Schwartz Lisa A, Radcliffe Jerilynn, Barakat Lamia P
Department of Psychology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Pediatr Blood Cancer. 2009 Jan;52(1):92-6. doi: 10.1002/pbc.21819.
Despite high rates of school absenteeism in adolescents with sickle cell disease (SCD), the issue remains understudied. Potential associates of school absenteeism in adolescents with SCD include demographic (age, income), psychosocial (IQ, self-efficacy, competence, internalizing symptoms, negative thinking), and health-related (hemoglobin, health-care utilization, pain, disease knowledge).
Forty participants ages 12-18 completed measures of psychosocial functioning, IQ, and pain. Medical chart reviews identified other health-related variables. A subsample also completed an assessment of goals. Using school records, absenteeism was the percent of school days missed in the previous year. Correlations tested associates of absenteeism and linear regression tested a model of absenteeism.
Participants missed an average of 12% of the school year and more than 35% missed at least 1 month of school. Health-related and psychosocial variables, but not demographic variables, correlated with absenteeism. Attendance at clinic appointments and parent-reported teen pain frequency were significant associates of absenteeism in the regression model. For those who completed goal assessment, over 40% of goals identified were academically focused. Absenteeism was positively related to current academic goals and health-related hindrance of academic goals, and negatively related to future-oriented academic goals.
School absenteeism is a significant problem for adolescents with SCD despite the presence of academic goals. Collaboration between schools, parents, patients, and providers to understand and manage the impact of SCD on school attendance is recommended.
尽管镰状细胞病（SCD）青少年的学校缺勤率很高，但该问题仍未得到充分研究。患有SCD的青少年缺勤的潜在相关因素包括人口统计学因素（年龄、收入）、心理社会因素（智商、自我效能感、能力、内化症状、消极思维）以及与健康相关的因素（血红蛋白、医疗保健利用、疼痛、疾病知识）。
40名年龄在12至18岁之间的参与者完成了心理社会功能、智商和疼痛的测量。病历审查确定了其他与健康相关的变量。一个子样本还完成了目标评估。利用学校记录，缺勤率是前一年错过的上学天数的百分比。相关性检验了缺勤的相关因素，线性回归检验了缺勤模型。
参与者平均错过学年的12%，超过35%的人至少错过1个月的学校学习。与健康相关的和心理社会变量与缺勤率相关，但人口统计学变量不相关。在回归模型中，门诊预约的出勤率和家长报告的青少年疼痛频率是缺勤的重要相关因素。对于完成目标评估的人来说，确定的目标中超过40%是学业相关的。缺勤率与当前的学业目标和学业目标的健康相关障碍呈正相关，与面向未来的学业目标呈负相关。
尽管存在学业目标，但学校缺勤对患有SCD的青少年来说仍是一个重大问题。建议学校、家长、患者和医疗服务提供者之间开展合作，以了解和管理SCD对上学出勤率的影响。
