Department of Pediatrics, Division of Pediatric Nephrology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
Biostatistics and Design Program, OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA.
Pediatr Nephrol. 2023 May;38(5):1591-1598. doi: 10.1007/s00467-022-05780-2. Epub 2022 Oct 21.
Children with chronic kidney disease (CKD) are at risk for neurocognitive deficits while simultaneously being at risk for chronic school absenteeism (≥ 18 school days per school year). Chronic school absenteeism compounds the negative impacts of CKD on academic achievement. In this study, we examined patient- and caregiver-reported factors associated with school absenteeism in children with non-dialysis- or transplant-dependent CKD in order to help identify which factors could be modifiable and ultimately improve school attendance.
We utilized a combination of chart review and questionnaires distributed in person to patients and caregivers at a pediatric nephrology clinic between November 2018 and August 2019 to gather data. We used descriptive statistics to illustrate clinical characteristics of the children included in the study, caregiver characteristics, and examined reported reasons for missing school.
Twenty-one percent of participants (10/48) missed 18 full days of school or more, categorizing them as chronically absent. The top three reasons for missing school were doctor appointments, feeling sick, and being bullied. More specific sequelae of CKD were not highly reported as reasons for missing school.
Chronic absenteeism is a highly reported phenomenon among children with pediatric CKD. Given that missing school for doctor appointments was a top reason for absenteeism, this data suggests alternative appointment hours and virtual appointments may reduce chronic school absenteeism in children, and by extension improve their health, behavioral, and academic outcomes. A higher resolution version of the Graphical abstract is available as Supplementary information.
患有慢性肾脏疾病（CKD）的儿童存在神经认知缺陷的风险，同时也存在慢性学校缺课（每年≥18 天）的风险。慢性学校缺课加剧了 CKD 对学业成绩的负面影响。在这项研究中，我们研究了非透析或移植依赖型 CKD 儿童的患者和照顾者报告的与缺课相关的因素，以帮助确定哪些因素是可以改变的，并最终提高出勤率。
我们利用病历回顾和问卷调查相结合的方法，于 2018 年 11 月至 2019 年 8 月期间在一家儿科肾病诊所对患者和照顾者进行了问卷调查，以收集数据。我们使用描述性统计方法说明了研究中纳入的儿童的临床特征、照顾者特征，并检查了报告的缺课原因。
21%的参与者（10/48）缺课 18 天或以上，被归类为长期缺课。缺课的前三个原因是看医生、生病和被欺负。更具体的 CKD 后遗症并没有被高度报告为缺课的原因。
慢性缺课是儿科 CKD 儿童中一个高度报告的现象。鉴于因看医生而缺课是缺课的主要原因之一，这一数据表明，调整预约时间和进行虚拟预约可能会减少儿童的慢性学校缺课，从而改善他们的健康、行为和学习成绩。更清晰的图表摘要版本可在补充信息中查看。
