School demands and subjective health complaints among Swedish schoolchildren: A multilevel study

Abstract

Objectives: As children spend a great deal of their time in school, the climate in the classroom can constitute a resource, but also a risk factor in the development of the pupils’ health. The aim of the present study was to determine the extent to which demands in the classroom are associated with subjective health complaints in Swedish schoolchildren. Methods: Data from the 2001/2002 and 2005/2006 Swedish cross-national Health Behaviour in School-aged Children (HBSC) survey were analysed using a multilevel logistic regression technique. Results: The study demonstrated a substantial variation between school classes in pupils’ subjective health complaints. In school classes with high demands, the odds of having subjective health complaints was about 50% higher than in school classes with low demands. Further, the results indicated that these effects were mediated by sex so as to girls being more affected by high levels of demands in the school class. Conclusions: The findings are important since they point at the crucial role that teachers play in creating a favourable school climate. Therefore interventions aiming at supporting teachers to set realistic demands and expectations are one way to improve the school climate. Such interventions should also make clear the need to take into consideration the fact that the school class effect was mediated by sex, i.e. girls being more vulnerable to high level of school class demands.

Keywords

Child context HBSC health promotion multilevel logistic regression schools

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References

SOU 2006 :77. Ungdomar, stress och psykisk ohälsa. Analyser och förslag till åtgärder (in Swedish). Stockholm : SOU; 2006.

Haugland S. , Wold B. Subjective health complaints in adolescence - reliability and validity of survey methods. J Adolesc 2001;24(5):611-24.

Haugland S. , Wold B. , Stevenson J. , Aaroe LE , Woynarowska B. Subjective health complaints in adolescence. A cross-national comparison of prevalence and dimensionality. Eur J Public Health 2001;11(1):4-10.

Sweeting H. , West P. Sex differences in health at ages 11, 13 and 15. Soc Sci Med 2003;56(1):31-9.

Torsheim T. , Ravens-Sieberer U. , Hetland J. , Välimaa R. , Danielson M. , Overpeck M. Cross-national variation of gender differences in adolescent subjective health in Europe and North America. Soc Sci Med 2006;62(4):815-27.

Östberg V. , Alfven G. , Hjern A. Living conditions and psychosomatic complaints in Swedish schoolchildren. Acta Paediatr 2006 ;95(8):929-34.

Berntsson L. , Köhler L. , Gustafsson J. Psychosomatic complaints in schoolchildren: a Nordic comparison. Scand J Public Health 2001;29(1):44-54.

Gådin KG , Hammarström A.

A possible contributor to the higher degree of girls reporting psychological symptoms compared with boys in grade nine?

Eur J Public Health 2005 ;15(4):380-5.

Hjern A. , Alfven G. , Östberg V. School stressors, psychological complaints and psychosomatic pain . Acta Paediatr 2008;97(1):112-17.

10.

Murberg T. , Bru E. The role of neuroticism and perceived school-related stress in somatic symptoms among students in Norwegian junior high schools . J Adolesc 2007;30(2):203-12.

11.

Natvig G. , Albrektsen G. , Anderssen N. , Qvarnström U. School-related stress and psychosomatic symptoms among school adolescents. J Sch Health 1999;69(9):362-8.

12.

Takakura M. , Wake N. , Kobayashi M. Psychosocial school environment, satisfaction with school, and health complaints among Japanese high school students. School Health 2005 ;1:1-8.

13.

Torsheim T. , Aaroe LE , Wold B.

Sense of coherence and school-related stress as predictors of subjective health complaints in early adolescence: interactive, indirect or direct relationships?

Soc Sci Med 2001;53(5):603-14.

14.

Gådin KG , Hammarström A. Do changes in the psychosocial school environment influence pupils’ health development? Results from a three-year follow-up study. Scand J Public Health 2003;31(3):169-77.

15.

Currie C , Roberts C , Morgan A , Smith R , Settertobulte W , Samdal O , et al., editors. Young People’s Health in Context. Health Behaviour in School-aged Children (HBSC) Study: International Report from the 2001/2002 Survey. Geneva: World Health Organization; 2004.

16.

Sellström E. , Bremberg S. Is there a ‘school effect’ on pupil outcomes? A review of multilevel studies. J Epidemiol Community Health 2006;60(2):149-55.

17.

Stansfeld S. , Candy B. Psychosocial work environment and mental health: a meta-analytic review. Scand J Work Environ Health 2006;32(6):443-62.

18.

Karvonen S. , Vikat A. , Rimpelä M. The role of school context in the increase in young people’s health complaints in Finland. J Adolesc 2005;28(1):1-16.

19.

Torsheim T. , Aaroe LE , Wold B. School-related stress, social support, and distress; Prospective analysis of reciprocal and multilevel relationships . Scand J Psychol 2003;44(2):153-9.

20.

Torsheim T. , Wold B. School-related stress, support, and subjective health complaints among early adolescents: a multilevel approach . J Adolesc 2001;24(6):701-13.

21.

Swedish National Institute of Public Health. Health Behaviour in Swedish School-children (in Swedish) Svenska Skolbarns Hälsovanor 2001/2002. Stockholm : Swedish National Institute of Public Health; 2003.

22.

Swedish National Institute of Public Health. Health Behaviour in Swedish School-children (in Swedish) Svenska Skolbarns Hälsovanor 2005/2006. Stockholm : Swedish National Institute of Public Health; 2006.

23.

Currie C , Gabhain S , Godeau E , Roberts C , Smith R , Currie D , et al., editors. Inequalities in Young People’s Health. Health Behaviour in School-aged Children. International Report from the 2005/2006 Survey. Edinburgh: World Health Organisation; 2008.

24.

Simonsson B. , Nilsson K. , Leppert J. , Diwan V. Psychosomatic complaints and sense of coherence among adolescents in a county in Sweden: a cross-sectional school survey. Biopsychosoc Med 2008;2:4.

25.

Ravens-Sieberer U. , Erhart M. , Torsheim T. , Hetland J. , Freeman J. , Danielson M. , et al. An international scoring system for self-reported health complaints in adolescents . Eur J Public Health 2008;18(3):294-9.

26.

Currie C , Samdal O , Boyce W , Smith R , editors. Health Behaviour in School-aged Children: a WHO Cross-National Study (HBSC), Research Protocol for the 2001/2002 Survey. University of Edinburgh: Child and Adolescent Health Research Unit (CAHRU); 2001 .

27.

Rasmussen M. , Samdal O. , Wolfgang D. , School. In Freeman J , Currie C , Samdal O , et al, editors. Health Behaviour in School -Aged Children. a WHO Cross-National Study. Research Protocol for the 2005/2006. Edinburgh: University of Edinburgh; 2005.

28.

Snijders T. , Bosker R. Multilevel Analysis. An introduction to basic and advanced multilevel modeling . London: SAGE Publications; 1999.

29.

Twisk J. Applied Multilevel Analysis. Cambridge: Cambridge University Press; 2006.

30.

Rasbash J. , Steele F. , Browne W. , Prosser B. A user’s guide to MLwiN. Version 2.0. University of Bristol: Centre for Multilevel Modelling; 2005.

31.

Rajaratnam J. , Burke J. , O’Campo P. Maternal and child health and neighborhood context: The selection and construction of area-level variables. Health Place 2006;12(4): 547-56.

32.

MacCallum R. , Zhang S. , Preacher K. , Rucker D. On the practice of dichotomization of quantitative variables. Psychol Methods 2002;7(1):19-40.