The Child & Family Experiences of Illness Flashcards

1
Q

How does a child’s significant illness impact the family?

A

-Systems = interactions + patterns in beh within families
-Illness enters system & get feedback (within = what family knows already/has been exposed to, & what comes out externally) affect ind’s beh - better/worse
-Way ind’s beh altered depends on perspectives + emotional state of parents (key stakeholders)
-Get changes to family dynamics - ind’s identity

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2
Q

What is the impact of an illness on the child, & why?

A

-Children = identity (of who they are) not fixed
-Identity via their illness (how see themselves in future)
–> affects mental health in future
-More emotional stressors = relationships affected
-More support systems needed

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3
Q

What role does support play in childhood illness?

A

-Sufficient social support for families = better clinical outcomes
–> e.g., early interventions (paed care) from diagnosis can relieve int/ext factors - stress + social surroundings (people)
-Must be balance between int/ext factors for best coping

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4
Q

How can families be affected by chronic (long-term) health condition in a child?

A

-Expense & time commitment
-Confusion due to conflicting systems of health care management
-Lost opportunities (e.g., family members providing primary care to child - can’t work)
-Loss of hope for “ideal” child
-Social isolation (can’t participate in society)
-Siblings may resent extra attention ill child gets

Would this be different if child had acute/1 off illness?

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5
Q

What is involved in the “ideal” child?

A

Healthy - meet milestones
-Able bodied - social stigma
-Goals, aspirations of child

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6
Q

Role of healthcare professionals in chronic childhood treatment - what should/shouldn’t they do?

A

-Must be compassionate & non-judgemental:
*develop rapport
*avoid confrontation
*address any fears (will the child die?)
*subjective symptom severity - must attempt to take ind perspective of child’s symptoms
*understand child’s sit in family

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7
Q

Health contact points for children & their families?

A

(just for minor illnesses)

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8
Q

What may be involved in hospital stays?

A

-Admission – history, examination, investigation, management plan
-Continued observations & treatment by nurses
-Planned 3 times daily medical reviews
-Discharge explanation & plan

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9
Q

What must be considered in managing child’s treatment?

A

-How child feels
-Child’s experience
-How family system reacts - feedback from within & out
-Ext/out = interactions with healthcare

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10
Q

What communications may be involved in child hospital stay?

A

-Needs of child & parent reassured
-Progress reported…
-Handover of care
-Advice for parents
-W/ primary care - ongoing clinical needs - addressing parent’s concerns

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11
Q

What impacts on experiences/comes back into system (int) from ext system???

A

Child’s emotional development

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12
Q

What is the attachment theory?

A

Developed understanding of others - informs understanding of self & then understanding of future relationships
-at diff ages/stages of development

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13
Q

What is the internal working model of attachment?

A

-Child = shaped by their interactions with the world and the people around them

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14
Q

What is attachment?

A

Type of affectional bond where a person’s sense of security is bound up in the relationship

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15
Q

How do people develop different attachment styles?

A

Learnt interactions w/ early care givers –> superimpose onto other relationships in future

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16
Q

What are internal working models?

A

Mental representation of child’s expectation for future relationships - based on early care giver’s relationship w/ child (learnt interaction style)
-Emotionally driven system
-Occurs as emotional centres develop faster than cognitive oens

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17
Q

How does the internal working model link to children’s medical care?

A

Child will have individual expectations of people based upon early learnt experience w/ care giver - will superimpose onto healthcare profs

18
Q

When might the internal working model have negative effects on child?

A

If early care giver for child doesn’t provide sufficient care for child - needs not met i.e., neglectful/abusive = child will adopt negative future expectations of people - so may feel hospital caregivers are not safe too

19
Q

What are internal working models?

A

Mental representation of child’s expectation for future relationships - based on early care giver’s relationship w/ child (learnt interaction style)
-Emotionally driven system
-Occurs as emotional centres develop faster than cognitive ones

20
Q

What are the 3 criteria for attachment development in 1st 18 months of child’s life?

A

-Stranger anxiety - response to stranger
-Separation anxiety - distress when care giver leaves & comfort when return
-Social referencing - child refers to care giver on how to respond to new situations

21
Q

What are the distinct age-related stages of attachment?

A

0-6 weeks = asocial
6 weeks - 7 months = indiscriminate attachments
7-9 months = specific attachments
10 months… = multiple attachments

22
Q

What happens in the 0-6 weeks: asocial stage?

A

Many stimuli - favour one may smile

23
Q

What happens in the 6 weeks - 7 months: indiscriminate attachments stage?

