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HK J Paediatr (New Series)
Vol 13. No. 4,
2008
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HK J Paediatr (New Series) 2008;13:239-252
Original Article
Psychological Vulnerability and Resilience in Children and Adolescents with Thalassaemia Major
ASM Fung, LCK Low, SY Ha, PWH Lee Department of Clinical Psychology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China ASM Fung (馮淑敏) BSocSc, MSocSc(Clin Psy), PhD Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China LCK Low (盧忠啟) MBChB, FHKAM(Paed) SY Ha (夏修賢) MBBS, FHKAM(Paed), FHKAM(Path) Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China PWH Lee (李永浩) BSocSc, MSocSc(Clin Psy), PhD Correspondence to: Dr ASM Fung Received May 23, 2008
Abstract Objectives: Chronic childhood illness may be a risk factor for psychosocial or psychiatric disturbances. Yet, children with chronic illnesses may also show resilience and active coping with varying degrees of success or failure. The present study aims to outline the patterns of coping and adjustment of patients with thalassaemia major, and identify specific developmental issues associated with living with the chronic illness. Method: Seventy-three patients receiving treatments at Queen Mary Hospital were assessed with a set of semi-structured interview and questionnaires instruments covering the children's perceptions of their quality of life, illness and treatment. Their psychological adjustment was assessed through measures on life satisfaction, the extent and nature to which they felt they had been adversely affected by the illness and treatment, and their views of the future and of themselves. Results: The patients had multiple concerns and dissatisfactions with their illness, treatments, and health status, but many of their concerns were also commonly noted in normal healthy children. Resilience is demonstrated in a proportion of patients. There were clear developmental trends showing that patients had changing concerns over different stages of their development. Older patients had more adverse impact as chronicity and mental exhaustion in coping with the illness seemed to be an important factor affecting adjustment. Conclusions: The results indicate the need for psychosocial interventions, especially for the older patients with thalassaemia major. Keyword : Adjustment; Coping; Developmental patterns; Resilience; Thalassaemia major Abstract in Chinese
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