Saturday, July 12, 2003

This presentation is part of : Child Health

Behavioral, Emotional, and Family Functioning of Hospitalized Chinese Children

Christine Kennedy, RN, PhD, associate professor1, Susan Kools, PhD, RN, Assistant Professor2, Sarah Kong, MPH, BApp, (Nursing), RN, RM, Assistant Professor3, Jyu-Lin Chen, PhD, RN, Research Associate1, 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 children
Learning Objective #2: Identify the rationale for incorporating culturally and developmentally appropriate behavioral assessments and interventions into nursing care for hospitalized Chinese children

Objective: This study examined behavioral and emotional problems, social competence, and family functioning of hospitalized Chinese children.

Design: The study was descriptive, cross-sectional.

Sample & Setting: A convenience sample of 210 hospitalized children ages 2-11 and their families participated. Families came from hospitals in five regions of 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 an age-appropriate Chinese version of the Child Behavior Checklist and a Chinese version of the Family Assessment Devise. Multiple regression models were used to examine predictors of children's behavioral and emotional problems.

Findings: Behavioral patterns appeared specific to developmental stage. Toddlers and preschool children exhibited withdrawn and anxious behavior while school-aged children exhibited more complex behavioral profiles, including both internalizing and externalizing behaviors. Children from the Chinese Mainland experienced more internalizing and externalizing problems than those from Hong Kong. Children had greater problems when their families demonstrated poorer affective involvement. However, according to their parents, sick children exhibit some resiliency based on social and academic competency factors.

Conclusions: Hospitalized Chinese children manifest behavioral, emotional, and family problems that vary by region, developmental stage, and gender. Problems predominantly of an internalizing nature characterize this group. This may be explained by the socialization practices in the Chinese culture emphasizing obedience, conformity, good behavior, and emotional control. Even young children learn that the expression of strong, negative emotions or behaviors is inappropriate.

Implications: Findings support the need for culturally appropriate behavioral assessment and interventions with hospitalized Chinese children.

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Sigma Theta Tau International
10-12 July 2003