I worked for many years with hospitalized children and children living with chronic and life threatening illness. Here are some of my reflections on that work.
Survival
Due to successful medical advancement over the past 25 years in early detection, diagnosis, and treatment, many life-threatening illnesses are no longer terminal, but are now chronic or even curable diseases. The attention is now on improving the quality of life, both psychologically and socially for children and adolescents surviving life-threatening illnesses.
Self-Esteem
Poor self-esteem can be a critical problem for children with chronic illness. Treatments and surgical procedures can be disfiguring. Medications may cause undesirable side effects. These disturbances have the potential to cause serious damage to a child’s developing self-image. Most common are worries about body disfigurement or integrity, social isolation due to rejection from peers, and the ensuing social stigma of having a chronic illness.
Long Term Effects
Ongoing research is finding increasing evidence concerning the immediate and delayed psychological and social effects of chronic illness. Studies demonstrate that children and adolescents are left with the following problems:
• decreased sense of personal control
• social withdrawal, passivity and loneliness
• poor social skills and assertiveness
• excessive clinginess and dependence upon parents
• poor self-worth, self-image and confidence
• at risk for depression, anxiety and other emotional problems
School Attendance & Normalcy
School is the workplace of children. It is their normal environment necessary for growth and development. School provides children with challenges, diversion, new experiences, a sense of mastery, and peer interaction. School provides respite from the concerns and preoccupations of illness. While there may be many missed school days due to clinic and hospital visits, treatments or feeling ill, attending school as much as possible encourages emotional maturity through social contact and provides a sense of normalcy and organization in sick children’s lives.