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School-related experience and performance with inflammatory bowel disease: results from a cross-sectional survey in 675 children and their parents
  1. Magdalena Freckmann1,
  2. Alexander Seipp1,
  3. Martin W Laass2,
  4. Sibylle Koletzko3,
  5. Martin Claßen4,
  6. Antje Ballauff5,
  7. Jenny Peplies6,
  8. Antje Timmer1,6
  1. 1 Division of Epidemiology and Biometry, Medical Faculty, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
  2. 2 Institute and Outpatient Clinics of Pediatric and Adolescent Medicine, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
  3. 3 Dr. von Hauner Children’s Hospital, Ludwig Maximilian University, Munich, Germany
  4. 4 Childrens Hospital, Klinikum Links der Weser, Bremen, Germany
  5. 5 Division of Pediatric Gastroenterology and Hepatology, Hospital Links der WeserCenter for Pediatrics and Adolescent Medicine, Krefeld, Germany
  6. 6 Epidemiological Methods and Etiological Research, Leibniz-Institute for Prevention Research and Epidemiology, Bremen, Germany
  1. Correspondence to Dr Antje Timmer; antje.timmer{at}


Objective We describe school performance and experience in children with inflammatory bowel disease (IBD) across Germany and Austria. Predictors of compromised performance and satisfaction were evaluated to identify subgroups of increased risk.

Design This cross-sectional analysis was based on a postal survey in children aged 10–15 with Crohn’s disease, ulcerative colitis or unclassified IBD and their families. Multivariate regression analysis was used to assess influential factors on parental satisfaction with school, attending advanced secondary education (ASE), having good marks and having to repeat a class. Satisfaction was assessed based on the Child Healthcare–Satisfaction, Utilisation and Needs instrument (possible range 1.00–5.00).

Results Of 1367 families contacted, 675 participated in the study (49.4%). Sixty-eight participants (10.2%) had repeated a year, 312 (46.2%) attended ASE. The median school satisfaction score was 2.67 (IQR 2.00–3.33). High socioeconomic status (SES) and region within Germany were predictive for ASE (OR high SES 8.2, 95% CI 4.7 to 14.2). SES, female sex and region of residence predicted good marks. Grade retention was associated with an active disease course (OR 2.7, 95% CI 1.4 to 5.3) and prolonged periods off school due to IBD (OR 3.9, 95% CI 1.8 to 8.6).

Conclusions A severe disease course impacted on the risk of grade retention, but not on type of school attended and school marks. Low satisfaction of parents of chronically ill children with the school situation underlines the need for a more interdisciplinary approach in health services and health services research in young people.

  • inflammatory bowel diseases
  • school
  • education

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  • Contributors MF contributed to literature search, refinement of study questions, statistical analyses, first draft of the manuscript. AS contributed to statistics and non-standard multivariate analyses. SK and MC were consulting on the pediatric content of the study, pretesting of questionnaire, patient recruitment, review of manuscript. AB and MWL provided the pediatric expertise and contributed to the questionnaire development, patient recruitment and review of manuscript. JP was responsible for the coordination of survey and data collection, development and editing of questionnaires and data entry and review of manuscript. AT prepared the study concept and design; did the literature search, funding proposal, development of questionnaires; supervision of survey, statistical analysis and writing of manuscript. All authors contributed to and approved of the final manuscript.

  • Funding This work was supported by a grant from the German Ministry of Education and Science (BMBF, Ripi Study, grant number FK 01GY1139).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was granted (Bremen University Ethics Committee, date of approval 12 March, 2013). Informed consent was secured after written information from parents or guardians, and the children.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data sharing is not possible due to patient consent excluding third party use of data. There are no additional unpublished data available.

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