[Chronic diseases and perception of school demands among school children aged 11-15 years in Poland].

Background: There are children for whom because of chronic diseases, functioning in school is more difficult. They are absent more often, causing gaps in knowledge and isolation from peer group. These pupils need extra support in order to make normal school progress without the need to move to special schools or individual schooling. The aim of the study is to compare the stress and perception of school demands among healthy and ill schoolchildren.

Methods: The study concerned 5489 children aged 11-15 years who participated in the Polish part of the international study on health behaviour in schoolchildren (HBSC - Health Behaviour in School-aged Children) conducted in 2006. As outcome measures, three items concerning school stress and school-related demands were chosen. Chronically ill pupils were defined as those who suffered from prolonged health problems diagnosed by a doctor and, as a result, had to take medication on permanent basis and/ or stay away from school for this reason. Logistic regression was applied and odds ratio (OR) with 95% confidence interval (CI) was estimated. All analyses were adjusted for age, gender and family economic status measured by Family Affluence Scale (FAS). At first step FAS was included as independent variable, while at the second step three models specific for FAS groups were estimated.

Results: The studies revealed that schoolchildren suffering from chronic illness have greater problems with fulfilling their development tasks connected with education. The difference between ill and healthy children is significantly raised by a low family economic status. Students with chronic diseases are at increased risk of finding school work heavy. For the three FAS groups, the odds ratio was: in poor families OR = 1.62 (95% CI: < 1.10-2.38>), in average income families OR = 1.49 (95% C1: < 1.07-2.08 >), and in rich families OR = 1.26 (95% Cl:< 0.84- 1.88 >).

Conclusion: Young people with chronic health problems are at a higher risk of poor school adjustment. There is only a weak relationship between family socio-economic status and the prevalence of chronic diseases in the population of schoolchildren. However, family economic status modifies the relationship between chronic diseases and perception of school demands. The way a sick child functions in the school environment should become part of a wider discussion among teachers, parents and pediatricians.