to the participants, MASS makes it easier for teachers to enter into conversation with students and their parents about medical absence. MASS prevents damage to the relationship with parents and medical problems being missed. In implementing MASS the main obstacles are teachers’ dialogue about medical absence with students and their parents, teachers’ follow-up of the feedback of the youth health care physicians (YHCPs), and correct registration. The participants were convinced that MASS also improves collaboration with parents regarding the optimization of care for students. Conclusions MASS allows schools to identify students at risk of dropout at an early stage and to optimise guidance of these students. The intervention matches schools’ need to address medical absenteeism by providing a clear framework, an approach from concern rather than control, and socio-medical expertise through the collaboration with YHCPs. MASS can support schools to maximize the number of students graduating and to improve parental involvement in school. These outcomes may help to put the subject of addressing medical absenteeism on the agenda of all schools, and contribute to prioritization, support adoption and secure sustainable implementation and dissemination of MASS.
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Affiliation(s)
- Yvonne Vanneste
- Department of Youth Health Care, Regional Public Health Service West Brabant, Tilburg, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
- School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
- * E-mail:
| | - Marlou van de Loo
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Frans Feron
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Carin Rots – de Vries
- Department of Youth Health Care, Regional Public Health Service West Brabant, Tilburg, The Netherlands
- School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ien van de Goor
- School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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Askeland KG, Haugland S, Stormark KM, Bøe T, Hysing M. Adolescent school absenteeism and service use in a population-based study. BMC Public Health 2015; 15:626. [PMID: 26155938 PMCID: PMC4497412 DOI: 10.1186/s12889-015-1978-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 06/26/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND School absenteeism is linked to a range of health concerns, health risk behaviors and school dropout. It is therefore important to evaluate the extent to which adolescents with absenteeism are in contact with health care and other services. The aim of the current study was to investigate service use of Norwegian adolescents with moderate and high absenteeism in comparison to students with lower rates of absence. METHODS The study employs data from a population-based study from 2012 targeting all pupils in upper secondary education in Hordaland County, Norway (the youth@hordaland-survey). A total of 8988 adolescents between the ages of 16 and 18 were included in the present study. Information on service use was based on adolescent self-report data collected in the youth@hordaland-survey. Absence data was collected using administrative data provided by the Hordaland County Council. RESULTS High absence (defined as being absent 15% or more the past semester) was found among 10.1% of the adolescents. Compared to their peers with low absence (less than 3% absence the past semester), adolescents with high absence were more likely to be in contact with all the services studied, including mental health services (odds ratio (OR) 3.96), adolescent health clinics (OR 2.11) and their general practitioner (GP) (OR 1.94). Frequency of contact was higher among adolescents with moderate and high absence and there seems to be a gradient of service use corresponding to the level of absence. Still, 40% of the adolescents with high absence had not been in contact with any services. CONCLUSIONS Adolescents with high absence had increased use of services, although a group of youth at risk seems to be without such contact. This finding suggests a potential to address school absenteeism through systematic collaboration between schools and health personnel.
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Affiliation(s)
- Kristin Gärtner Askeland
- Norwegian Institute of Public Health, Division of Mental Health, Department of Public Mental Health, Bergen, Norway.
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
| | - Siren Haugland
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
| | - Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.
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