Chronic diseases, social context and adolescent health

Studies have claimed children with chronic diseases to have greater probability of behavioural and emotional problems, while others have emphasized good adaptation of most children. Protection and risk factors were identified as determinants of positive adaptation to chronic conditions, such as family and school related dimensions. This study tested the negative association between a chronic disease and positive health. A nationally representative sample of 6131 Portuguese adolescents, mean age 14, was surveyed based on a self-completed questionnaire. We used data from the Portuguese study of the 2002 HBSC (Health Behaviour in School-Aged Children), namely the questions on chronic disease, demographics, psychological symptoms, school life related variables, substance use and life satisfaction. Preliminary multilevel analysis and Structural Equation Model were specified. Students with chronic disease reported more psychological symptoms, less global. satisfaction and less positive perception of school environment. Results supported the assumption that chronic disease is negatively associated with adolescent global life satisfaction, and that this relation is moderated by gender, school grade and socioeconomic status, and mediated by variables related with the school. The data supports a recommendation for schools to develop more systematic procedures to attend students with chronic conditions.