title: Quality of Life and School Absenteeism in Children With Chronic Illness.
abstract: OBJECTIVE
  Children and adolescents with a chronic illness (CI) tend to demonstrate diminished physical and social functioning, which contribute to school attendance issues. We investigated the role of social and physical functioning in reducing school absenteeism in children participating in Mastering Each New Direction (MEND), a family-based psychosocial intervention for youths with CI.
  
  
  METHODS
  Forty-eight children and adolescents with a CI (70.8% female, M age = 14.922, SD = 2.143) and their parent(s) completed a health-related quality of life (HRQOL) measure pre- and postintervention. Using multiple mediation, we examined whether parent- and child-rated physical and social HRQOL mediated the relationship between school attendance before and after MEND. Once the mediational model was not supported, we investigated whether HRQOL moderated the relationship between missed school days pre- and postintervention.
  
  
  RESULTS
  Neither physical nor social functioning mediated or moderated the relationship between missed school days pre- and postintervention. Instead, higher parent-rated physical functioning directly predicted decreased number of missed school days, while lower parent-rated social and child-rated physical functioning predicted increased missed school days.
  
  
  CONCLUSIONS
  Parent-perceived HRQOL may have a direct effect on health-related behaviors such as school attendance. Future research should determine whether gains in parent-rated QOL are maintained in the long term and whether these continue to impact markers of functional well-being.
authors.affiliation: Department of Psychology, Loma Linda University, Loma Linda, CA, USA ndemerson@llu.edu.
authors.forename: Natacha D
authors.initials: ND
authors.lastname: Emerson
authors.affiliation: School of Behavioral Health and Behavioral Health Institute, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Distelberg
authors.affiliation: Department of Psychology, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Holly E R
authors.initials: HE
authors.lastname: Morrell
authors.affiliation: Department of Counseling and Family Sciences, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Jackie
authors.initials: J
authors.lastname: Williams-Reade
authors.affiliation: Behavioral Medicine Center, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tapanes
authors.affiliation: School of Behavioral Health and Behavioral Health Institute, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Montgomery
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: adolescents; children; chronic illness; quality of life; school attendance