Lecture 12: Understandig health, illness and coping - childhood & adolescence Flashcards Preview

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Flashcards in Lecture 12: Understandig health, illness and coping - childhood & adolescence Deck (39)
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What is health promotion?

health education for chronic illnesses


What are the major chronic illnesses listed?

Cystic fibrosis
nut allergies
juvenile rheumatoid arthritis
HIV aids
risk of substance abuse/dependence


What is the importance of cognitive development for understanding health, illness and coping during childhood and adolescence?

important to always check in to see what someone understands about their illness but also where they are in their thinking

need to be a good listener and ask important questions about their understanding


what is the importance of cognitive level of understanding for preparation of medical procedures in children? (surgery)

Research suggests the people with more knowledge cope better with medical procedyres


What factors should be considered in public health promotion?

The level of understanding of the public as you are targeting them to receive your health message


How long has preparing children from hospitalisation and medical procedure programmes been going on for?

since 1980s


What is now current practice with children hospitalisation preparation programmes?

parents can stay in the hospital or nearby

this makes a huge difference to children


What are problems with the programmes that prepare children from hospitalisation and medical procedure?

They are often not well attended
or they are targeted at a wide age group (from 3-12)
and what a child understands at 3 is different to what they understand at 12

need a more specific targeted programme for younger and older children as they are at different levels of cognitive development and understand differently about their illness


What are some of the things you need to do for children to prepare them for a medical procedure? Applies to out patient procedures as well

Individual one on one preparation
to Establish cognitive level of patient,
determine illness experience, (positive? negative?)
establish experience of specific treatment
check understanding of explanations


What usually happens to people going into the health setting for the first time?

stress levels are high, so memory probably isnt very good because they are focusing more on the environment, and not someone whos talking to them.


why should you check in with child patients?

a lot of terms misunderstood for children
e.g. odema in stomach may be heard as demon
may be distressing to know they have iron inside them, or IV (ivy), or bugs.

becareful what you say, also with metaphors you use especially with young children e.g. lungs = balloon


What does effective preparation include?

depends on developmental level
type/acuity of surgery - the more age appropriate knowledge, the better it is for them
relevant past experiences (prior surgeries)
cultural / ethnic background (avoid unnecessary stressful situations)
family composition and dynamics (happy or conflict. Some times better if one parent isnt around e.g. overemotional mother)
available support systems


How can you prepare a parent for their child's surgery?

make sure they are calm and confident around child,
make sure they understand anything and know they can ask you for clarification


Why might a surgeon be intimidating to a child?

they do not see people with masks on every day.


What are the best ways some programmes have done before to prepare children forsurgery?

tours of theatre and related places
videos,slides, movies about surgical procedures
Interactive materials – colouring books – Ipad?
•Puppet shows
•Medical play using actual hospital equipment (not appropriate for very young children)
•Books using popular figures children can identify with such as “Big Bird” or “Dora the Explorer”
•Board games
•Art therapy
•Relaxation techniques & coping


How do children and adolescents respond to chronic illness & how do they cope?

Emotional responses: denial, anxiety, depression, positive


What are the implications of denial?

a common reaction
can help people cope
But may interfere with treatment and adherence


What are the implications of anxiety?

Crisis, anxiety & disorientation
Focus on symptoms
Fearful of continuing daily activities
Recurring anxiety about the future and possible complications of the illness


What are the implications of depression?

25% affected by depression
Often sets in later when full consequences are realised
Can be long term
Affects functioning
Often goes untreated


What are the implications of a positive emotional response?

Children may feel empowered
Escaped death
Examine priorities
Improved relationships
Healthy lifestyle changes


What are the 4 common signs of psychosocial distress?

1.Unexplained medical symptoms
2.Poor adherence to treatment
3.School Refusal
4.Engagement in risky behaviours involving sex and drug use


What do coping responses to chronic illness depend on?

Appraisal of the degree of threat posed by illness
Resources available


What are the two types of coping strategies?

Problem focused coping strategies (alter the situation)
Emotion focused coping strategies (regulating emotional response to situation)

Both useful but need to be matched to the situation
avoiding coping is often linked to poorer outcomes


what are factors that influence coping?

Perceptions of the illness: its identity, cause, controllability, timeline, and consequences
Social support: instrumental or emotional support. Usually positive effects, but can be negative
Individual differences: e.g. optimism, age, education


what are factors which determine the impact of chronic illness on adolescents?

1.Type & degree of physical impairment
2.Visibility of illness
3.Uncertainty about prognosis
4.Irregular and unpredictable effects of illness
5.Treatment & pain associated to disease & treatment


What are factors that might impact treatment for acute and chronic illnesses?

Social & emotional development
•Biological functioning
•Mental age rather than Chronological Age better for determining developmental aspects of adherence (illnesses can change how you mature)
•Family functioning


What is the importance of family during a child's illness/treatment/hospitilisation?

Children present for treatment with family member
•Child’s understanding of illness & treatment limited
•Child reliant on family for care
•Families must manage a range of problems
•Families must address impact of all these issues on family functioning


What are the 2 constrcuts that piaget talked about?

Egocentrism and personal fable

adolescent have an imaginary audience where they think everyone looks at them. believe their appearance is so important


What affects coping?

your developmental stage.
Younger children are more focused on problems
more maturity - emotion focused.
e.g. using cognitive abilities to say, just need to get through this procedure


What are some biological issues which arise with chronic illness in children?

may go through puberty earlier
certain drugs given for treatment e.g. chemotherapy, can affect your hearing, may make them sterile so often take eggs from ovary and semen to freeze for other options