Health> Vol.5 No.11B, November 2013

Individual factors related to chronic condition in Portuguese adolescents: Highlights from the HBSC/WHO study

ABSTRACT

Background: Adolescence includes a period (10 to 19 years) of profound biopsychosocial changes, constituting potentially difficult challenges, which may become more pronounced in the presence of a chronic condition and its limitations. Responses are not homogeneous and can be quite variable, depending on various specific individual factors. Research comparing adolescents with or without chronic illness, or comparing across different conditions, has been contradictory, not confirming a direct relationship between the degree of suffering and the chronic condition. Objective: To characterize and assess the impact of 1) having a chronic condition (CC) and 2) how CC affects school participation; and its association with life satisfaction and perception of wellness, controlling for demographic factors: age, gender and family socioeconomic status (SES). Methods: 5050 Portuguese adolescents with an average age of 14 years participated in the Health Behaviour in School-aged Children/WHO (HBSC). Results: The majority of the adolescents with CC reported that their conditions did not affect school participation. Adolescents with CC who indicated that CC affected school participation felt more frequently unwell and presented lower life satisfaction. Being a boy, younger and having high family socio economic status (SES) were identified as predictors of higher life satisfaction; on the other hand, being a girl, older, having lower SES, living with CC and feeling that CC affects school participation are predictors for feeling more frequently unwell. Conclusions: These adolescents showed an increased vulnerability, presenting internalized symptoms and lower life satisfaction. Furthermore, when there was simultaneous occurrence of living with CC and that CC affected school participation, the impact was even higher. Thus, it is crucial that future interventions should include the identified predictors, combined with “listen to the voice” of adolescents, throughout the adaptation process.

KEYWORDS


Cite this paper

Santos, T. , de Matos, M. , Simões, M. , Fonseca, H. and Machado, M. (2013) Individual factors related to chronic condition in Portuguese adolescents: Highlights from the HBSC/WHO study. Health, 5, 25-34. doi: 10.4236/health.2013.511A2005.

