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Associations Among Teacher-Reported School, Communication, and Behavioral Difficulties in Students With Chronic Illness

Terézia Harčaríková1, Katarína Kelemenová1, Lukáš Stárek2, Jarmila Klugerová2
1Department of Special and Inclusive Education, Faculty of Education, Comenius University Bratislava, Račianska 59, 813 34 Bratislava, Slovak Republic
2Department of Pedagogy, Ambis University, Lindnerova 575/1, 180 00 Praha 8–Libeň, Czech Republic
DOI: https://doi.org/10.70517/revcc2624207
Published: 13/11/2026
: Terézia Harčaríková, Katarína Kelemenová, Lukáš Stárek, Jarmila Klugerová. Associations Among Teacher-Reported School, Communication, and Behavioral Difficulties in Students With Chronic Illness. Revista Cultura Científica, 2026 Issue 24. pg. 2583-2592.

Abstract

Students with chronic illness may experience school, communication, and behavioral difficulties. This study examined associations among these three categories of teacher-reported difficulties in Slovak lower-secondary schools. A secondary analysis of cross-sectional survey data from 403 teachers was conducted. Associations were assessed using Pearson’s chi-square test, odds ratios (ORs), 95% confidence intervals (CIs), and phi coefficients, with Holm’s correction for multiple comparisons. School difficulties were reported by 37.5% of teachers, communication difficulties by 22.3%, and behavioral difficulties by 18.9%. Positive associations were found between school and communication difficulties (OR = 5.21; 95% CI, 3.14–8.64), school and behavioral difficulties (OR = 4.99; 95% CI, 2.91–8.55), and communication and behavioral difficulties (OR = 3.64; 95% CI, 2.13–6.21). All associations remained statistically significant after Holm adjustment (adjusted p < .001). Implications for School Health Policy, Practice, and Equity: The findings support a comprehensive assessment of educational needs and coordinated school support that addresses academic, communication, and behavioral concerns. The categories of difficulties reported by teachers were significantly associated. The findings do not establish causal relationships or confirm the co-occurrence of difficulties in individual students.

Keywords: chronic illness; school health; teachers; school difficulties; communication difficulties; behavioral difficulties

Abstract

Students with chronic illness may experience school, communication, and behavioral difficulties. This study examined associations among these three categories of teacher-reported difficulties in Slovak lower-secondary schools. A secondary analysis of cross-sectional survey data from 403 teachers was conducted. Associations were assessed using Pearson’s chi-square test, odds ratios (ORs), 95% confidence intervals (CIs), and phi coefficients, with Holm’s correction for multiple comparisons. School difficulties were reported by 37.5% of teachers, communication difficulties by 22.3%, and behavioral difficulties by 18.9%. Positive associations were found between school and communication difficulties (OR = 5.21; 95% CI, 3.14–8.64), school and behavioral difficulties (OR = 4.99; 95% CI, 2.91–8.55), and communication and behavioral difficulties (OR = 3.64; 95% CI, 2.13–6.21). All associations remained statistically significant after Holm adjustment (adjusted p < .001). Implications for School Health Policy, Practice, and Equity: The findings support a comprehensive assessment of educational needs and coordinated school support that addresses academic, communication, and behavioral concerns. The categories of difficulties reported by teachers were significantly associated. The findings do not establish causal relationships or confirm the co-occurrence of difficulties in individual students.

Keywords: chronic illness; school health; teachers; school difficulties; communication difficulties; behavioral difficulties

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Terézia Harčaríková
Department of Special and Inclusive Education, Faculty of Education, Comenius University Bratislava, Račianska 59, 813 34 Bratislava, Slovak Republic
harcarikova@fedu.uniba.sk
Katarína Kelemenová
Department of Special and Inclusive Education, Faculty of Education, Comenius University Bratislava, Račianska 59, 813 34 Bratislava, Slovak Republic
Lukáš Stárek
Department of Pedagogy, Ambis University, Lindnerova 575/1, 180 00 Praha 8–Libeň, Czech Republic
Jarmila Klugerová
Department of Pedagogy, Ambis University, Lindnerova 575/1, 180 00 Praha 8–Libeň, Czech Republic

How to cite:

Terézia Harčaríková, Katarína Kelemenová, Lukáš Stárek, Jarmila Klugerová. Associations Among Teacher-Reported School, Communication, and Behavioral Difficulties in Students With Chronic Illness. Revista Cultura Científica, 2026 Issue 24. pg. 2583-2592.

Publication History

  • Received: 18/05/2026
  • Accepted: 19/08/2026
  • Published: 13/11/2026
Copyright © 2026, Terézia Harčaríková, Katarína Kelemenová, Lukáš Stárek, Jarmila Klugerová. Published by Revista Cultura Científica. This article is published as open access under the Creative Commons Attribution 4.0 International (CC BY 4.0) license (http://creativecommons.org/licenses/by/4.0/).

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