Children's underst and ing of illness: Effects of developmental level and degree of contact with illness.

Abstract

This investigation examined the effects of cognitive developmental level and degree of contact with illness on children's underst and ing of illness. The intent of the inquiry was to examine from a Piagetian perspective how pediatric cancer patients, their siblings, and their friends of different ages expressed their underst and ing of various illness concepts. Ninety-eight children between the ages of five and sixteen years (mean age = 10.6 $\\pm$ 3.15) were interviewed about their ideas of the etiology, mechanisms, and implications of illness on a variety of illness subtasks. These children were classified in one of three cognitive developmental levels (preoperational, transitional, or concrete operational) based on Piagetian tasks of conservation, transformation, interrelationship among parts, and physical causality. Ill children, their siblings, and their friends within each developmental level were assessed in terms of the degree of sophistication of their underst and ing of illness and in terms of the number of cognitive errors (phenomenism, contagion, or immanent justice) they made. The findings of this study suggested that the cognitive development of children, not their amount of contact with illness, determined their underst and ing of illness concepts. The study documented a developmental progression of illness underst and ing which corresponded to cognitive maturation in a predictable manner. Older children demonstrated more advanced ideas about illness than did their younger counterparts. In contrast, there were no significant differences across illness groups on any of the underst and ing of illness measures or on the type or number of cognitive errors children make when explaining illness.