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中等职业教育学校患病上报学生的医疗建议(MASS):一项前后对照研究的设计

Medical Advice for Sick-reported Students (MASS) in intermediate vocational education schools: design of a controlled before-and-after study.

作者信息

Van der Vlis Madelon K, Lugtenberg Marjolein, Vanneste Yvonne T M, Berends Wenda, Mulder Wico, Bannink Rienke, Van Grieken Amy, Raat Hein, de Kroon Marlou L A

机构信息

Department of Public Health, Erasmus University Medical Centre, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.

Department of Youth Health Care, Regional Public Health Service West Brabant, PO Box 3024, 5033, DA, Tilburg, The Netherlands.

出版信息

BMC Public Health. 2017 Jun 29;17(1):608. doi: 10.1186/s12889-017-4530-2.

Abstract

BACKGROUND

School absenteeism, including medical absenteeism, is associated with early school dropout and may result in physical, mental, social and work-related problems in later life. Especially at intermediate vocational education schools, high rates of medical absenteeism are found. In 2012 the Dutch intervention 'Medical Advice for Sick-reported Students' (MASS), previously developed for pre-vocational secondary education, was adjusted for intermediate vocational education schools. The aim of the study outlined in this paper is to evaluate the effectiveness of the MASS intervention at intermediate vocational education schools in terms of reducing students' medical absenteeism and early dropping out of school. Additionally, the extent to which biopsychosocial and other factors moderate the effectiveness of the intervention will be assessed.

METHODS

A controlled before-and-after study will be conducted within Intermediate Vocational Education schools. Schools are allocated to be an intervention or control school based on whether the schools have implemented the MASS intervention (intervention schools) or not (control schools). Intervention schools apply the MASS intervention consisting of active support for students with medical absenteeism provided by the school including a consultation with the Youth Health Care (YHC) professional if needed. Control schools provide care as usual. Data will be collected by questionnaires among students in both groups meeting the criteria for extensive medical absenteeism (i.e. 'reported sick four times in 12 school weeks or for more than six consecutive school days' at baseline and at 6 months follow-up). Additionally, in the intervention group a questionnaire is completed after each consultation with a YHC professional, by both the student and the YHC professional. Primary outcome measures are duration and cumulative incidence of absenteeism and academic performances. Secondary outcome measures are biopsychosocial outcomes of the students.

DISCUSSION

It is hypothesized that implementing the MASS intervention including a referral to a YHC professional on indication, will result in a lower level of medical absenteeism and a lower level of school drop outs among intermediate vocational education students compared to students receiving usual care. The study will provide insight in the effectiveness of the intervention as well as in factors moderating the intervention's effectiveness.

TRIAL REGISTRATION

Nederlands Trial Register NTR5556. Date of clinical trial registration: 29-Oct-2015.

摘要

背景

包括因病缺勤在内的学校缺勤现象与早期辍学相关,并可能在日后生活中导致身体、心理、社交及工作方面的问题。尤其是在中等职业教育学校,因病缺勤率较高。2012年,荷兰针对中等职业教育学校调整了此前为职业前中等教育开发的“为因病上报学生提供医疗建议”(MASS)干预措施。本文所述研究的目的是评估MASS干预措施在中等职业教育学校减少学生因病缺勤和早期辍学方面的有效性。此外,还将评估生物心理社会因素及其他因素对干预效果的调节程度。

方法

将在中等职业教育学校开展一项前后对照的对照研究。根据学校是否实施MASS干预措施(干预学校)或未实施(对照学校),将学校分配为干预学校或对照学校。干预学校实施MASS干预措施,包括学校对因病缺勤学生的积极支持,如有需要还包括与青少年保健(YHC)专业人员进行咨询。对照学校照常提供护理。将通过问卷调查收集两组符合因病缺勤标准(即基线时和6个月随访时“在12个教学周内因病上报4次或连续超过6个教学日”)的学生的数据。此外,在干预组中,学生和YHC专业人员在每次与YHC专业人员咨询后都要填写一份问卷。主要结局指标是缺勤的持续时间和累积发生率以及学业成绩。次要结局指标是学生的生物心理社会结局。

讨论

假设实施包括根据指征转介给YHC专业人员的MASS干预措施,与接受常规护理的学生相比,中等职业教育学生的因病缺勤水平和辍学率会更低。该研究将深入了解干预措施的有效性以及调节干预效果的因素。

试验注册

荷兰试验注册库NTR5556。临床试验注册日期:2015年10月29日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7755/5492675/dd3224542eab/12889_2017_4530_Fig1_HTML.jpg

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