Abstract
This study intends to analyze the influence that the health condition (with/without chronic condition (CC) and CC that affect/does not affect the school participation), the factors related to the school context (liking school, perception of school success, difficulties at school, relationship with peers and teachers) and the physical and psychological symptoms exert on the adolescents’ quality of life (QoL). This work is part of the HBSC 2018 study and relies on the participation of 8215 students (52,6% female), aged between 10 and 22 years old (M=14.36 and SD=2.28). The results show that the adolescents with CC have more physical and psychological symptoms and a lower perception of QoL. Having a CC that does not affect school participation is associated with a better QoL. The students with CC that affect school participation like school less than the students with CC that does not affect school participation, perceive a lower academic success and a lower QoL, have more difficulties at school and present more physical and psychological symptoms. Liking school, having a better relationship with teachers and peers, a higher perception of school success, fewer difficulties at school and fewer physical and psychological symptoms is associated with a better QoL. These results underline the importance of school participation regarding the adolescents’ well-being and QoL. More than having a CC, what causes a greater impact on the adolescents’ QoL is the fact that this condition affects the school participation which reinforces the importance of promoting and ensuring the school participation of the students with CC.
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Allen, C. W., Diamond-Myrsten, S., & Rollins, L. K. (2018). School absenteeism in children and adolescents. American family physician, 98(12), 738–744.
Anaby, D., Hand, C., Bradley, L., DiRezze, B., Forhan, M., DiGiacomo, A., & Law, M. (2013). The effect of the environment on participation of children and youth with disabilities: a scoping review. Disability and rehabilitation, 35(19), 1589–1598. https://doi.org/10.3109/09638288.2012.748840
Bai, G., Herten, M. H. V., Landgraf, J. M., Korfage, I. J., & Raat, H. (2017). Childhood chronic conditions and health-related quality of life: Findings from a large population-based study. PloS one, 12(6), e0178539. https://doi.org/10.1371/journal.pone.0178539
Barry, M. M. (2019). Concepts and principles of mental health promotion. In M. M. Barry, A. M. Clarke, I. Peterson & Rachel Jenkins (Eds.), Implementing mental health promotion (2nd ed.) (pp. 3-34). Springer Nature.
Bell, M. F., Bayliss, D. M., Glauert, R., Harrison, A., & Ohan, J. L. (2016). Chronic illness and developmental vulnerability at school entry. Pediatrics, 137(5). https://doi.org/10.1542/peds.2015-2475
Bethell, C., Forrest, C. B., Stumbo, S., Gombojav, N., Carle, A., & Irwin, C. E. (2012). Factors promoting or potentially impeding school success: disparities and state variations for children with special health care needs. Maternal and Child Health Journal, 16(1), 35–43. https://doi.org/10.1007/s10995-012-0993-z
Bonell, C., Parry, W., Wells, H., Jamal, F., Fletcher, A., Harden, A., Thomas, J., Campbell, R., Petticrew, M., Murphy, S., Whitehead, M., & Moore, L. (2013). The effects of the school environment on student health: a systematic review of multi-level studies. Health & Place, 21, 180–191. https://doi.org/10.1016/j.healthplace.2012.12.001
Butler, A., Van Lieshout, R. J., Lipman, E. L., MacMillan, H. L., Gonzalez, A., Gorter, J. W., Georgiades, K., Speechley, K. N., Boyle, M. H., & Ferro, M. A. (2018). Mental disorder in children with physical conditions: a pilot study. BMJ open, 8(1), e019011. https://doi.org/10.1136/bmjopen-2017-019011
Casas, F., & González, M. (2017). School: One world or two worlds? Children's perspectives. Children and Youth Services Review, 80, 157–170. https://doi.org/10.1016/j.childyouth.2017.06.054
Casas, F., Bălţătescu, S., Bertran, I., González, M., & Hatos, A. (2013). School satisfaction among adolescents: Testing different indicators for its measurement and its relationship with overall life satisfaction and subjective well-being in Romania and Spain. Social Indicators Research, 111(3), 665–681. https://doi.org/10.1007/s11205-012-0025-9
Casier, A., Goubert, L., Gebhardt, W. A., Baets, F. D., Aken, S. V., Matthys, D., & Crombez, G. (2013). Acceptance, well-being and goals in adolescents with chronic illness: a daily process analysis. Psychology & Health, 28(11), 1337–1351. https://doi.org/10.1080/08870446.2013.809083
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Lawrence Erlbaum Associates.
