Tuesday, November 6, 2007

This presentation is part of : Caring for Children with Special Healthcare Needs
Chinese Children with Chronic Illnesses: An Educational Intervention to Enhance Coping and Psychological Adjustment
Yang Li, MS, RN, School of Nursing, Peking Union Medical College, Beijing, China and Susan C. Immelt, RN, PhD, School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Learning Objective #1: discuss the stressors and coping strategies of Chinese children with chronic medical conditions and their parents.
Learning Objective #2: describe a theoretical framework for an educational intervention to improve coping with chronic illness in Chinese children and their parents

Of the more than 350 million children under age18 years in China, medical experts in Beijing estimate a prevalence of chronic illness of 20%. Review of the international literature yielded no precise data on numbers, nor any discussion of child and family adjustment, stress, or coping in this growing population. In the Chinese authorís years of experience caring for hospitalized children with chronic medical conditions, she noted depression, withdrawal, avoidance, and anxiety in her patients. They lacked knowledge about their disease processes, self-care, and ways of coping with their diseases. Her experience led her to hypothesize the positive effects of an educational intervention for children and their parents addressing both disease related knowledge and coping strategies. The literature on the effects of educational interventions on improving coping and psychological outcomes in western samples showed evidence of improved disease-related knowledge, and some improvements in coping and adjustment (Davis et al, 2004; Hazzard et al, 2002; Kaslow et al, 2000; Stark et al, 2002). The present study uses a conceptual model to plan implementation and testing of an educational intervention with Chinese children hospitalized with chronic illnesses. The conceptual framework for this study is adapted from the transactional stress and coping model (Thompson & Gustafson, 1996). The model indicates that child and parental adaptational processes mediate adjustment to a chronic illness. The educational intervention, offered in one-hour segments to parents and to children, explicitly addresses disease-related knowledge and coping strategies, thereby promoting adaptation processes in both parents and children in order to promote positive psychological adjustment. The presenters will discuss the progress of the planned quasi-experimental clinical trial, using a sample of 140 children, aged 8 to 16, with the diagnoses of juvenile rheumatoid arthritis or nephrotic syndrome, and their parents.