Children's conceptions of illness

Abstract

In psychological, psychiatric, and pediatric literature of the past several decades, there has been considerable attention given to the psychological needs of the ill child. Until very recently, the major theoretical format for understanding and intervening in the behavior of sick children has been psychoanalysis. A number of studies, both clinical and empirical, have addressed children's responses to illness and/or hospitalization in terms of the feelings of the child. The psychic and physical trauma experienced by the sick child were seen to result in feelings of fear, anger, anxiety, withdrawal, and depression. Thus, therapeutic interventions were best directed to the affective leveltoward acknowledging and modifying these negative feelings.But, even within the psychoanalytic orientation, it became obvious that the feelings of the sick child or adult were related to beliefs or concepts about illness-that is,, to the way the patient understood illness at a cognitive level. For example, much of the depression and withdrawal of the hospitalized child was presumed to be related to the child's belief that he or she was being punished for wrongdoing or was to blame -was at fault -for the illness being contracted. The negative affect or feeling was in some way seen to be related to the child's cognition or understanding of the causes of the illness.

Developmental levels in adult's conceptions of health and disease

“…Cognitive-developmental studies suggest that children's conceptions 3 of illness evolve in a systematic and predictable sequence consistent with Piaget's theory of cognitive development (e.g., Bibace & Walsh, 1979;Bibace, Schmidt & Walsh, 1994;Burbach & Peterson, 1986;Perrin & Gerrity, 1981). For example, Bibace and Walsh (1979) proposed a sequence of six levels of conceptions regarding definition, causes and treatment of diseases in children and adolescents.…”

Desenvolvimento sociocognitivo de significações leigas em adultos: Causas e prevenção das doenças

“…De facto, estudos efectuados com crianças parecem demonstrar que as suas concepções sobre processos de doença evoluem no sentido de uma cada vez maior diferenciação e complexidade, e de uma forma sistemática e previsível consistente com a teoria piagetiana do desenvolvimento cognitivo (e.g., Bibace & Walsh, 1979;Bibace et al, 1994;Burbach & Peterson, 1986;Perrin & Gerrity, 1981).…”

“…De acordo com estes autores, as formas de raciocínio de cada nível têm uma natureza genérica e constituem explicações para uma grande variedade de doenças (Bibace, Schmidt & Walsh, 1994).…”

Development and evaluation of an interactive CD-ROM for children with leukemia and their families

“…Providing children with information rests on arguments not only related to its effects on children's behavior and clinical outcomes, but also on children's "right to know." Without information, children may form beliefs and attitudes that are often erroneous, cause fear and anxiety, and may adversely affect compliance [4,[7][8][9][10][11].…”