Assa Amit, Ish-Tov Alona, Rinawi Firas, Shamir Raanan
*Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petah-Tikva †Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Pediatr Gastroenterol Nutr. 2015 Nov;61(5):553-7. doi: 10.1097/MPG.0000000000000850.
Inflammatory bowel disease (IBD) and functional abdominal pain (FAP) are associated with debilitating symptoms and frequent medical visits that may disrupt school functioning. The aim of this study was to assess school-related quality of life and school absenteeism in children with IBD, compared with FAP and healthy controls.
School absenteeism and participation in school and after-school activities data were obtained for 43 children with Crohn disease (CD), 31 children with ulcerative colitis (UC), 42 children with FAP, and 30 age-matched healthy controls for the 2013-2014 school year. We used a semistructured questionnaire for both children and parents. For diminishing recall bias, absenteeism data were cross-matched with the patient's school annual report cards.
Children with FAP, CD, and UC missed significantly more school days than age-matched healthy controls (17.6 [8.75-30], 24 [14-30], and 21 [12-25] vs 5.1 [3.75-6.25], respectively, P < 0.001). Compared with children with FAP, absenteeism because of medical appointments and hospitalization was significantly greater in children with CD and UC (8.8 [4-14] and 7.1 [3-10] vs 4.4 [2-6.25], P = 0.001). Participation of children with FAP and IBD in various school and after-school activities was significantly reduced compared with healthy controls. There was no difference in school attendance and functioning between children with IBD and FAP.
FAP has a significant impact on school attendance and functioning similar to IBD. These findings show that significant psychosocial and academic difficulties are faced not only by children with chronic diseases like IBD but also by children with FAP.
炎症性肠病(IBD)和功能性腹痛(FAP)会导致使人衰弱的症状以及频繁就医,这可能会扰乱学校生活。本研究旨在评估IBD患儿与FAP患儿及健康对照相比,与学校相关的生活质量和缺课情况。
获取了2013 - 2014学年43名克罗恩病(CD)患儿、31名溃疡性结肠炎(UC)患儿、42名FAP患儿以及30名年龄匹配的健康对照的缺课情况,以及他们参与学校和课外活动的数据。我们对患儿及其父母都使用了半结构化问卷。为减少回忆偏差,缺课数据与患儿的学校年度成绩单进行了交叉核对。
FAP患儿、CD患儿和UC患儿的缺课天数显著多于年龄匹配的健康对照(分别为17.6[8.75 - 30]天、24[14 - 30]天和21[12 - 25]天,而健康对照为5.1[3.75 - 6.25]天,P<0.001)。与FAP患儿相比,CD患儿和UC患儿因就医预约和住院导致的缺课情况显著更严重(分别为8.8[4 - 14]天和7.1[3 - 10]天,而FAP患儿为4.4[2 - 6.25]天,P = 0.001)。与健康对照相比,FAP患儿和IBD患儿参与各种学校和课外活动的情况显著减少。IBD患儿和FAP患儿在出勤和学校生活方面没有差异。
FAP对出勤和学校生活的影响与IBD相似,具有显著影响。这些发现表明,不仅患有IBD等慢性疾病的儿童,而且患有FAP的儿童都面临着重大的心理社会和学业困难。