Share This Article:

Extensive Medical Absenteeism among Secondary School Students: An Observational Study on Their Health Condition from a Biopsychosocial Perspective

Full-Text HTML XML Download Download as PDF (Size:386KB) PP. 111-121
DOI: 10.4236/ojpm.2015.53013    2,824 Downloads   3,513 Views   Citations

ABSTRACT

An adequate approach to reducing school absenteeism should focus on medical absenteeism as this is the most prevalent form of school absenteeism. The objective of this study is to explore the health condition of pre-vocational secondary students with extensive medical absenteeism from a biopsychosocial perspective. Data were obtained from medical assessments and Strengths and Difficulties Questionnaires (SDQs) of students with medical absence above threshold criteria (i.e. reported sick four times in 12 school weeks or more than six consecutive school days) who were referred to a youth health care physician. The results showed that the students had a mean absence rate of 14% in 12 school weeks. Of all students, 43.5% had a diagnosed disease and 81.5% had problems such as physical complaints not yet diagnosed, psychosocial problems, lifestyle problems and sleeping difficulties. Four groups could be distinguished: 13.4% with a diagnosed disease and no problem, 30.1% with a diagnosed disease and a problem, 51.5% with a problem and no diagnosed disease and 5.1% without a diagnosed disease or problem. Significantly higher scores of the Total difficulties-scale on the SDQ were found (mean 10.5; SD 5.8) in the study group, compared to a reference group (mean 9.1; SD 4.9). In conclusion, this study shows that when using the aforementioned criteria for extensive medical absenteeism to intervene with the absence, students with a mean absence rate of 14% in 12 school weeks are identified. If there was a diagnosed disease, it was accompanied by problems about twice as often. More than half of the students’ absence was caused by problems rather than a disease. The great diversity of these problems calls for a personalized approach. A broad perspective, including medical expertise, is needed to distinguish between emerging mental and physical diseases, psychosocial and lifestyle problems.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Vanneste, Y. , P. Mathijssen, J. , van de Goor, I. , Rots-de Vries, C. and M. Feron, F. (2015) Extensive Medical Absenteeism among Secondary School Students: An Observational Study on Their Health Condition from a Biopsychosocial Perspective. Open Journal of Preventive Medicine, 5, 111-121. doi: 10.4236/ojpm.2015.53013.

