Children's understanding of illness: students' assessments.

The purpose of this study was to examine the perceptions of graduate students in the fields of nursing, social work, child life, and counseling education regarding children's understanding of illness concepts. Students were assessed as to their knowledge of children's perceptions of illness as described from a Piagetian developmental viewpoint. Eighty-five graduate students from a southern university in the fields of nursing, social work, child development/child life, and counseling categorized statements made by children regarding their understanding of illness concepts. A data-gathering instrument, developed by Perrin & Perrin (1983), was used to assess the graduate students' ability to assign a developmental age to children's responses to illness-concept questions. Additionally, the students were evaluated on their knowledge of how children perceive illness identification, causality, prevention, treatment, and use of medication. The students correctly categorized by age, children's statements regarding illness concepts only 38% of the time and correctly identified knowledge statements 50% of the time. No remarkable differences were found among the areas of specialization. Without a knowledge base of developmental theories that can be applied directly to clinical practice, nurses are at a disadvantage when working with children and their families. A better understanding of children's communication needs can ultimately lead to improved coping abilities on the part of the child and appropriate interventions on the part of the nurse. The relatively low number of correct responses suggests a need for additional training opportunities that would incorporate cognitive developmental theory into clinical practice for nurses and other health care professionals who plan to work with children.

Impact of a chronic illness in childhood: siblings' perceptions.

This project investigated siblings' perceptions of family disruption when a brother or sister had cystic fibrosis (CF) or asthma. Data were gathered by phone interviews and questionnaires. Phone interviews were conducted with siblings of chronically ill children and employed open-ended questions focusing on the impact of the illness on the sibling and the family unit. Along with the interview, siblings also completed a separate self-esteem measure. Assessments of family functioning and demographic variables were obtained through parental questionnaires. Only the sibling interview data are addressed in this article. Fifteen families from the two illness groups participated. There were 6 male and 9 female respondents, with a mean age of 10.1 years. The average age of the well sibling was slightly older than the average age of the chronically ill child. For siblings of both disease groups, positive outcomes included strengthening some family relationships, achieving more personal independence, and experiencing satisfaction in seeing improvement in the ill child. Negative outcomes included worrying about the brother's or sister's illness, being jealous of the attention paid to the ill child, and the restriction of family events. Appropriate family interventions are suggested, as well as feedback as to the efficacy of phone interviews with school-age children.

Nurses, children, and play.

A child's play is recognized as a useful tool for nurses in the diagnostic process of making judgments about a hospitalized child's compliance with medical procedures, adjustment to the hospital environment, degree of pain, and level of psychosocial functioning. However, the knowledge base that is required to effectively help a pediatric patient "play" in a therapeutic mode appears to be extremely limited for most nurses and is rarely addressed in a substantive manner in nursing education. Educational programs must be willing to incorporate a "developmentally appropriate, culturally sensitive, and family-centered approach" using clinical experiences and professional role models in their nursing curricula. The end product should be nurses who are competent in a much wider range of medical technological and psychosocial issues than has been necessary in the past. In short, nurses must learn to play.

The aftereffects of a hostage situation on children's behavior.

The effects of the trauma on the behavior of elementary-school children who had been held hostage or been closely involved with the hostage situation were investigated, as also were the effects on the lives of their families. Specific types of negative behavior exhibited by the children were identified by teachers and parents, and were found to be linked to the length of time for which the children had been held hostage.

Perception of body image in children with burns, five years after burn injury.

Burn injuries and subsequent disfigurement may place children at high risk for psychologic dysfunction. If medical professionals are to aid the child in achieving psychologic resolution and acceptance of the injury, they must be aware of the stage of body-image perception that the child is experiencing. This study was designed to determine differences in body image between children with burns and children without burns through the use of human figure drawings. The experimental group consisted of 32 children with burns, aged 5 to 15 years, studied at approximately 5 years after burn injury. The control group consisted of 32 children without burns, aged 6 to 15 years. Subjects in the burn group were matched to control subjects by age and sex. There were no significant differences in body image in relation to any of the demographic measures except age. Age was inversely related to body image both in patients with burns and in control subjects.

Evaluation of social problem-solving abilities in rural home health visitors and visiting nurses.

A number of studies have shown the value of using home health visitors and visiting nurses in intervention outreach programs designed to provide pre- and postnatal care for low-income women. The purpose of this study was to compare the abilities of a selected sample of professionally trained nurses and nonprofessionally trained home health visitors to suggest and prioritize solutions to a medical dilemma. Data were gathered by the use of a Practical Solutions Test and a Ranking Solutions Procedure. The subjects for the study were 77 females residing in rural counties in West Alabama. The four study groups were comprised of: (a) trained home visitors with 0 to 6 months of experience, (b) trained home visitors with more than 6 months of experience, (c) professionally trained nurses, and, (d) a control group of women with no training or experience. Data were analyzed using one-way analysis of variance (ANOVA). The findings suggest that all of the trained groups were able to generate more solutions to a typical client medical dilemma than could the control group: F(3.76) = 11.79; p = .0001. Faced with the same medical dilemma, the nursing group was more likely to suggest medical options over socioemotional solutions than were the home visitors: chi 2(3.76) = 9.41; p = .02. The nurses also prioritized the solutions differently by ranking them in a different sequence.

Pediatric family home visitors: effectiveness in problem solving.

A number of studies have shown the value of using home health visitors in intervention outreach programs for low-income families. This study was designed to examine the relationship between home visitors' and nurses' training/home visiting experience and their decision-making ability as determined by the Defining Issues Test (DIT). The subjects were 36 home visitors, 13 visiting nurses, and 28 controls. A difference was found between the home visitors' and nurses' training/experience levels and group scores on the DIT, F(3, 75) = 3.13, p = 0.03. The nurses were better able to make decisions based on issues of fairness and justice than were the home visitors or the controls. The findings suggest the advisability of providing educational opportunities for home visitors to improve decision-making skills.