Conversano, C. (2019). Common psychological factors in chronic diseases. Frontiers in Psychology, 10(2727). https://doi.org/10.3389/fpsyg.2019.02727
Dahl, R. E., Allen, N. B., Wilbrecht, L., & Suleiman, A. B. (2018). Importance of investing in adolescence from a developmental science perspective. Nature, 554(7693), 441–450. https://doi.org/10.1038/nature25770
Emerson, N. D., Distelberg, B., Morrell, H. E., Williams-Reade, J., Tapanes, D., & Montgomery, S. (2016). Quality of life and school absenteeism in children with chronic illness. The Journal of School Nursing, 32(4), 258–266. https://doi.org/10.1177/1059840515615401
Forgeron, P. A., King, S., Stinson, J. N., McGrath, P. J., MacDonald, A. J., & Chambers, C. T. (2010). Social functioning and peer relationships in children and adolescents with chronic pain: A systematic review. Pain Research and Management, 15(1), 27–41. https://doi.org/10.1155/2010/820407
Forgeron, P., King, S., Reszel, J., & Fournier, K. (2018). Psychosocial interventions to improve social functioning of children and adolescents with chronic physical conditions: A systematic review. Children's Health Care, 47(3), 326–355. https://doi.org/10.1080/02739615.2017.1328600
Forrest, C. B., Bevans, K. B., Riley, A. W., Crespo, R., & Louis, T. A. (2011). School outcomes of children with special health care needs. Pediatrics, 128(2), 303–312. https://doi.org/10.1542/peds.2010-3347
García-Moya, I., Brooks, F., Morgan, A., & Moreno, C. (2015). Subjective well-being in adolescence and teacher connectedness: A health asset analysis. Health Education Journal, 74(6), 641–654. https://doi.org/10.1177/0017896914555039
Gaspar, T., & Matos, M. G. (2008). Qualidade de vida em crianças e adolescentes. Versão Portuguesa dos instrumentos Kidscreen-52 [Quality of life in children and adolescents. Portuguese version of Kidscreen-52 instruments]. Aventura Social & Saúde.
Gaspar, T., Bilimória, H., Albergaria, F., & Matos, M. G. (2016). Children with special education needs and subjective well-being: social and personal influence. International Journal of Disability, Development and Education, 63(5), 500–513.
Gaspar, T., Cerqueira, A., Branquinho, C., & Matos, M. G. (2018a). The effect of a social-emotional school-based intervention upon social and personal skills in children and adolescents. Journal of Education and Learning, 7(6), 57–66. https://doi.org/10.5539/jel.v7n6p57
Gaspar, T. Cerqueira, A., Branquinho, C., & Matos, M. G. (2018b). Dimensions of social and personal skills in children and adolescents: age and gender differences. International Journal .of Development Research, 8(1), 18394-18400. http://www.fmh.utl.pt/aventurasocial/pdf/Qualidade.de.Vida.KIDSCREEN.pdf
Gaspar, T., Tomé, G., Gaspar, S., Guedes, F. B., Cerqueira, A., & Matos, M. G. (2019). Como passam os adolescentes que vivem com doença crónica na escola, na família e com os amigos? [How adolescents living with chronic disease are doing at school and with family and friends?]. Revista de Psicologia da Criança e do Adolescente, 10(1), 121–130.
Gómez, D. O., Casas, F., Inzunza, J.A, Costa, P. A. (2017). School and Neighborhood Influences of Subjective Well-Being in Chilean Children. In J. C. Sarriera & L. M. Bedin (Eds), Psychosocial Well-Being of Children and Adolescents in Latin America. Evidence-based Interventions (pp. 153-166). Springer.
González, C., Varela, J., Sánchez, P. A., Venegas, F., & De Tezanos-Pinto, P. (2021). Students’ Participation in School and its Relationship with Antisocial Behavior, Academic Performance and Adolescent Well-Being. Child Indicators Research, 14(1), 269–282. https://doi.org/10.1007/s12187-020-09761-5
Huff, M. B., McClanahan, K. K., & Omar, H. A. (2010). Chronic illness and mental health issues. In E. Bell & J. Merrick (Eds.), Rural Child Health: International Aspects (pp. 171–180). Nova Science Publishers, Inc..
Inchley, J. C., Currie, D. B., Young, T., Samdal, O., Torsheim, T., Augustson, L., Mathison, F., Aleman-Diaz, A., Molcho, M., Weber, M., & Barnekow, V. (Eds.) (2016). Growing up unequal: gender and socioeconomic differences in young people’s health and well-being: Health Behaviour in School-aged Children (HBSC) study: international report from the 2013/2014 survey. World Health Organization (WHO) Regional Office for Europe.