References

[1] [1] Delaney, L. and Smith, J.P. (2012) Childhood health: Trends and consequences over the life course. Future Child, 22, 43-63.
http://dx.doi.org/10.1353/foc.2012.0003
[2] Barros, L. (2009) Adolescents with chronic disease. In: Matos, M. and Sampaio, D., Eds., Jovens com Saúde. Diálogo com uma geracao, Texto Editores, Lisboa, 304-320.
[3] Simoes, C., Matos, M.G., Ferreira, M. and Tomé, G. (2010) Risk and resilience in adolescents with special educational needs: Development of a resilience program in adolescence. Psicologia, Saúde & Doencas, 11, 101-119.
[4] Michaud, P.A., Suris, J.C. and Viner, R. (2007) The adolescent with a chronic condition. Epidemiology, developmental issues and health care provision. Department of Child and Adolescent Health and Development, Geneva.
[5] Suris, J.C., Michaud, P.A. and Viner, R. (2004) The adolescent with a chronic condition. Part I: Developmental issues. Archives of Disease in Childhood, 89, 938-942.
http://dx.doi.org/10.1136/adc.2003.045369
[6] Law, M., King, G., King, S., Kertoy, M., Hurley, P., Rosenbaum, P., Young, N. and Hanna, S. (2006) Patterns of participation in recreational and leisure activities among children with complex physical disabilities. Developmental Medicine & Child Neurology, 48, 337-342.
http://dx.doi.org/10.1017/S0012162206000740
[7] Serrabulho, M.L., Matos, M.G. and Raposo, J. (2012) The health and lifestyles of adolescents with type 1 diabetes in Portugal. European Diabetes Nursing, 9, 12-16.
http://dx.doi.org/10.1002/edn.197
[8] Verhoof, E., Maurice-Stam, H., Heymans, H. and Grootenhuis, M. (2012) Growing into disability benefits? Psychosocial course of life of young adults with a chronic somatic disease or disability. Acta Paediatrica, 101, 19-26. http://dx.doi.org/10.1111/j.1651-2227.2011.02418.x
[9] Bernstein, C., Soren, K., Stockwell, M., Rosenthal, S. and Gallagher, M.P. (2011). Mood symptons and disordered eating behaviors in adolescents with type 1 diabetes. Journal of Adolescent Health, 48, S20-S21.
http://dx.doi.org/10.1016/j.jadohealth.2010.11.050
[10] Oeseburg, B., Jansen, D.E., Groothoff, J.W., Dijkstra, G.J. and Reijneveld, S.A. (2010). Emotional and behavioural problems in adolescents with intellectual disability with and without chronic diseases. Journal of Intellectual Disability Research, 54, 81-89.
http://dx.doi.org/10.1111/j.1365-2788.2009.01231.x
[11] Geist, R. (2003). Psychosocial issues in the child with chronic conditions. Best Practice & Research Clinical Gastroenterology, 17, 141-152.
http://dx.doi.org/10.1016/S1521-6918(02)00142-7
[12] Vanhalst, J., Rassart, J., Luyckx, K., Goossens, E., Apers, S., Goossens, L., Moons, P. and i-DETACH Investigators (2013) Trajectories of loneliness in adolescents with congenital heart disease: Associations with depressive symptoms and perceived health. Journal of Adolescent Health, 19. http://dx.doi.org/10.1016/j.jadohealth.2013.03.027
[13] Miyazaki, M., Amaral, V., Jr., J. and Grecca, K. (2006) Cap. 3, Asma e depressao em criancas e adolescentes. In: Miyazaki, M., Domingos, N. and Valério, N., Eds., Psicologia da Saúde, Pesquisa e Prátic, THS Arantes Editora, Sao José do Rio Preto, 47-56.
[14] Lavigue, J.V. and Fier-Routman, J. (1992) Psychological adjustment to pediatric physical disorders: A meta-analytic review. Journal of Pediatric Psychology, 17, 133-157. http://dx.doi.org/10.1093/jpepsy/17.2.133
[15] Saunders, B. (2011) “Sometimes you’ve just got to have fun, haven’t you?”: The discursive construction of social drinking practices in young adults’ accounts of chronic illness. Communication & Medicine, 8, 77-87.
http://dx.doi.org/10.1558/cam.v8i1.77
[16] Scaramuzza, A., De Palma, A., Mameli, C., Spiri, D., Santoro, L. and Zuccotti, G. (2010) Adolescents with type 1 diabetes and risky behaviour. Acta Padiatrica/Acta Padiatrica, 99, 1237-1241.
http://dx.doi.org/10.1111/j.1651-2227.2010.01813.x
[17] Combs-Orme, T., Helfinger, C.A. and Simpkins, C. (2002) Comorbidity of mental health problems and chronic health conditions in children. Journal of Emotional and Behavioral Disorders, 2, 116-125.
http://dx.doi.org/10.1177/10634266020100020601
