Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2020

Open Access 01-12-2020 | Research

Influence of schooling on the health-related quality of life of children with rare diseases

Authors: Berta Paz-Lourido, Francisca Negre, Begoña de la Iglesia, Sebastià Verger

Published in: Health and Quality of Life Outcomes | Issue 1/2020

Login to get access

Abstract

Background

Although participation of children with rare diseases in school is considered beneficial, it poses new challenges for the educational system, but also for the affected children and their families. The aim of this study is to identify which aspects of the schooling experience may have an impact on the health-related quality of life of children with rare diseases.

Method

A qualitative study was conducted using the social-critical paradigm as theoretical perspective. Participants (n = 28) included children with rare diseases (n = 8), parents (n = 12) and school staff (n = 8). Data was obtained through in-depth interviews and focus groups and analysed through discourse analysis as methodological orientation.

Results

Participants’ discourses placed value on the social benefits of inclusion of children with rare diseases in schooling. Discourses also highlighted how the low numbers of children with rare diseases and the delay, or lack, of a clear diagnosis are among the difficulties experienced in the pursuit of the adaptations that children and teachers need to promote a healthy and normalized school experience. The issues identified in their health-related quality of life were summarized in seven categories: Attendance, Knowledge, Participation, Acceptance, Discrimination, Safety, Health-Related Support.

