Team approach to the treatment of school children with chronic non-communicable diseases:a model and efficiency

The aim of this investigation was evaluation of continued eight year care for school children with chronic non-communicable diseases using the team work principles. The expert team consisted of a school doctor and general practitioner, psychologist, pedagogue, special teacher, primary teacher, social worker, and other experts depending on the disease. The study comprised pupils enrolled in grades 1 – 8 of the «A.G. Matoš» elementary school in Zagreb during school year 2000/2001. There were 337 girls and 321 boys. The selection was made based on the retrospective analysis of health charts, systematic examinations and other medical records as well as according to the definition of chronic diseases and an orientation list of diseases found in children with developmental disorders. The results of the study showed that 13.4% of pupils suffered from chronic non-communicable disease, the incidence being higher in boys (15.1%) than in girls (11.5%). Most frequent diseases were chronic respiratory diseases (4.4%), neurological diseases (2.3%), vascular and cardiovascular diseases (1.4%), urogenital diseases (1.1%), sensory organ diseases and etc. 87.5% of pupils suffering from chronic diseases had very good and good school performance. Learning problems were found in 11.4% of pupils with chronic diseases, whereas behavioral or psychological disorders were present in 19.3% of all pupils with chronic diseases. 82.4% of these came from socially and economically deprived communities. Psychological testing of this group showed no statistically significant difference either in the psychological features of the examined groups or in the perception of self-competence (t= 1.15; p > 0.05), the level of developed self-esteem (t=1.22; p> 0.05), and the presence of two character factors: introversion-extroversion and neuroticism – emotional stability (t= 1.06; p > 0.05). According to the survey conducted in the teachers, pupils with chronic diseases did not use their disease to achieve higher grades. By applying team work principles, using expert competence of a multi-expert team and implementing adequate measures, the following goals can be achieved: efficient care of school children with chronic diseases, efficient psychosocial adaptation and good school performance, good disease control, reduced absence from school and reduced hospitalization, as well as establishment of good communication with the child, its family and members of the team.