title: [School-attendance problems, subjective symptoms and lifestyle factors: the Shizuoka health and lifestyle survey of students].
abstract: OBJECTIVE
  This cross-sectional study was conducted to examine the prevalence of students with a sense of not wishing to-attend school, and associations with subjective symptoms and lifestyle factors.
  
  
  METHODS
  The database of the Shizuoka health and lifestyle survey of students conducted in November 2003 was used. The subjects were 5448 elementary, junior high and high school students and 1051 caregivers of elementary school students. A self-administered questionnaire was administered to obtain infiromation on non-willingness to-attend school, subjective symptoms and lifestyle factors for students and lifestyle factors for caregivers.
  
  
  RESULTS
  Valid responses were obtained from 2675 elementary school students, 940 junior high school students, 1377 high school students and 659 caregivers. The prevalence of students who experienced unwillingness to attend school in males was 11.4% in elementary schools, 12.1% in junior high schools and 25.3% in high schools. The prevalences in females were 9.8%, 19.6% and 35.9%, respectively. Multiple logistic regression analysis with such unwillingness as the objective variable and subjective symptoms and lifestyle factors as the explanatory variables, stratified by school and sex, adjusted for school grade in elementary schools, showed significantly high odds ratios (ORs) for reduction of vitality (OR: 3.68-8.22), irritable moods (OR: 3.00-6.30), feelings of fatigue and weariness (OR: 3.63-5.10) and difficulty waking up in the morning (OR: 1.98-2.69) in each school and sex, with an additional strong tendency for weight loss (OR: 1.83-2.97), with insignificantly high OR of boys in junior high schools (OR: 2.09, 95% Confidence interval: 0.95-4.60). No significant association was found between unwillingness to attend school in elementary school students with the lifestyle factors of their caregivers.
  
  
  CONCLUSIONS
  There was no gender difference in the prevalence of students with feeleings of unwillingness to attend school in elementary school students, but figures were higher in females than in males for junior high and high school students. This was associated with the same subjective symptoms as those observed for students actually not attending school.
authors.affiliation: Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine.
authors.forename: Mieko
authors.initials: M
authors.lastname: Nakamura
authors.forename: Imako
authors.initials: I
authors.lastname: Kondo
authors.forename: Akio
authors.initials: A
authors.lastname: Kubota
authors.forename: Ihoko
authors.initials: I
authors.lastname: Furukawa
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Suzuki
authors.forename: Harunobu
authors.initials: H
authors.lastname: Nakamura
authors.forename: Norika
authors.initials: N
authors.lastname: Hayakawa
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ojima
authors.forename: Nobuo
authors.initials: N
authors.lastname: Aoki
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D007564:Japan; D008019:Life Style; D008297:Male; D010698:Phobic Disorders / Q000523:psychology*