Partizipation und Bildung als Endpunkte in der pädiatrischen Versorgungsforschung

Abstract

ZusammenfassungAngesichts des sich wandelnden Krankheitsspektrums in der Pädiatrie ist eine gut organisierte pädiatrische Versorgungsforschung notwendig. Wir stellen in diesem Artikel aus entwicklungspädiatrischer Sicht ausschlaggebende, neue Endpunkte der pädiatrischen Versorgungsforschung vor, nämlich Partizipation (= soziale Teilhabe) und Bildung. Durch zwei derzeit in Deutschland laufende Validierungsstudien werden in absehbarer Zeit zwei soziokulturell adaptierte deutschsprachige Instrumente zur Messung von Partizipation zur Verfügung stehen (CASP bzw. CAPE). Eine weitere Studie wird erstmals in Deutschland die Zusammenhänge zwischen Gesundheitsstand und frühen Bildungsendpunkten am Übergang von der Kindergarten- zur Grundschulzeit darstellen. Bei der zukünftigen Evaluation von pädiatrischen Versorgungsangeboten und -strukturen muss der Fokus vermehrt darauf gelegt werden, ob Partizipation und Bildung verbessert werden. Um dies zu erreichen, wird eine intensivere Vernetzung von medizinischer Versorgung und pädagogischer Förderung im Vordergrund stehen.

School absenteeism in children with special health care needs. Results from the prospective cohort study ikidS

“…school activities that may stimulate their learning and development, ii) it is an important predictor for academic achievement [8], iii) it has been suggested as a causal link (i.e., mediator) between SHCN and impaired educational outcomes [7], and iv) it may be a potentially modifiable target for specific health-related interventions [9].…”

“…In addition, most studies on the association between SHCN and educational outcomes used cross-sectional instead of longitudinal study designs [6], which may have introduced bias. These research gaps motivated the launch of the ikidS project in 2013 ("ich komme in die Schule" (German); I will start school) [7], which aimed to investigate the outcomes of children with SHCN in a regular school setting. We previously showed that a child's actual need for special health care due to a physical or mental chronic health condition (mean difference -0.95; 95% CI -1.55, -0.35)-and not the sole presence of a physician diagnosis of a condition (0.02; 95% CI -0.38, 0.42)-was associated with poor school performance at the end of first grade [10].…”

“…The present study used data from the population-based prospective cohort study "ikidS". Details on the ikidS cohort have been published elsewhere [7,10]. In short, first graders within the city of Mainz and the surrounding district of Mainz-Bingen (Rhineland-Palatinate, Germany) that started school in 2015 were enrolled within their pre-school health examination.…”

“…The relationships between child health and educational outcomes and the potential mediating and moderating factors have been conceptualized in a theoretical framework by Suhrcke and de Paz Nieves [5]. This framework was later modified by Dadaczynski [6] and further extended by our group (Fig 1) by including additional potential mediators, moderators, and further school-related outcomes [7].…”

“…Within this framework, school absenteeism plays a crucial role for several reasons: i) It may hamper a child's ability to build relationships with classmates and keep it from participating in Fig 1 . Analytical framework of the association between health and education. Based on Suhrcke and de Paz Nieves [5] with extensions by Dadaczynski [6] and Urschitz et al [7] indicated in italics. https://doi.org/10.1371/journal.pone.0287408.g001…”