Inchley, J., Currie, D., Budisavljevic, S., Torsheim, T., Jåstad A, Cosma, A., Kelly, C., & Már, A. (2020). Spotlight on adolescent health and well-being. Findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. International report. WHO Regional Office for Europe. https://apps.who.int/iris/bitstream/handle/10665/332091/9789289055000-eng.pdf
Jackson, M. (2013). The special educational needs of adolescents living with chronic illness: A literature review. International Journal of Inclusive Education, 17(6), 543–554. https://doi.org/10.1080/13603116.2012.676085
Kapustin, J. (2010). Chronic disease prevention across the lifespan. The Journal for Nurse Practitioners, 6(1), 16–24. https://doi.org/10.1016/j.nurpra.2009.09.015
Kidger, J., Araya, R., Donovan, J., & Gunnell, D. (2012). The effect of the school environment on the emotional health of adolescents: a systematic review. Pediatrics, 129(5), 925–949. https://doi.org/10.1542/peds.2011-2248
Kim, D. H., & Yoo, I. Y. (2010). Factors associated with resilience of school age children with cancer. Journal of Paediatrics and Child Health, 46(7-8), 431–436. https://doi.org/10.1111/j.14401754.2010.01749.x
Koster, M., Pijl, S. J., Nakken, H., & Van Houten, E. (2010). Social participation of students with special needs in regular primary education in the Netherlands. International Journal of Disability, Development and Education, 57(1), 59–75. https://doi.org/10.1080/10349120903537905
Layte, R., & McCrory, C. (2013). Paediatric chronic illness and educational failure: the role of emotional and behavioural problems. Social Psychiatry and Psychiatric Epidemiology, 48(8), 1307–1316. https://doi.org/10.1007/s00127-012-0609-3
Li, Y., Doyle Lynch, A., Kalvin, C., Liu, J., & Lerner, R. M. (2011). Peer relationships as a context for the development of school engagement during early adolescence. International Journal of Behavioral Development, 35(4), 329–342. https://doi.org/10.1177/0165025411402578
Longobardi, C., Prino, L. E., Marengo, D., & Settanni, M. (2016). Student-teacher relationships as a protective factor for school adjustment during the transition from middle to high school. Frontiers in psychology, 7, 1988. https://doi.org/10.3389/fpsyg.2016.01988
Lum, A., Wakefield, C. E., Donnan, B., Burns, M. A., Fardell, J. E., & Marshall, G. M. (2017). Understanding the school experiences of children and adolescents with serious chronic illness: A systematic meta-review. Child: Care, Health and Development, 43(5), 645–662. https://doi.org/10.1111/cch.12475
Lum, A., Wakefield, C. E., Donnan, B., Burns, M. A., Fardell, J. E., Jaffe, A., Kasparian, N. A., Kennedy, S. E., Leach, S. T., Lemberg, D. A., & Marshall, G. M. (2019a). School students with chronic illness have unmet academic, social, and emotional school needs. School Psychology, 34(6), 627. https://doi.org/10.1037/spq0000311
Lum, A., Wakefield, C. E., Donnan, B., Burns, M. A., Fardell, J. E., Jaffe, A., Kasparian, N. A., Kennedy, S. E., Leach, S. T., Lemberg, D. A., & Marshall, G. M. (2019b). Facilitating engagement with school in students with chronic illness through positive education: A mixed-methods comparison study. School Psychology, 34(6), 677. https://doi.org/10.1037/spq0000315
Marquez, J., & Main, G. (2021). Can schools and education policy make children happier? A comparative study in 33 countries. Child Indicators Research, 14(1), 283–339. https://doi.org/10.1007/s12187-020-09758-0
Maslow, G. R., Haydon, A., McRee, A. L., Ford, C. A., & Halpern, C. T. (2011). Growing up with a chronic illness: social success, educational/vocational distress. Journal of Adolescent Health, 49(2), 206–212. https://doi.org/10.1016/j.jadohealth.2010.12.001
Matinez, L., & Ferreira, A. (2007). Análise de dados com o SPSS [Data analysis with SPSS]. Escolar Editora.
