Psychological vulnerability and resilience in children and adolescents with thalassaemia major

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.