References

[1] Eckstein, Z. and Wolpin, K.I. (1999) Why Youths Drop Out of High School: The Impact of Preferences, Opportunities, and Abilities. Econometrica, 67, 1295-1339.
http://doi:10.1111/1468-0262.00081
[2] Rumberger, R.W. (2001) Why Students Drop Out of School and What Can Be Done. Dropouts in America: How Severe is the Problem? What Do We Know about Intervention and Prevention? Harvard University.
http://civilrightsproject.ucla.edu/research/k-12-education/school-dropouts/why-students-drop-out-of-
school-and-what-can-be-done/rumberger-why-students-dropout-2001.pdf
[3] Christenson, S.L. and Thurlow, M.L. (2004) School Dropouts: Prevention Considerations, Interventions, and Challenges. Current Directions In Psychological Science, 13, 36-39.
http://doi:10.1111/j.0963-7214.2004.01301010.x
[4] Kearney, C.A. (2008) School Absenteeism and School Refusal Behavior in Youth: A Contemporary Review. Clinical Psychology Review, 28, 451-471.
http://doi:10.1016/j.cpr.2007.07.012
[5] Droomers, M., Schrijvers, C.T.M., van de Mheen, H. and Mackenbach, J.P. (1998) Educational Differences in Leisure-Time Physical Inactivity: A Descriptive and Explanatory Study. Social Science & Medicine, 47, 1665-1676.
http://doi:10.1016/S0277-9536(98)00272-X
[6] Droomers, M., Schrijvers, C.T.M., Stronks, K., van de Mheen, D. and Mackenbach, J.P. (1999) Educational Differences in Excessive Alcohol Consumption: The Role of Psychosocial and material stressors. Preventive Medicine, 29, 1-10.
http://doi:10.1006/pmed.1999.0496
[7] Havas, J., Bosma, H., Spreeuwenberg, C. and Feron, F.J. (2010) Mental Health Problems of Dutch Adolescents: The Association with Adolescents’ and Their Parents’ Educational Level. European Journal of Public Health, 20, 3, 258-264.
http://doi:10.1093/eurpub/ckp172
[8] Dahlgren, G. and Whitehead, M. (2006) European Strategies for Tackling Social Inequities in Health: Levelling up Part 2. World Health Organization Regional Office for Europe.
http://www.euro.who.int/__data/assets/pdf_file/0018/103824/E89384.pdf?ua=1
[9] Mackenbach, J.P. (2006) Health Inequalities: Europe in Profile. Rotterdam: Erasmus MC.
http://www.who.int/social_determinants/resources
[10] Thrane, C. (2006) Explaining Educational-Related Inequalities in Health: Mediation an Moderator Models. Social Science & Medicine, 62, 467-478.
http://doi:10.1016/j.socscimed.2005.06.010
[11] Bosma, H., van de Mheen, H.D., Borsboom, G.J.J.M. and Mackenbach, J.P. (2001) Neighborhood Socioeconomic Status and All-Cause Mortality. American Journal of Epidemiology, 153, 363-371.
http://dx.doi.org/10.1093/aje/153.4.363
[12] Huisman, M., Kunst, A.E., Bopp, M., Borgan, J.K., Borrell, C., Costa, G., Deboosere, P., Gadeyne, S., Glickman, M., Marinacci, C., Minder, C., Regidor, E., Valkonen, T. and Mackenbach, J.P. (2005) Educational Inequalities in Cause-Specific Mortality in Middle-Aged and Older Men and Women in Eight Western European Populations. The Lancet, 365, 493-500.
http://dx.doi.org/10.1016/S0140-6736(05)17867-2
[13] 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
[14] Lager, A.C. and Torssander, J. (2012) Causal Effect of Education on Mortality in a Quasi-Experiment on 1.2 Million Swedes. Proceedings of the National Academy of Sciences of the United States of America, 109, 8461-8466.
http://dx.doi.org/10.1073/pnas.1105839109
[15] Gathmann, C., Jurges, H. and Reinhold, S. (2014) Compulsory Schooling Reforms, Education and Mortality in Twentieth Century Europe. Social Science & Medicine, 127, 74-82.
http://dx.doi.org/10.1016/j.socscimed.2014.01.037
[16] Kulhánová, I., Hoffmann, R., Eikemo, T.A., Menvielle, G. and Mackenbach, J.P. (2014) Educational Inequalities in Mortality by Cause of Death: First National Data for the Netherlands. International Journal of Public Health, 59, 687-696.
http://dx.doi.org/10.1007/s00038-014-0576-4
[17] WHO, World Health Organisation (2014) Health for the World’s Adolescents.
http://www.who.int/maternal_child_adolescent/topics/adolescence/second-decade/en
[18] Hawkrigg, S. and Payne, D.N. (2014) Prolonged School Non-Attendance in Adolescence: A Practical Approach. Archives of Disease in Childhood, 99, 954-957.
http://dx.doi.org/10.1136/archdischild-2013-304595
[19] Eaton, D.K., Brener, N. and Kann, L.K. (2008) Associations of Health Risk Behaviors with School Absenteeism. Does Having Permission for the Absence Make a Difference? Journal of School Health, 78, 223-229.
http://dx.doi.org/10.1111/j.1746-1561.2008.00290.x
[20] Jones, R., Hoare, P., Elton, R., Dunhill, Z. and Sharpe, M. (2009) Frequent Medical Absences in Secondary School Students: Survey and Case-Control Study. Archives of Disease in Childhood, 94, 763-767.
http://dx.doi.org/10.1136/adc.2008.140962
[21] NIPO het marktonderzoeksinstituut (2002) Report on School Absenteeism in Secondary School (Rapport: School-verzuim in het Voortgezet Onderwijs). Amsterdam.
http://www.tns-nipo.com/pages/persvannipo/pdf/schoolverzuim03.pdf
[22] Wieske, R.C.N., Nijhuis, M.G., Carmiggelt, B.C., Wagenaar-Fischer, M.M. and Boere-Boonekamp, M.M. (2012). Preventive Youth Health Care in 11 European Countries: An Exploratory Analysis. International Journal of Public Health, 57, 637-641.
http://dx.doi.org/10.1007/s00038-011-0305-1