[18] Barlow, J.H. and Ellard, D.R. (2006) The psychosocial well-being of children with chronic disease, their parents and siblings: An overview of the research evidence base. Child: Care, Health and Development, 32, 19-31.
http://dx.doi.org/10.1111/j.1365-2214.2006.00591.x
[19] Barros, L., Matos, M.G. and Batista-Foguet, J. (2008). Chronic diseases, Social context and adolescent health: Results of the Portuguese national health behaviour in school-aged children survey. Revista Brasileira de Terapias Cognitivas, 4.
[20] Lee, S.L., Cheung, Y.F., Wong, H.S.W., Leung, T.H., Lam, T.H. and Lau, Y.L. (2013). Chronic health problems and health-related quality of life in Chinese children and adolescents: A population-based study in Hong Kong. BMJ Open, 3, e001183.
http://dx.doi.org/10.1136/bmjopen-2012-001183
[21] Sawyer, M.G., Whaites, L., Rey, J.M., Hazell, P.L., Graetz, B.W. and Baghurst, P. (2002). Health-related quality of life of children and adolescents with mental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 530-537.
http://dx.doi.org/10.1097/00004583-200205000-00010
[22] Quittner, A.L., Romero, S.L., Kimberg, C.I., Blackwell, L.S. and Cruz, I. (2011) Chronic illness. Encyclopedia of Adolescence, 3, 91-99.
http://dx.doi.org/10.1016/B978-0-12-373951-3.00105-8
[23] Logan, D.E., Simons, L.E., Stein, M.J. and Chastain, L. (2008) School impairment in adolescents with chronic pain. Journal of Pain, 9, 407-416.
http://dx.doi.org/10.1016/j.jpain.2007.12.003
[24] Verhoof, E., Maurice-Stam, H., Heymans, H. and Grootenhuis, M. (2013) Health-related quality of life, anxiety and depression in young adults with disability benefits due to childhood-onset somatic conditions. Child and Adolescent Psychiatry and Mental Health, 7, 12.
http://dx.doi.org/10.1186/1753-2000-7-12
[25] Maslow, G.R., Haydon, A., McRee, A.L., Ford, C.A. and Halpern, C.T. (2011) Growing up with a chronic illness: Social success, educational/vocational distress. Journal of Adolescent Health, 49, 206-212.
http://dx.doi.org/10.1016/j.jadohealth.2010.12.001
[26] Holden, E.W., Chmielewski, D., Nelson, C.C. and Kager, V.A. (1997). Controlling for general and disease-specific effects in child and family adjustment to chronic childhood illness. Journal of Pediatric Psychology, 22, 15-27.
http://dx.doi.org/10.1093/jpepsy/22.1.15
[27] Barros, L. (2003) Chronic disease: Conceptualization, evaluation and intervention. In: Psicologia Pediátrica: Perspectiva Desenvolvimentista, 2nd Edition, Climepsi Editores, Manuais Universitários 13, Lisboa, 135-172.
[28] Taylor, R.M., Gibson, F. and Franck, L.S. (2008) A concept analysis of health-related quality of life in young people with chronic illness. Journal of Clinical Nursing, 17, 1823-1833.
http://dx.doi.org/10.1111/j.1365-2702.2008.02379.x
[29] Panamonta, N., Prathipanawatr, T. and Panamonta, O. (2012) Factors influencing chronic diabetic complications in type 1 diabetes. The Southeast Asian Journal of Tropical Medicine and Public Health, 43, 1245-1251.
[30] Gortmaker, S.L., Walker, D.K., Weitzman, M. and Sobol, A.M. (1990). Chronic conditions, socioeconomic risks, and behavioral problems in children and adolescents. Pediatrics, 85, 267-276.
[31] Matos, M.G., Tomé, G., Borges, A.I., Manso, D., Simoes, C. and Ferreira, A. (2012) Anxiety, depression and coping: CDI, MASC and CRI-Y for screening purposes in schools. Spanish Journal of Psychology, 15, 348-356.
http://dx.doi.org/10.5209/rev_SJOP.2012.v15.n1.37341
[32] La Greca, A.M., Swales, T, Klemp, S., Madigan, S. and Skyler, J. (1995) Adolescents with diabetes: Gender differences in psychosocial functioning and glycemic control. Children’s Health Care, 24, 61-78.
http://dx.doi.org/10.1207/s15326888chc2401_6
[33] Suris, J.C., Parera, N. and Puig, C. (1996) Chronic illness and emotional distress in adolescence. The Journal of Adolescence Health, 19, 153-156.
http://dx.doi.org/10.1016/1054-139X(95)00231-G
[34] Matos, M.G., Barrett, P., Dadds, M. and Shortt, A. (2003) Anxiety, depression, and peer relationships during adolescence: Results from the Portuguese national health behaviour in school-aged children survey. European Journal of Psychology of Education, 18, 3-14.