Matos, M. G., & Equipa Aventura Social (2018). A Saúde dos Adolescentes após a Recessão - Dados nacionais do estudo HBSC de 2018 ebook [Adolescent Health after the Recession - National data from the 2018 HBSC study ebook]. http://aventurasocial.com/publicacoes/publicacao_1545534554.pdf
Minier, M., Hirshfield, L., Ramahi, R., Glassgow, A. E., Fox, K., & Martin, M. A. (2018). Schools and health: an essential partnership for the effective care of children with chronic conditions. Journal of school health, 88(9), 699–703. https://doi.org/10.1111/josh.12671
Moreira, J. M., Soares, C. M. B. M., Teixeira, A. L., Silva, A. C. S., & Kummer, A. M. (2015). Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease. Pediatric Nephrology, 30(12), 2153–2162. https://doi.org/10.1007/s00467-015-3159-6
Muntaner, J. J., Forteza, D., & Salom, M. (2014). The inclusion of students with chronic diseases in regular schools. Procedia-Social and behavioral sciences, 132(2014), 74–79. https://doi.org/10.1016/j.sbspro.2014.04.280
Noonan, K., Reichman, N. E., Corman, H., & Jiménez, M. E. (2020). School and community involvement of adolescents with chronic health conditions. Journal of Adolescent Health, 67(4), 576–582. https://doi.org/10.1016/j.jadohealth.2020.02.028
Oeseburg, B., Jansen, D. E. M. C., Reijneveld, S. A., Dijkstra, G. J., & Groothoff, J. W. (2010). Limited concordance between teachers, parents and healthcare professionals on the presence of chronic diseases in ID-adolescents. Research in Developmental Disabilities, 31(6), 1645–1651. https://doi.org/10.1016/j.ridd.2010.04.015
Rapee, R. M., Oar, E. L., Johnco, C. J., Forbes, M. K., Fardouly, J., Magson, N. R., & Richardson, C. E. (2019). Adolescent development and risk for the onset of social-emotional disorders: A review and conceptual model. Behaviour research and therapy, 123, 103501. https://doi.org/10.1016/j.brat.2019.103501
Roberts, C., Freeman, J., Samdal, O., Schnohr, C., Looze, M., Nic Gabhainn, S., Iannotti, I., Rasmussen, M., Matos, M. G., & in the International HBSC study group. (2009). The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions. International Journal of Public Health, 54(Suppl. 2), 140–150.
Runions, K. C., Vithiatharan, R., Hancock, K., Lin, A., Brennan-Jones, C. G., Gray, C., & Payne, D. (2020). Chronic health conditions, mental health and the school: A narrative review. Health Education Journal, 79(4), 471–483. https://doi.org/10.1177/0017896919890898
Santos, T., Matos, M. G., Simões, C., & Machado, M. C. (2015). Psychological well-being and chronic condition in Portuguese adolescents. International Journal of Adolescence and Youth, 20(3), 334–345. https://doi.org/10.1080/02673843.2015.1007880
Santos, T., Matos, M. G., Marques, A., Simões, C., Leal, I., & Machado, M. C. (2016a). Adolescent’s subjective perceptions of chronic disease and related psychosocial factors: highlights from an outpatient context study. BMC pediatrics, 16(1), 1–10. https://doi.org/10.1186/s12887-016-0748-x
Santos, T., Matos, M. G., Simões, M. C., & Machado, M. C. (2016b). Contextual factors related to chronic condition in portuguese adolescents: highlights from the HBSC/WHO study. Psicologia: Reflexão e Crítica, 29(1), 3. https://doi.org/10.1186/s41155-016-0008-x
Santos, T., Matos, M. G. D., Marques, A., Simões, C., Leal, I., & Machado, M. D. C. (2018). Psychosocial Profile in Portuguese Adolescents with Chronic Disease Attending an Outpatient Department in a Hospital Setting. International Journal of Pediatrics, 2018. https://doi.org/10.1155/2018/9382648
Santrock, J. (2014). Adolescence (15th ed.). McGraw-Hill Education.
Sav, A., King, M. A., Whitty, J. A., Kendall, E., McMillan, S. S., Kelly, F., Hunter, B., & Wheeler, A. J. (2015). Burden of treatment for chronic illness: a concept analysis and review of the literature. Health Expectations, 18(3), 312–324. https://doi.org/10.1111/hex.12046
Sentenac, M., Arnaud, C., Gavin, A., Molcho, M., Gabhainn, S. N., & Godeau, E. (2012). Peer victimization among school-aged children with chronic conditions. Epidemiologic Reviews, 34(1), 120–128. https://doi.org/10.1093/epirev/mxr024
Sentenac, M., Gavin, A., Gabhainn, S. N., Molcho, M., Due, P., Ravens-Sieberer, U., Matos, M. G. M., Malkowska-Szkutnik, A., Gobina, I., Vollebergh, W., Arnaud, C., & Godeau, E. (2013). Peer victimization and subjective health among students reporting disability or chronic illness in 11 Western countries. The European Journal of Public Health, 23(3), 421–426. https://doi.org/10.1093/eurpub/cks073
Silva, N., Pereira, M., Otto, C., Ravens-Sieberer, U., Canavarro, M. C., & Bullinger, M. (2019). Do 8-to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? A meta-analysis of studies using the KIDSCREEN questionnaires. Quality of Life Research, 28(7), 1725–1750. https://doi.org/10.1007/s11136-019-02189-7
Simões, C., Matos, M. G., Ferreira, M., & Tomé, G. (2010). Risco e resiliência em adolescentes com necessidades educativas especiais: Desenvolvimento de um programa de promoção da resiliência na adolescência [Risk and resilience in adolescents with special educational needs: Development of a program to promote resilience in adolescence]. Psicologia, Saúde & Doenças, 11(1), 101–119.