Conclusion

Children with rare diseases remain, in many cases, invisible at the educational level due to the low numbers of children affected, limiting the kind of resources available to the child and teaching staff. This situation requires inter-disciplinary and inter-sector measures between health services and educational environments to articulate a comprehensive approach focused on children’s clinical needs.
Literature
1.
go back to reference Hertzman C, Boyce T. How experience gets under the skin to create gradients in developmental health. Annu Rev Public Health. 2010;31:329–47.CrossRef Hertzman C, Boyce T. How experience gets under the skin to create gradients in developmental health. Annu Rev Public Health. 2010;31:329–47.CrossRef
3.
go back to reference Varni JW, Limbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007. https://doi.org/10.1186/1477-7525-5-43. Varni JW, Limbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007. https://​doi.​org/​10.​1186/​1477-7525-5-43.
4.
go back to reference Solans M, Pane S, Estrada MD, Serra-Sutton V, Berra S, Herdman M, et al. Health-related quality of life measurement in children and adolescents: a systematic review of generic and Disease-specific instruments. Value Health. 2008;11(4):742–64.CrossRef Solans M, Pane S, Estrada MD, Serra-Sutton V, Berra S, Herdman M, et al. Health-related quality of life measurement in children and adolescents: a systematic review of generic and Disease-specific instruments. Value Health. 2008;11(4):742–64.CrossRef
5.
go back to reference Rahmil L, Roizen M, Urzúa A, Hidalgo-Rasmussen C, Fernández G, Dapueto JJ. Health-related quality of life measurement in children and adolescents in Ibero-American countries, 2000 to 2010. Value Health. 2012;15(2):312–22.CrossRef Rahmil L, Roizen M, Urzúa A, Hidalgo-Rasmussen C, Fernández G, Dapueto JJ. Health-related quality of life measurement in children and adolescents in Ibero-American countries, 2000 to 2010. Value Health. 2012;15(2):312–22.CrossRef
6.
go back to reference Jackson M. A life course perspective on child health, cognition and occupational skill qualifications in adulthood: evidence from a British cohort. Soc Forces. 2010;89:89–116.CrossRef Jackson M. A life course perspective on child health, cognition and occupational skill qualifications in adulthood: evidence from a British cohort. Soc Forces. 2010;89:89–116.CrossRef
7.
go back to reference Halfon N, Larson K, Russ S. Why social determinants? Healthc Q. 2010;14(Suppl):8–20.CrossRef Halfon N, Larson K, Russ S. Why social determinants? Healthc Q. 2010;14(Suppl):8–20.CrossRef
8.
go back to reference Coller RJ, Kuo AA. Social determinants of child health. In: Kuo AA, Coller RJ, Stewart-Brown S, Blair M, editors. Child health: a population perspective. New York: Oxford University Press; 2015. p. 79–110.CrossRef Coller RJ, Kuo AA. Social determinants of child health. In: Kuo AA, Coller RJ, Stewart-Brown S, Blair M, editors. Child health: a population perspective. New York: Oxford University Press; 2015. p. 79–110.CrossRef
9.
go back to reference Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C, et al. Social determinants of health and well-being among young people. Health behaviour in school-aged children (HBSC) study: international report from the 2009/2010 survey. Copenhagen: WHO Regional Office for Europe; 2012. Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C, et al. Social determinants of health and well-being among young people. Health behaviour in school-aged children (HBSC) study: international report from the 2009/2010 survey. Copenhagen: WHO Regional Office for Europe; 2012.
10.
go back to reference Huang K-Y, Cheng S, Theise R. School contexts as social determinants of child health: current practices and implications for future public health practice. Public Health Rep. 2013;128(Suppl 3):21–8.CrossRef Huang K-Y, Cheng S, Theise R. School contexts as social determinants of child health: current practices and implications for future public health practice. Public Health Rep. 2013;128(Suppl 3):21–8.CrossRef
11.
go back to reference Adams CD, Streisand RM, Zawacki T, Joseph KE. Living with a chronic illness: a measure of social functioning for children and adolescents. J Pediatr Psychol. 2002;27:593–605.CrossRef Adams CD, Streisand RM, Zawacki T, Joseph KE. Living with a chronic illness: a measure of social functioning for children and adolescents. J Pediatr Psychol. 2002;27:593–605.CrossRef
12.
go back to reference Closs A. The education of children with medical conditions. London: Routledge; 2013.CrossRef Closs A. The education of children with medical conditions. London: Routledge; 2013.CrossRef
13.
go back to reference Hopkins L. An Australian and New Zealand review of education support for children with chronic health conditions. Melbourne: The Royal Children’s Hospital Education Institute; 2015. Hopkins L. An Australian and New Zealand review of education support for children with chronic health conditions. Melbourne: The Royal Children’s Hospital Education Institute; 2015.
15.
go back to reference Schieppati A, Henter JI, Daina E, Aperia A. Why rare diseases are an important medical and social issue. Lancet. 2008;371:2039–41.CrossRef Schieppati A, Henter JI, Daina E, Aperia A. Why rare diseases are an important medical and social issue. Lancet. 2008;371:2039–41.CrossRef
17.
go back to reference Cohen JS, Biesecker BB. Quality of life in rare genetic conditions: a systematic review of the literature. Am J Med Genet. 2010;152A:1136–56. Cohen JS, Biesecker BB. Quality of life in rare genetic conditions: a systematic review of the literature. Am J Med Genet. 2010;152A:1136–56.
22.
go back to reference Varni JW, Limbers CA, Burwinkle TM. Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:2.CrossRef Varni JW, Limbers CA, Burwinkle TM. Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:2.CrossRef
24.
go back to reference Vetter TR, Bridgewater CL, Mcgwin G. An observational study of patient versus parental perceptions of health-related quality of life in children and adolescents with a chronic pain condition: who should the clinician believe? Health Qual Life Outcomes. 2012. https://doi.org/10.1186/1477-7525-10-85. Vetter TR, Bridgewater CL, Mcgwin G. An observational study of patient versus parental perceptions of health-related quality of life in children and adolescents with a chronic pain condition: who should the clinician believe? Health Qual Life Outcomes. 2012. https://​doi.​org/​10.​1186/​1477-7525-10-85.
