School and vocational orientation of pupils with chronic diseases and health disturbances

Pupils’ health is an important factor in making decisions regarding further education and vocational choice. A great deal of research has shown that 10-15% of children have some kind of chronic disease. School doctors monitor pupils by means of regular medical check-ups and other examinations and have a good insight into the health and psychological and physical abilities of these pupils. As part of a team, school and vocational guidance helps chronically sick pupils choose a career for which their illness is not a limiting factor or a risk factor for any deterioration in the disease or interruption of education. The goal of the research was to determine the reasons why pupils were sent for vocational guidance. The subjects were eighth grade pupils at elementary school over two time periods: the period of integrated health care (school year 1987/8-1996/7) and the period of preventive health care (school year 1997/8-2000/01) In the first period 13.1% pupils and in the second 9.2% pupils were found to have chronic diseases or health disturbances. In both periods more boys were sent for vocational guidance than girls. The reasons for vocational guidance for the pupils were sorted on the basis of the main diagnosis in the group of diseases according to the International Classification of Diseases. In the first period there were five leading groups diagnosed: diseases of the musculoskeletal system and tissue (22.6%), diseases of the eye and optical adnexa (16.9%), respiratory system diseases (14.9%), diseases of the ear and mastoid process (13.3%) and psychological and behavioural disturbances (7.7%). In the second period psychological and behavioural disturbances were in first place with 37.4%, then diseases of the eye and optical adnexa (25.0%), diseases of the respiratory system (11.6%), diseases of the ear and mastoid process (9.4%) and in fifth place diseases of the nervous system (8.6%). Despite recommendation 11.6% pupils chose a school for which their health was a contraindication. Boys more often did not follow recommendations. 7.1% of pupils did not continue with their education. The results shown demonstrate that in the current organisation of school medicine vocational guidance is an important area of professional work for the school doctor.