Conceptions of illness and hospital behavior in children receiving treatment for cancer

Abstract

This qualitative study was to explore 1) the conceptions of illness by children with acute lymphocytic leukemia (ALL), 2) the factors, which would influence the development of conceptions of illness by children with ALL, 3) how conceptions of illness influences hospital behavior during their receiving treatment. The study included 12 children (4 - 12 years old) with ALL and their parents. The children were interviewed for their conceptions of illness (Conceptions of Cancer Protocol) and cognitive development (conservation tasks). The parents were interviewed for their ways of communication with their children on their illness. They were asked to complete a behavior-rating list about their children after hospitalization (Posthospital Behavioral Questionnaire). Qualitative approach was adopted for a broader and deeper understanding of the development of conceptions of illness and their influence on the children with cancer. A separate pilot study was conducted on a child with newly diagnosed to have cancer disease to explore the relationship between conceptions of illness and hospital behavior. The results demonstrate a systematic difference in children's conceptions of illness. The different is a function of cognitive mature, treatment experience and the communication among children and their parents. There are differences in the children in understanding of illness. Older children reported more sophisticatedly about their illness than the younger children. Children during consolidation and maintenance treatment stage showed good understanding of conceptions of illness. Parents, who communicated openly, could assist children to develop their conceptions of illness. The effect was more observable especially for the younger or less cognitive maturity children. When young children and children with newly diagnosed with cancer have a good understanding their illness, they exhibited better hospital behavior. The limitations of this study were the small sample size and the health condition of the children. It is hope that this research could provide a broad understands about the conceptions of illness and their relationship with cognitive development, treatment experience, parents' open communication and hospital behavior with their children about their illness to the researchers and practitioners. Recommendations are provided to enhance parents and children communication and educational interventions with children, parents and medical professionals.