http://dx.doi.org/10.1007/BF03173600
[35] Maatta, H., Hurtig, T., Taanila, A., Honkanen, M., Ebeling, H. and Koivumaa-Honkanen, H. (2013) Childhood chronic physical condition, self-reported health, and life satisfaction in adolescence. European Journal of Pediatrics. http://dx.doi.org/10.1007/s00431-013-2015-6
[36] Currie, C., Zanotti, C., Morgan, A., Currie, D., De Looze, M., Roberts, C., Samdal, O., Smith, O. and Barnekow, V. (2012) Social determinants of health and well-being among young people. Health behaviour in school-aged children (HBSC) study: International report from the 2009/2010 survey. WHO Regional Office for Europe, Copenhagen.
[37] Marcotte, D., Fortin, L., Potvin, P. and Papillon, M. (2002). Gender differences in depressive symptoms during adolescence. Role of gender-typed characteristics, self-esteem, body image, stressful life events, and pubertal status. Journal of Emotional and Behavioral Disorders, 10, 29-42.
http://dx.doi.org/10.1177/106342660201000104
[38] Cavallo, F., Zambon, A., Borraccino, A., Raven-Sieberer, U., Torsheim, T. and Lemma, P. (2006) Girls growing through adolescence have a higher risk of poor health. Quality of Life Research, 15, 1577-1585.
http://dx.doi.org/10.1007/s11136-006-0037-5
[39] Piko, B.F. (2006) Satisfaction with life, psychosocial health and materialism among Hungarian youth. Journal of Health Psychology, 11, 827-831.
http://dx.doi.org/10.1177/1359105306069072
[40] Oishi, S., Diener, E.F., Lucas, R.E. and Suh, E.M. (1999) Cross-Cultural variations in predictors of life satisfaction: Perspectives from needs and values. Social Indicators Research Series, 38, 109-127.
http://dx.doi.org/10.1007/978-90-481-2352-0_6
[41] Olén, O., Bihagen, E., Rasmussen, F. and Ludvigsson, J.F. (2012) Socioeconomic position and education in patients with coeliac disease. Digestive and Liver Disease, 44, 471-476. http://dx.doi.org/10.1016/j.dld.2012.01.006
[42] Borges, A., Matos, M.G. and Diniz, J.A. (2011) Estatuto familiar e auto percepcao de saúde nos adolescentes [Familiar status and heath self-perception in adolescents]. Temas em Psicologia, 19, 347-360.
[43] Matos, M.G., Simoes, C., Batista-Foguet, J. and Cottraux, J. (2010) Personal and social factors associated with the perception of health and the perception of happiness in a nonclinical adolescent population. L'Encéphale, 36, 39-45. http://dx.doi.org/10.1016/j.encep.2008.08.002
[44] Lunc, J. and Kaplan, G. (2000) Socioeconomic position. In: Berkman, L.F. and Kawachi, I., Eds., Social Epidemiology, Oxford University Press, New York, 13-35
[45] Mackenbach, J.P., Stirbu, I., Roskam, A.R., Schaap, M.M., Menvielle, G., Leinsalu, M. and Kunst, A.E. (2008) Socioeconomic inequalities in health in 22 European countries. The New England Journal of Medicine, 358, 2468-2481. http://dx.doi.org/10.1056/NEJMsa0707519
[46] Richter, M., Erhart, M., Vereecken, C.A., Zambon, A., Boyce, W. and Nic Gabhainn, S. (2009) The role of behavioural factors in explaining socio-economic differences in adolescent health: A multilevel study in 33 countries. Social Science & Medicine, 69, 396-403.
[47] Torsheim, T., Currie, C., Boyce, W., Kalnins, I., Overpeck, M. and Haugland, S. (2004) Material deprivation and self-rated health: A multilevel study of adolescents from 22 European and North American countries. Social Science & Medicine, 59, 1-12.
[48] Cui, W.J. and Zack, M.M. (2013) Trends in health-related quality of life in among adolescents in the United States, 2001-2010. Preventing Chronic Disease, 10, 120334.
http://dx.doi.org/10.5888/pcd10.120334
[49] Zashikhina, A. and Hagglof, B. (2013) Self-Esteem in adolescents with chronic physical illness vs. controls in Northern Russia. International Journal of Adolescent Medicine and Health, 10, 1-7. [Epub ahead of print]
http://dx.doi.org/10.1515/ijamh-2013-0507
[50] Currie, J. (2009) Healthy, Wealthy, and Wise: Socioeconomic status, poor health in childhood, and human capital development. Journal of Economic Literature, 47, 87-122. http://dx.doi.org/10.1257/jel.47.1.87
