The existing literature on adaptation to childhood cancer is integrated within the stress and coping paradigm (Lazarus & Folkman, 1984) to demonstrate its functional utility. The coping resources (i.e. psychological and social resources) and coping efforts of 21 children (9 male, 12 female) diagnosed with cancer were assessed and compared with standardized norms. Within-group differences were explored as the cancer sample was subdivided by stage of therapy (i) newly diagnosed, (ii) currently in treatment, and (iii) off treatment. Results suggest that children with cancer differed significantly from typical children on measures of coping effort (Coping Inventory) in that they demonstrated relatively more adaptive and efficient coping behavior as compared to their normative peers. Children with cancer differed slightly from typical children on measures of psychological resources (Assessment of Coping Style) such that they utilized a slightly more restrictive style of coping. Children with cancer did not differ significantly from normative children on measures of social resources (Social Support Scale for Children). The data are analyzed and discussed with reference to mediating factors including developmental stage, gender, and stage of illness.

No description available.

No description available.

In an effort to prevent serious psychological damage to individuals and families due to illness or disability, professionals in the health field have studied every aspect of one's health. From the "traumatic violence" of birth to the painful complexities of death and dying, the emotional health of human beings has been observed, recorded and analysed. Despite the breadth of this voluminous research, one area of interest merits more thorough study and evaluation. In order to more fully understand the intricacies of health and illness we need to know more about the effect one seriously ill child has upon the emotional health of his or her siblings. This study was conducted to gather more information about this important area of human experience. The focus was specifically aimed at the interaction between the parents of a sick child and his or her siblings.

The purpose of this retrospective study was to investigate some psychosocial factors that may be related to the development of childhood cancer. The questions that guided the study were: When compared to families of healthy children (1) Do the family structure, dynamics and atmosphere present any commonalities among children with cancer? (2) Are there any personality characteristics common to children with cancer? (3) Have children with cancer experienced more of stressful events during the year that preceded diagnosis? (4) Have children with cancer experienced a major loss? Twelve children between the ages of 2 to 13 who were diagnosed with a form of cancer were compared to twelve healthy but accidently injured children of the same age, and sex and socioeconomic background hospitalized at the 2nd Pediatric Department of The University of Athens. A semistructured interview was used to gather information from their mothers within the month that followed the child's diagnosis or accident. Chi-square and T-test analyses were used at the .05 level of significance to determine differences between groups on each of the variables. Findings revealed that, compared to healthy children, children with cancer tended to belong to "broken home" families in which most had experienced (a) the loss or absence of a significant person (particularly the father) early in their life or (b) an unhappy marriage between their parents, frequently resulting from an "arranged" marriage. Within their family children occupied a special status and were raised as "only" or "first-borns." A major upcoming event was anticipated in most of their families within the same month that the diagnosis was pronounced; this event was aborted as a result of the child's diagnosis. Limitations of the study, discussion of the methodology and recommendations for further research are presented.

Coccidioidomycosis is a fungal infection endemic to the southwestern United States. Hematogenous dissemination of the etiologic agent produces a chronic basilar meningitis in a small percentage of children. While new and aggressive therapy has decreased mortality, children with coccidioidal meningitis (CM) continue to suffer significant morbidity. A comprehensive investigation of intellectual, achievement, and behavioral outcomes in a series of 9 children who were diagnosed and treated for CM at the Arizona Health Sciences Center between 1977 and 1988 was conducted. Nearest-age siblings were also evaluated. Findings revealed compromised cognitive abilities and an increased incidence of academic and behavioral difficulties in the patient group as compared to normative expectations and the performance of siblings. Results support the need for timely educational interventions to assist such patients in maximizing their potential in the academic environment.

The improving prognosis for pediatric leukemia patients requires that involved professionals increase attention to the emotional adjustment of these children. This study was designed to determine (a) how mothers of leukemia patients perceived their children's personalities in order to identify any specific emotional difficulties which these children may experience and (b) if their perceptions differed from either mothers of cystic fibrosis and diabetes patients or mothers of healthy children. Subjects included 24 mothers in each of three groups: leukemia, other illness, and healthy. Children in both illness groups received higher scores than healthy children on Adjustment, Achievement, Somatic Concern, Depression, Psychosis, and Social Skills scales as measured by the Personality Inventory for Children; however, only the leukemic children were rated higher in areas of Anxiety and Withdrawal. Implications for treatment and future research are discussed.