A

Enjoy any human company equally - upset if someone won’t interact
3 months = smile @ familiar faces more - more comfort from familiar care giver

24
Q

What happens in the 7-9 months: specific attachments stage?

A

-Prefer single care giver = attachment figure
–> look to them for security, comfort, protection - separation anxiety if leave
-Stranger fear

25
Q

What happens in the 10 months…: multiple attachments stage?

A

-Build attachment w/ other family members & more (more care givers)
18 months = more independent & makes many more attachments

26
Q

Role of attachment

A

–>Provide safety - so child develops sense of prox w./ others

To increase prox w/ attachment figures
-Proximity = regulated by attachment behs
-Smiling, vocalising = interest in interaction
-Crying = disliked beh - draws attachment figure in to stop
-If child approaches/follows = seeking proximity

*Biologically = for survival –> seek proximity when danger/stressed - gather understanding of people who let them seek proximity - are they helpful/unhelpful = adaptive mechanism (can be maladaptive if primary attachment figure = -ve)

27
Q

What type of development is attachment?

A

Emotional development

28
Q

What are Piaget’s 4 stages of cognitive development & why is it clinically important?

A

-Informs how communicate with children as patients - based on their capacity

-Explains how child views everything based on their current stage

29
Q

What does the sensorimotor stage (birth-2 years) involve?

A

-Understand world by what can see, smell, touch, taste (movements & sensations)
–> learn by touching, sucking, listening
-Learn things exist even when not seen = object permanence - still learning
-Know are separate beings from people, objs around
-Begin to see their actions have outcomes

30
Q

What does the preoccupation stage (2-7 years) involve?

A

-Start symbolically thinking - use of words, pics to represent objs
-Often egocentric - own perspective only seen (if good for them = good for all)
-Lang & thinking develops - have ‘concrete’ processes
-Skills develop - pretent play

31
Q

What does the concrete operational stage (7-11 years) involve?

A

-Logical, organised thinking - on ‘concrete’ events
-Concept conservation begins = things staying the same even though other elements change
-Inductive logic starts = inference - can extrapolate info from general principle (but not metaphors)

32
Q

What does the formal operational stage (12 years…) involve?

A

-Abstract thinking about hypothetical issues starts
-Moral, philosophical, ethical, social, political considerations start (use theoretical + abstract reasoning)
-Deductive logic starts = reasoning from general principle to specific info
-Development of personal identity

33
Q

How are children viewed by Piaget?

A

As scientists = have active role in learning - observations, experiments - to learn about world - gain/build on knowledge

34
Q

What is needed for +ve health outcomes for children (as patients)?

A

-Health profs = source of new info/learning to child - need +ve experience for engagement by:
*Knowledge
*Skills
*Age-appropriate Language
*Attitudes

35
Q

Knowledge & skills role in healthcare?

A

-How is info given - to have various effects - how is info communicated - MUST calm feedback in int/ext system - for +ve clinical outcomes
-Can be didactic/empowering - but should each be used? - based on child & family understanding
-Info MUST be effectively communicated

36
Q

Language & attitude role in healthcare?

A

-Must engage @ child’s level of devlopment
–> based on what language used (not above/below)

37
Q

Problems caused by communicating at wrong level of child’s cognitive development?

A

Feelings of…
-distrust
-disengagement
-resentment
and these feeling may cause –> poor clinical management, lack of adherence, follow up, engagement w/ healthcare services, -ve healthcare outcomes

38
Q

Outcomes (+ve) by communicating at correct level of child’s cognitive development?

A

Feelings of…
-being listened to
-being trusted
-being respected

39
Q

What is influenced by how Heathcare profs communicate?

A

Influence our feelings –> impacting on engagement, adherence & clinical outcomes

40
Q

Differences between treating 18-month-old vs 13-year-old?

A

-Older child = more understanding of world & so worry of what is wrong w/ them - can communicate how they feel more effectively
-Parent of younger child = more worried as child cannot say exactly how feel - more based on observation - & may be new parent - still learning
-Doctors - must tailor communication to child & parents @ correct level - whilst remaining compassionate & informative

41
Q

What is meant by treating the person 1st then condition after?

A

Building effective relationship w/ child & family - to then allow for more +ve clinical outcomes - effective treatment & management

42
Q

Why might treating patient 1st then condition after be useful when child has a chronic illness?

A

-So not faced w/ anger, doubt, cynicism
–> so parents do not disengage (would put child at risk = -ve clinical outcome)