[51] Erhart, M., Ottova, V., Gaspar, T., Jericek, H., Schnohr, C., Alikasifoglu, M., Morgan, A., Ravens-Sieberer, U. and Matos. M.G. in the HBSC Positive Health Focus Group (2009) Measuring mental health and well-being of schoolchildren in 15 European countries using the KIDSCREEN-10 Index. International Journal of Public Health, 54, 160-166. http://dx.doi.org/10.1007/s00038-009-5407-7
[52] Gaspar, T., Matos, M.G., Ribeiro, J., Leal, I. and Ferreira, A. (2009) Health-Related quality of life in children and adolescents and associated factors. Journal of Cognitive and Behavioral Psychotherapies, 9, 33-48.
[53] Matos, M.G. and Equipa do Projecto Aventura Social (2000; 2002; 2006) Aventura social & saúde, A saúde dos adolescentes Portugueses—Relatórios nacionais do estudo HBSC 2000, 2002 e 2006 [Social Adventure & Health: Portuguese adolescents’s health—Final report from HBSC 2000, 2002, 2006 study]. Centro Malária e Outras Doencas Tropicais/IHMT/UNL, FMH/UTL, Lisboa.
Retrieved: http://aventurasocial.com/
[54] Gaspar, T. and Matos, M.G. (Coord.) (2008) Qualidade de vida em criancas e adolescentes versao Portuguesa dos instrumentos Kidscreen-52 [Quality of life in children and adolescents—Portuguese version of Kidscreen-52 instrument]. CMDT/FMH/FCT, Lisboa.
[55] Cantril, H. (1965) The pattern of human concerns. Rutgers University Press, New Brunswick
[56] Matos, M.G., Goncalves, A., Gaspar, T. and Equipa do Projecto Aventura Social (2005) Aventura social, etnicidade e risco/preventio primária do VIH em adolescentes de comunidades migrantes [Social adventure, etnicity and risk/primary prevention of HIV in adolescents from migrant communities]. IHMT/UNL, FMU/UTL, HBSC/OMS.
[57] Boyce, W., Torsheim, T., Currie, C. and Zambon, A. (2006). The family affluence scale as a measure of national wealth: Validation of an adolescent self-report measure. Social Indicators Research, 78, 473-487.
http://dx.doi.org/10.1007/s11205-005-1607-6
[58] Matos, M.G., Simoes, C., Tomé, G., Camacho, I., Ferreira, M., Ramiro, L., Reis, M., Gaspar, T., Veloso, S., Loureiro, N., Borges, A., Diniz, J. and Equipa Aventura Social (2012) Aventura social & saúde, A saúde dos adolescentes portugueses—Relatório final do estudo HBSC 2010 [Social adventure & health: Portuguese adolescents’s Health—Final report from HBSC 2010 study]. Centro Malária e Outras Doencas Tropicais/IHMT/UNL, Lisboa, FMH/Universidade Técnica de Lisboa.
Web site: www.aventurasocial.com
[59] Currie, C., Samdal, O., Boyce, W. and Smith, R. (2001) HBSC, a WHO cross national study: Research protocol for the 2001/2002 survey. World Health Organisation, Copenhagen.
[60] Roberts, C., Currie, C., Samdal, O., Currie, D., Smith, R. and Maes, L. (2007) Measuring the health behaviours of adolescents through cross-national survey research: Recent developments in the Health Behaviour in School-Aged Children (HBSC) study. Journal of Public Health, 15, 179-186.
http://dx.doi.org/10.1007/s10389-007-0100-x
[61] Gaspar, T., Ribeiro, J.P., de Matos, M.G., Leal, I. and Ferreira, A. (2012) Health-Related quality of life in children and adolescents: Subjective well being. Spanish Journal of Psychology, 15, 177-186.
http://dx.doi.org/10.5209/rev_SJOP.2012.v15.n1.37306
[62] Casier, A., Goubert, L., Theunis, M., Huse, D., De Baets, F., Matthys, D. and Crombez, G. (2011) Acceptance and well-being in adolescents and young adults with cystic fibrosis: A prospective study. Journal of Pediatric Psychology, 36, 476-487.
http://dx.doi.org/10.1093/jpepsy/jsq111
[63] Serrabulho, M.L., Matos, M.G. and Raposo, J. (2012) Adolescents living with diabetes—In their own words. Diabetes Voice, 57, 19-22.
[64] Michaud, P.A., Suris, J.C. and Viner, R. (2004) The adolescent with a chronic condition. Part II: Healthcare provision. Archives of Disease in Childhood, 89, 943-949.
http://dx.doi.org/10.1136/adc.2003.045377
[65] Sartain, S.A., Clarke, C.L. and Heyman, R. (2000) Hearing the voices of children with chronic illness. Journal of Advanced Nursing, 32, 913-921.
http://dx.doi.org/10.1046/j.1365-2648.2000.t01-1-01556.x

comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.