[23] Kuo, A.A., Inkelas, M., Lotstein, D.S., Samson, K.M., Schoret, E.L. and Halfon, N. (2006) Rethinking Well-Child Care in the United States: An International Comparison. Pediatrics, 118, 1692-1702.
http://dx.doi.org/10.1542/peds.2006-0620
[24] Vanneste, Y.T.M., Rots-de Vries, M.C., Goor, L.A.M. van de and Feron, F.J.M. (2012) Medical Advice for Sick-Reported Students (MASS); Development of Anintervention (Medische Advisering Ziekgemelde leerling door de jeugdarts (M@ZL); ontwikkeling van een interventie). Tijdschrift voor Gezondheidswetenschappen, 90, 412-419.
www.tsg.bsl.nl
http://dx.doi.org/10.1007/s12508-012-0145-2
[25] Engel, G.L. (1977) The Need for a New Medical Model: A Challenge for Biomedicine. Science, 196, 129-136.
http://dx.doi.org/10.1126/science.847460
[26] Engel, G.L. (1992) The Need for a New Medical Model: A Challenge for Biomedicine. Family Systems Medicine, 10, 317-331.
http://dx.doi.org/10.1037/h0089260
[27] Groeneveld, M.J., Benschop, M. and Olvers, D. (2008) Typically Pre-Vocational Secondary Education: A Comparative Study of the Characteristics of Pre-Vocational Secondary Students and the Generation of Einstein (Kenmerkend vmbo: Een vergelijkende studie van de eigenschappen van de lagere vmbo-leerlingen en de generatie van Einstein). Hiteq, Hilversum.
http://www.hiteq.org/Hiteq/Downloads/Publicaties%20geheel/Kenmerkend%20vmbo%20mbo%
20havo%20en%20vwo.pdf
[28] van der Neut, I., Teurlings, C. and Kools, Q. (2005) To Respond to Learning Behaviour of Pre-Vocational Secondary Students (Inspelen op leergedrag van vmbo-leerlingen). IVA, Tilburg.
http://www.iva-onderwijs.nl/publicaties
[29] Goodman, R., Ford, T., Simmons, H., Gatward, R. and Meltzer, H. (2000) Using the Strengths and Difficulties Questionnaire (SDQ) to Screen for Child Psychiatric Disorders in a Community Sample. The British Journal of Psychiatry, 177, 534-539.
http://dx.doi.org/10.1192/bjp.177.6.534
[30] Goodman, R. (1997 and 2006) The Strengths and Difficulties Questionnaire: A Research Note. Journal of Child Psychology and Psychiatry, 38, 581-586.
http://dx.doi.org/10.1111/j.1469-7610.1997.tb01545.x
[31] Muris, P., Meesters, C. and van den Berg, F. (2003) The Strengths and Difficulties Questionnaire (SDQ)—Further Evidence for Its Reliability and Validity in a Community Sample of Dutch Children and Adolescents. European Child & Adolescent Psychiatry, 12, 1-8.
http://dx.doi.org/10.1007/s00787-003-0298-2
[32] van Widenfelt, B.M., Goedhart, A.W., Treffers, P.D.A. and Goodman, R. (2003) Dutch Version of the Strengths and Difficulties Questionnaire (SDQ). European Child & Adolescent Psychiatry, 12, 281-289.
http://dx.doi.org/10.1007/s00787-003-0341-3
[33] Vogels, A.C.M., Hoekstra, F. and Reijneveld, S.A. (2005) Three Questionnaires for the Detection of Psychosocial Problems in Children from Seven to Twelve Years (Drie vragenlijsten voor het opsporen van psychosociale problemen bij kinderen van zeven tot twaalf jaar). TNO Quality of Life, Leiden.
http://www.ggdkennisnet.nl/?file=2114&m=1310999371&action=file.download
[34] SCP Dutch Institute for Social Research.
http://www.scp.nl/
[35] CBS Dutch National Youth Monitor (2012) www.jeugdmonitor.cbs.nl/
[36] Mokkink, L.B., van der Lee, J.H., Grootenhuis, M.A., Offringa, M., van Praag, B.M.S. and Heymans, H.S.A. (2007) Scale and Impact of Chronic Diseases in Children (Omvang en gevolgen van chronische aandoeningen bij kinderen). Tijdschrift Kindergeneeskunde, 75, 154-158.
http://dx.doi.org/10.1007/BF03061684
[37] Dutch Ministry of Education (2012) Disability-Specific Special Schools (Speciaal onderwijs).
http://www.rijksoverheid.nl/ministeries/ocw
[38] Snyderman, R. and Langheier, J. (2006) Prospective Health Care: The Second Transformation of Medicine. Genome Biology, 7, 104.
http://dx.doi.org/10.1186/gb-2006-7-2-104
[39] Kessler, R., Amminger, G.P., Aguilar-Gaxiola, S., Alonso, J., Lee, S. and Ustin, T.B. (2007) Age of Onset of Mental Disorders: A Review of Recent Literature. Current Opinion in Psychiatry, 20, 359-364.
http://dx.doi.org/10.1097/YCO.0b013e32816ebc8c
[40] Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J.P., et al. (2004) Prevalence, Severity, and Unmet Need for Treatment of Mental Disorders in the World Health Organization World Mental Health Surveys. The WHO World Mental Health Survey Consortium. JAMA, 291, 2581-2590.
http://dx.doi.org/10.1001/jama.291.21.2581
[41] Theil, A., Verkerk, P.H. and Buiting, E. (2007) Quickly Back to School (Snel terug naar school). Medisch Contact, 62, 31-32.
[42] Eiser, C. (1993) Growing up with a Chronic Disease: The Impact on Children and Their Families. Jessica Kingsley Publishers, London.
[43] Lenzen, C., Fischer, G., Jentzsch, A., Kaess, M., Parzer, P., Carli, V., Wasserman, D., Resch, F. and Brunner, R. (2013) School Absenteeism in Germany: Prevalence of Excused and Unexcused Absenteeism and Its Correlation with Emotional and Behavioural Problems (Schulabsentismus in deutschland—Die Prävalenz von entschuldigten und unentschuldigten Fehlzeiten und ihre Korrelation mit emotionalen und Verhaltensauffälligkeiten). Praxis der Kinderpsychologie und Kinderpsychiatrie, 62, 570-582.
http://dx.doi.org/10.13109/prkk.2013.62.8.570

  
comments powered by Disqus

Copyright © 2018 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.