26.
go back to reference Durán A, Lara JL, Waveren M. Health systems in transition: Spain. Health system review. Copenhagen: WHO Regional Office for Europe; 2006. Durán A, Lara JL, Waveren M. Health systems in transition: Spain. Health system review. Copenhagen: WHO Regional Office for Europe; 2006.
27.
go back to reference Coba E, Grañeras M, Vázquez E. Spanish education system 2009. Madrid: Ministry of Education; 2010. Coba E, Grañeras M, Vázquez E. Spanish education system 2009. Madrid: Ministry of Education; 2010.
28.
go back to reference Kincheloe J, McLaren P. Rethinking critical theory and qualitative research. In: Denzin N, Lincoln Y, editors. The sage handbook of qualitative research. CA: Sage Publications; 2005. p. 303–42. Kincheloe J, McLaren P. Rethinking critical theory and qualitative research. In: Denzin N, Lincoln Y, editors. The sage handbook of qualitative research. CA: Sage Publications; 2005. p. 303–42.
29.
go back to reference Freire P. Pedagogy of Hope. Reliving pedagogy of the oppressed. New York: Continuum; 1995. Freire P. Pedagogy of Hope. Reliving pedagogy of the oppressed. New York: Continuum; 1995.
30.
go back to reference Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002. Patton MQ. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks: Sage; 2002.
31.
go back to reference Antaki C. Discourse analysis and conversation analysis. In: Alasuutari P, Bickman L, Brannan J, editors. The SAGE handbook of social research methods. London: Sage; 2008. p. 431–46.CrossRef Antaki C. Discourse analysis and conversation analysis. In: Alasuutari P, Bickman L, Brannan J, editors. The SAGE handbook of social research methods. London: Sage; 2008. p. 431–46.CrossRef
32.
go back to reference Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics. 2016;34(7):645–9.CrossRef Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics. 2016;34(7):645–9.CrossRef
33.
go back to reference Mays N, Pope C. Rigour and qualitative research. BMJ. 1995;311(6997):109–12.CrossRef Mays N, Pope C. Rigour and qualitative research. BMJ. 1995;311(6997):109–12.CrossRef
34.
go back to reference Richards HM, Schwartz LJ. Ethics of qualitative research: are there special issues for health services research? Fam Pract. 2002;19:135–9.CrossRef Richards HM, Schwartz LJ. Ethics of qualitative research: are there special issues for health services research? Fam Pract. 2002;19:135–9.CrossRef
35.
go back to reference Zurynski Y, Deverell M, Dalkeith T, Johnson S, Christodoulou J, Leonard H, et al. Australian children living with rare diseases: experiences of diagnosis and perceived consequences of diagnostic delays. Health Qual Life Outcomes. 2017;12:68. Zurynski Y, Deverell M, Dalkeith T, Johnson S, Christodoulou J, Leonard H, et al. Australian children living with rare diseases: experiences of diagnosis and perceived consequences of diagnostic delays. Health Qual Life Outcomes. 2017;12:68.
36.
go back to reference Beachamp BL, Deatrick JA. Children with chronic conditions: perspectives on condition management. J Pediatr Nurs. 2015;30(1):25–35.CrossRef Beachamp BL, Deatrick JA. Children with chronic conditions: perspectives on condition management. J Pediatr Nurs. 2015;30(1):25–35.CrossRef
37.
go back to reference Lightfoot J, Wright S, Sloper P. Supporting pupils in mainstream school with an illness or disability: young people's views. Child Care Health Dev. 1999;25(4):267–83.CrossRef Lightfoot J, Wright S, Sloper P. Supporting pupils in mainstream school with an illness or disability: young people's views. Child Care Health Dev. 1999;25(4):267–83.CrossRef
38.
go back to reference Jackson P. Health services: supporting children, families and schools. In: Closs A, editor. The education of children with medical conditions. London: David Fulton Publishers; 2000. Jackson P. Health services: supporting children, families and schools. In: Closs A, editor. The education of children with medical conditions. London: David Fulton Publishers; 2000.
39.
go back to reference Bendixen RM, Senesac C, Lott DJ, Vandenborne K. Participation and quality of life in children with Duchenne muscular dystrophy using the international classification of functioning, disability, and health. Health Qual Life Outcomes. 2012. https://doi.org/10.1186/1477-7525-10-43. Bendixen RM, Senesac C, Lott DJ, Vandenborne K. Participation and quality of life in children with Duchenne muscular dystrophy using the international classification of functioning, disability, and health. Health Qual Life Outcomes. 2012. https://​doi.​org/​10.​1186/​1477-7525-10-43.
41.
go back to reference Kopeć G, Podolec P. Establishing a curriculum on rare diseases for medical students. Orphanet J Rare Dis. 2012;7(Suppl 2):A15.CrossRef Kopeć G, Podolec P. Establishing a curriculum on rare diseases for medical students. Orphanet J Rare Dis. 2012;7(Suppl 2):A15.CrossRef
42.
go back to reference Jonas K, Waligóra M, Hołda M, Sulicka-Grodzicka J, Strach M, Podolec P, Kopeć G. Knowledge of rare diseases among health care students – the effect of targeted education. Przegl Epidemiol. 2017;71(1):80–9.PubMed Jonas K, Waligóra M, Hołda M, Sulicka-Grodzicka J, Strach M, Podolec P, Kopeć G. Knowledge of rare diseases among health care students – the effect of targeted education. Przegl Epidemiol. 2017;71(1):80–9.PubMed
43.
go back to reference Zurynski Y, Gonzalez A, Deverell M, Phu A, Leonard H, Christodoulou J, Elliott, et al. Impacts of Rare Diseases Study Partners, et al. Rare disease: a national survey of paediatricians’ experiences and needs. BMJ Paediatrics Open. 2017. https://doi.org/10.1136/bmjpo-2017-000172. Zurynski Y, Gonzalez A, Deverell M, Phu A, Leonard H, Christodoulou J, Elliott, et al. Impacts of Rare Diseases Study Partners, et al. Rare disease: a national survey of paediatricians’ experiences and needs. BMJ Paediatrics Open. 2017. https://​doi.​org/​10.​1136/​bmjpo-2017-000172.
Metadata
Title
Influence of schooling on the health-related quality of life of children with rare diseases
Authors
Berta Paz-Lourido
Francisca Negre
Begoña de la Iglesia
Sebastià Verger
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-020-01351-x

Other articles of this Issue 1/2020

Health and Quality of Life Outcomes 1/2020 Go to the issue