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Fatally ill children, even outpatients, show persistent awareness of their serious illness. They express more anxiety and preoccupation with body integrity compared to chronically ill children.
Area of Science:
- Pediatric Oncology
- Child Psychology
- Psychosocial Oncology
Background:
- Children with fatal illnesses often exhibit heightened awareness of their condition.
- Previous studies highlighted this in hospitalized children; this study examines outpatients.
Purpose of the Study:
- To investigate the psychological impact of fatal illness on children outside the hospital setting.
- To compare the anxiety and illness preoccupation levels of fatally ill outpatients with chronically ill children.
Main Methods:
- Comparative study involving fatally ill outpatient children and a control group of children with non-fatal chronic illnesses.
- Analysis of narrative content for themes of threat to body integrity and functioning.
- Assessment of general and situational anxiety levels.
Main Results:
- Fatally ill outpatients reported significantly more themes of body integrity threat than controls.
- Leukemic children displayed greater general and narrative-related anxiety.
- Leukemic children showed poor adaptability to clinic visits, with increasing anxiety over time and visit frequency.
Conclusions:
- Children with fatal illnesses maintain awareness of their condition's seriousness even as outpatients.
- Illness-related anxiety and preoccupation with bodily harm are significant in fatally ill pediatric outpatients.
- The psychological burden on these children necessitates tailored support, especially concerning treatment adherence.
Abstract:
Awareness of the seriousness of their illness seems to persist with fatally ill children, even when they are not in the hospital. As did the fatally ill hospitalized children in previous studies so, too, the fatally ill outpatient children in the present study related significantly more stories that contained elements of preoccupation with threat to their body integrity and functioning than did the control group of children with non-fatal chronic illnesses. Not only did they express a greater general anxiety and greater anxiety in relating the stories, but, in contrast to their chronically ill counterparts, the leukemic children exhibited a lack of adaptability to the necessity of clinic visits, becoming increasingly more anxious about the clinic both as visits became more frequent and as their illness became of longer duration. The children continue to dwell on their illness, even when treated as outpatients.