Children's perceptions of illness and death

Summary

Psychologists have long attempted to gain an understanding of how children view the world and its components. A particular interest within paediatric psychology has been children's perceptions of such environmental components as medical events; personnel, and procedures; diseases; and death (Roberts, 2000). In order to effectively change the environment in ways to create more positive perceptions, it becomes paramount to know, in fact, how children perceive chronic illness and death. Psychologists have investigated what have been variously called children's knowledge, attitudes, attributions, understanding, conceptions and perceptions of health-related events, issues and concepts. Similarly, clinicians have sought to understand children's perceptions of diseases such as asthma or cystic fibrosis in order to design interventions and explanations for those with such conditions. Additionally, perceptions of siblings and peers about children with chronic illness and disease have been examined in order to enhance their acceptance and development of social relationships. Finally, clinical investigators have assessed children's views of medication and the causes of disease in order to influence adherence to treatment regimens. The following selective review highlights children's perceptions regarding chronic illness and death, explicating theoretical and conceptual considerations, peer and sibling relationships, medication issues and clinical implications.

Theories of children's perceptions and attitudes

Several theoretical frameworks have been developed or modified within which to conceptualize children's perceptions and understanding of chronic illness and death. The Health Belief Model (HBM) has been widely used to conceptualize adults' motivations to adopt health-enhancing behaviours (Rosenstock, 1974).