Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Arts

Program

Education

Supervisor

Nowicki, Elizabeth A.

Abstract

Chronic health conditions are highly prevalent among childhood populations and lead to restrictions in everyday life. Previous research indicates that children and youth with a chronic health condition are at an elevated risk of psychosocial difficulties, including mental illness and social exclusion, compared to typically developing populations. Therefore, the purpose of this study was to determine the impact of chronic health conditions on psychosocial factors during childhood by comparing the psychosocial functioning of children with chronic health conditions and children without chronic illnesses using a meta-analysis. Specifically, three elements of psychosocial functioning were examined, (a) social-emotional functioning, (b) behavioural functioning, and (c) mental health. Comparisons were also analyzed across parent-reported and child-reported data. Studies were included in this meta-analysis if they involved a quantitative analysis comparing the psychosocial functioning of children with chronic health conditions to children without chronic health conditions, using either self-report or parent-report measures. A total of 64 studies met the inclusion criteria, allowing for 113 comparisons across 47 358 participants. Weighted mean effect sizes were used to compare children with chronic health conditions and the comparison group across social-emotional functioning, behavioural functioning, and mental health for each report type. Small to medium effect sizes were found across social-emotional functioning, behavioural functioning, and mental health, and reporter type. It was concluded that children with chronic health conditions likely do experience more psychosocial difficulties than their peers without chronic illnesses and that it is important to consider the perspectives of children and their parents regarding children’s psychosocial functioning.

Summary for Lay Audience

Many children suffer from chronic health conditions, such as asthma, diabetes, and epilepsy. While these conditions can be controlled with treatment, there are no cures. This places a burden on individuals with chronic health conditions, particularly children, which can lead to psychosocial difficulties. The purpose of this study was to understand whether children with chronic health conditions experience more psychological and social difficulties than their peers without chronic health conditions. To compare these two groups of children, a meta-analysis, or systematic review, was used to evaluate 64 studies looking at the psychosocial functioning of children with chronic health conditions compared to their peers without chronic health conditions. Psychosocial functioning was separated into three components, (a) social-emotional functioning (i.e., psychological and social well-being and quality of life), (b) behavioural functioning (i.e., observable behavioural difficulties including aggression and delinquency), and (c) mental health (i.e., symptoms of clinically diagnosable disorders such as anxiety and depression). Results indicated that children with chronic health conditions likely have more difficulties compared to their peers without chronic health conditions on social-emotional functioning, behavioural functioning, and mental health. The biggest difference between the two populations was on social-emotional functioning. Based on these results, it was suggested that health care practitioners, educators, and other support services working with children with chronic health conditions are aware of the influence a chronic health condition has on a child’s psychosocial health. Additionally, this study looked separately at parent and child reports of psychosocial functioning. Differences between parent-report data and child-report data on social-emotional functioning, behavioural functioning, and mental health were small. However, the pattern of data suggested that parents reported greater social-emotional difficulties but fewer mental health problems in their children with chronic health conditions compared to the children’s reports. How parents and children rated behavioural functioning was similar. It was concluded that the differences in reporting found in this study are likely based on the unique perspectives children and parents provide. It is recommended that both perspectives are considered when making decisions that could affect a child’s psychosocial health.

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