Functional Limitations Associated with Chronic Health Conditions Among School-Aged Children, in Kayseri, Turkey As. Pro

1. Functional Limitations Associated with Chronic Health Conditions Among School-Aged Children, in Kayseri, Turkey As. Prof. Vesile ŞENOL Prof. Dr. Fevziye ÇETİNKAYA Erciyes University, TURKEY

2. Purpose The aim of this study was • to assess theprevalenceof activity limitations in school aged children with CHC /impairments and • the affecting factors in Kayseri, Turkey

3. Method • Thiscross-sectionalstudywasconducted in Kayseri, Turkey, in 2005-2006. • 99 primaryschoolswerestratifiedaccordingtothesocio-economiclevels of thefamilies of thechildren as: welfare, middleandpoor. • Bysimplerandomsamplingtechnique, 20 primaryschoolswereincluded in thesample, 1/5 fromeachstratum.

4. Method • A questionnairewasusedforthepresentstudy • In total, theparents of 4508 childrenansweredthequestionnaires. • Theresponse rate was 93 %.

5. According to InternationalClassification of Functional (ICF): • Disability,which is actually considered“an umberalla term” for; • Impairment, • Activity limitations and • Participitation restriction.

6. Chronic HealthCondition • Health Conditions-diseases, disorders and injuries • These are considered to be chronic when they are long-term (at least three months’ duration) or are of a permanent nature, which has interfered with daily functions during the last year.

7. Impairments (ICF) • Impairment: Problems in body functions or structure • Body Functions: Physiological functions of body systems • Body structure: anatomical parts of body

8. ActivityLimitations &ParticipitationRestriction (ICF) • Activity - The execution of a task or action by an individual • Activity limitations difficulties an individual may have in executing activities • Participitation : involvement in a life situation • Participitation restriction : Problems an individual may experience in involvement in life situation

9. Chronic HealthCondition / Impairments • Reported 29 chronic health conditions emerged under three headings; • Chronic diseases (6) • Physical impairments (5) • Emotional/behavioral disorders (5).

10. Activity Limitations • Mobility included being in need of help or supervision when going to school • Self-care needing help while eating, dressing and bathing • Communication having in difficulties in communicating with friends and teachers

11. SchoolActivity Restirictions • School performance • School attendance • Grade repetition -be measured as animpact on aspects ofchildren’s school life-

12. School Performance be classified by asking the teachersas: Poor Fair Good

13. Family Ecology • Parental education • Occupation • Family income.

14. Results • Childrenhad one or more chronic health conditions35.3 % The most commonly reported CHC are: • Teeth and periodontal diseases 32.7 % • Visual impairments 30.7 % • Urinary incontinence 14.7 %

15. Table 1. Prevalence of chronic health and activity-limiting conditions among school-aged children

16. Activity Limiting Conditions • The rate of all the children have one or more activity limitations 3.7 % • In children with CHC 9.2 % • In children withoutCHC 0.8 %

17. The Type of Activity Limiting Conditions • Mobility : 4.3 % • Self-care : 4.4 % • Communication : 4.0 %

18. Table 2. Prevelance of functional limitations among school-aged children

19. School Activity Restirictions In children with CHC • School absence days 29.7 % • Grade repetition 4.6 % In children withoutCHC • School absence days 21.6 % • Grade repetition 2.4 %

20. Table 3. Impact of chronic health conditions on school-aged children’s school-activity levels

21. The Rate of Activity Limitations • Teethandperiodontaldiseases47.9% • Visualimpairments31.5 % • Speechimpediments26.7 % • Depression19.9 % • Musculoskeletal impairment 9.0 %

22. Table 4. Impact of chronic health conditions on school-aged children’s functional activity levels

23. ActivityLimitations • Activity limitations in boys • School absence days and grade repetition among 13-17 age groups Were the most common (p<0.05)

24. Table 5. Prevalence of activity limitations according to some socio-demographic characteristics in children with CHC

25. ActivityLimitations • low-educated • Unemployed • low-income -were higher in children fromfamilies-

26. Table 6. Prevalence activity limitations according to some socio-demographic variables in children with CHC

27. SchoolPerformance Poorschoolperformance 53.4 % In children with CHC 53.5 % In children without CHC 53.3 % Good school performance 10.9 % In children with CHC 20.0 % In children without CHC 6.0 % *Thesuccess rate in thechildrenwho had chronichealthproblemswassurprisinglyhigherthanthosewhodid not.

28. Conclusion • Activity-limiting conditions in school-aged children with CHC are a major public health problem. • The findings of this study confirm that as well as long chronic health conditions, disrupted family environmental variables are likely to be significant risk factors for functional activity limitations.

29. Conclusion • Better health promotion and disease prevention may reduce the prevalence of disability depending on chronic health conditions/impairments. • Targetting prevention and rehabilitation efforts toward disavantaged children and families may be an important way of ameliorating the impact of these conditions.