This study investigated the relationship between cognitive development and children’s understanding of the hospital nurse’s role. A group of 35 hospitalized children with chronic conditions and without neurological deficits, aged 4 to 10 years, were given three tasks (i.e., the Nurse’s Role Task, the Balance Beam Task, and the Task of Intrapersonal Understanding), scored for developmental level using Case’s (1992) neo-Piagetian theory of cognitive development as a framework. A full sample of 4—year—olds was not pursued due to the distracting hospital environment which, in combination with the shorter attention span of the 4-year-olds, rendered the interviews extremely difficult to complete. Descriptive results indicated a moderately advanced understanding of the hospital nurse’s role by 8— and lO—year—olds, being on the order of one—third of a substage (i.e., approximately 8 months ahead in development), whereas 4— and 6—year—olds showed an age— appropriate level of understanding of the hospital nurse’s role. Analysis of Variance indicated a statistically significant effect for age on all three tasks (p < .01). Six levels of social—cognitive development in understanding the hospital nurse’s role were found, which were, in successive order: (1) Roles of the nurse as scripted actions (i.e., 4-year-old level), (2) Roles of the nurse as motivated action sequences (i.e., 6—year—old level), (3) Roles of the nurse as planned action sequences (i.e., 8— year—old level), (4) Roles of the nurse as generalized dispositions toward action (i.e., 10—year-old level), (5) Roles of the nurse as demonstrating logically planned decisions towards action (i.e., 12-year—old level), and (6) Roles of the nurse as demonstrating logically planned action sequences (i.e., 14—year—old level). Furthermore, results indicate that a few 6- and 8-year-olds and the majority of l0—year—olds could give an accurate description of the duties of the hospital nurse, that is, 1) nurses are there to help children, 2) nurses have a responsibility for the well-being of their patients, 3) nurses want to improve the physical and emotional health of their patients, 4) nurses also see their own shortcomings in their care for children and have good intentions, and 5) nurses are human and have their own feelings, thoughts, doubts, and ideas. Suggestions for future research have been provided in order to further improve communication between health care professionals and hospitalized children with chronic conditions.

This study investigated the relationship between cognitive development and children’s understanding of the hospital nurse’s role. A group of 35 hospitalized children with chronic conditions and without neurological deficits, aged 4 to 10 years, were given three tasks (i.e., the Nurse’s Role Task, the Balance Beam Task, and the Task of Intrapersonal Understanding), scored for developmental level using Case’s (1992) neo-Piagetian theory of cognitive development as a framework. A full sample of 4—year—olds was not pursued due to the distracting hospital environment which, in combination with the shorter attention span of the 4-year-olds, rendered the interviews extremely difficult to complete. Descriptive results indicated a moderately advanced understanding of the hospital nurse’s role by 8— and lO—year—olds, being on the order of one—third of a substage (i.e., approximately 8 months ahead in development), whereas 4— and 6—year—olds showed an age— appropriate level of understanding of the hospital nurse’s role. Analysis of Variance indicated a statistically significant effect for age on all three tasks (p < .01). Six levels of social—cognitive development in understanding the hospital nurse’s role were found, which were, in successive order: (1) Roles of the nurse as scripted actions (i.e., 4-year-old level), (2) Roles of the nurse as motivated action sequences (i.e., 6—year—old level), (3) Roles of the nurse as planned action sequences (i.e., 8— year—old level), (4) Roles of the nurse as generalized dispositions toward action (i.e., 10—year-old level), (5) Roles of the nurse as demonstrating logically planned decisions towards action (i.e., 12-year—old level), and (6) Roles of the nurse as demonstrating logically planned action sequences (i.e., 14—year—old level). Furthermore, results indicate that a few 6- and 8-year-olds and the majority of l0—year—olds could give an accurate description of the duties of the hospital nurse, that is, 1) nurses are there to help children, 2) nurses have a responsibility for the well-being of their patients, 3) nurses want to improve the physical and emotional health of their patients, 4) nurses also see their own shortcomings in their care for children and have good intentions, and 5) nurses are human and have their own feelings, thoughts, doubts, and ideas. Suggestions for future research have been provided in order to further improve communication between health care professionals and hospitalized children with chronic conditions. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

Utilizing a collective case study design, I examined and described the filial therapy (FT) process and adaptations discovered to be necessary and unnecessary in working with families who have a child with a life-threatening illness in the hospital setting. Data from a total of 7 parents was utilized, including those who terminated early, in order to gain a greater understanding of adapting FT for families who have a child with a life-threatening illness and their participation patterns. The parents attended 10 one- to two-hour FT sessions. The data was analyzed to examine for themes, patterns and relationships intrinsically with each case participant, as well as across cases. Analysis indicated that parents with a child with a life-threatening illness had great difficulty committing to attend FT; and a high rate of attrition occurred for those who did commit. A theme regarding flexibility was found to be of eminent importance in a variety of manifestations including therapeutic methods, session format, location and time of sessions, and intense vs traditional FT. Therapeutic adaptations in flexibility found to be important including openness to cathartic and personal parenting sessions, tolerance of forgetfulness, and lowering typical therapeutic concerns of dependency in the relationship. An inability for parents in this situation to benefit from intense FT methods was also noted. Changes noted in the child of focus included increased confidence, increased cooperation in the medical setting, increased communication with the parent and with medical staff regarding medical issues, and increased communication with the parent regarding personal feelings and issues. Changes noted in the parents included increased confidence in parenting skills, increased awareness of the child's perceptions of the environment, increased tolerance in allowing the child to struggle in and out of the medical setting, with both emotional and physical pain in order to gain coping skills, increased ability to allow the child to empower self, and increased abilities in limit setting.