Saturday, July 12, 2003

This presentation is part of : Child Health

Psychosocial Functioning of Hospitalized Chinese Adolescents and Their Families

Susan Kools, PhD, RN, Assistant Professor1, Christine Kennedy, RN, PhD, associate professor2, Sarah Kong, MPH, BApp, (Nursing), RN, RM, Assistant Professor3, Jyu-Lin Chen, PhD, RN, Research Associate2, Linda Franck, PhD, RN, Professor4, and Thomas K. S. Wong, PhD, MSc(IT), BEd(Soc), RN, Head of Department3. (1) Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA, USA, (2) Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA, USA, (3) Department of Nursing and Health Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, (4) Great Ormond Street Hospital for Children NHS Trust, Institute for Child Health, School of Nursing and Midwifery, King's College, London, England
Learning Objective #1: Describe the behavioral, emotional, social, and family functioning of hospitalized Chinese adolescents
Learning Objective #2: Identify the strengths and limitations of using the Child Behavior Checklist and the Family Assessment Device in a Chinese population

Objective: The purpose of the study was to describe behavioral and emotional problems, social competence, and family functioning of hospitalized Chinese adolescents.

Design: The study was descriptive, cross-sectional.

Sample & Setting: A convenience sample of 103 hospitalized adolescent patients and their families participated. Families came from five regions in the Chinese Mainland and two hospitals in Hong Kong.

Variables Studied: Study variables included behavioral and emotional problems, social competence, and family functioning.

Methods: Parents completed Chinese versions of the Child Behavior Checklist and the Family Assessment Devise. Hospitalized adolescents completed a Chinese Youth Self-Report.

Findings: Hospitalized adolescents in Hong Kong and the Chinese Mainland exhibited lower behavioral and emotional problems than norms reported in community samples of Chinese and Chinese-American adolescents. In the domain of social competence, adolescents identified major academic concerns related to the disruption of hospitalization. Family affective overinvolvement was significantly related to adolescent psychosocial functioning, but only in Mainland Chinese families.

Conclusions: The muting of affect and behavior seen in hospitalized Chinese adolescents may be attributed to cultural values and socialization practices that stress self-control, obedience, and forbearance in the face of suffering. Outward displays of emotion are considered inappropriate for youth. Likewise, education is highly valued in Chinese society and academic achievement is the primary task of adolescence. Illness and hospitalization compound academic-related stress for adolescents. The finding of family affective overinvolvement must be interpreted with caution as Chinese families have patterns of relating that are distinct from Western cultures.

Implications: This study provided a first snapshot of the psychosocial functioning of hospitalized Chinese adolescents and their families. Their muted emotional and behavioral responses to hospitalization and the heightened stress of school disruption are possible indicators of this group's mental health vulnerability. Further research is needed to understand the impact of hospitalization on Chinese families.

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