Valero-Moreno, S., Lacomba-Trejo, L., Casaña-Granell, S., Prado-Gascó, V. J., Montoya-Castilla, I., & Pérez-Marín, M. (2019). Factor structure of the Hospital Anxiety and Depression Scale in adolescent patients with chronic disease. Archivos Argentinos de Pediatria, 117(4), 252–258. https://doi.org/10.5546/aap.2019.eng.252
Van Der Lee, J. H., Mokkink, L. B., Grootenhuis, M. A., Heymans, H. S., & Offringa, M. (2007). Definitions and measurement of chronic health conditions in childhood: a systematic review. Jama, 297(24), 2741–2751. https://doi.org/10.1001/jama.297.24.2741
Verhoof, E. J., Maurice-Stam, H., Heymans, H. S., Evers, A. W., & Grootenhuis, M. A. (2014). Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions. Child and adolescent psychiatry and mental health, 8(1), 12. https://doi.org/10.1186/1753-2000-8-12
Wentzel, K. R. (2017). Peer relationships, motivation, and academic performance at school. In A. J. Elliot, C. S. Dweck, & D. S. Yeager (Eds.), Handbook of competence and motivation: Theory and application (pp. 586–603). The Guilford Press.
Whitley, J., Smith, J. D., Vaillancourt, T., & Neufeld, J. (2018). Promoting Mental Health Literacy Among Educators: A Critical Aspect of School-Based Prevention and Intervention. In A. W. Leschied, D. H. Saklofske, & G. L. Flett (Eds.), Handbook of School-Based Mental Health Promotion (pp. 143–165). Springer.
World Health Organization. (2005). Preventing chronic diseases: a vital investment. https://apps.who.int/iris/bitstream/handle/10665/43314/9241563001_eng.pdf?sequence=1&isAllowed=y
World Health Organization. (2014) Global status report on noncommunicable diseases 2014. https://apps.who.int/iris/bitstream/handle/10665/148114/9789241564854_eng.pdf;jsessionid=0E7C2C0332F7B72A259A872D7CA8DE29?sequence=1
World Health Organization (2017). Preventing noncommunicable diseases (NCD’s) by reducing environmental risk factors. https://apps.who.int/iris/bitstream/handle/10665/258796/WHO-FWC-EPE-17.01-eng.pdf
World Health Organization. (2018a). Noncommunicable Disease Education Manual. A primer for policy-makers and health-care professionals. https://apps.who.int/iris/handle/10665/260505.
World Health Organization. (2018b) – World Health Organization: Noncommunicable diseases – Fact Sheet. http://www.who.int/mediacentre/factsheets/fs355/en/
World Health Organization. (2020). Noncommunicable diseases in the western pacific. https://www.who.int/westernpacific/health-topics/noncommunicable-diseases
Yu, M. V. B., Johnson, H. E., Deutsch, N. L., & Varga, S. M. (2018). “She calls me by my last name”: Exploring adolescent perceptions of positive teacher-student relationships. Journal of Adolescent Research, 33(3), 332–362. https://doi.org/10.1177/0743558416684958
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Ana Cerqueira – Foundation for Science and Technology [Fundação para a Ciência e a Tecnologia - FCT] scholarship (SFRH/BD/148403/2019).
Fábio Botelho Guedes – Foundation for Science and Technology [Fundação para a Ciência e a Tecnologia - FCT] scholarship (SFRH/BD/148299/2019).
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Cerqueira, A., Gaspar, T., Botelho Guedes, F. et al. Chronic Conditions, School Participation and Quality of Life of Portuguese Adolescents: Highlights from the Health Behavior in School aged Children study - HBSC 2018. Child Ind Res 15, 297–313 (2022). https://doi.org/10.1007/s12187-021-09868-3
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DOI: https://doi.org/10.1007/s12187-021-09868-3