Chronic Disease as a Risk Factor for Psychosocial Child Development

1. Chronic Disease as a Risk Factor for Psychosocial Child Development Mr. Inge Vlašić Cicvarić, clinical psychologist Department of Clinical Psychology Clinical Hospital Centre Rijeka

2. Psychosocial development takes place in a continuingsequence of stages. End of one development stage is the basis of the next. It is necessary that each stage is completely finished so that normal development may continue undisturbed.

3. There are numerous causes of disorders in psychosocial development. One of them is CHRONIC DISEASE.

4. MENTAL HEALTH CHRONICALLY ILL CHILD PHYSICAL HEALTH

5. Chronic disease in childhood is a risk factor fordeveloping mental disorders. Mental disorders incidence in children is 6.6%. This is almost doubled among the chronically ill children .

6. MENTAL DISORDERS CHILDREN AND ADOLESCENTS 6.6% CHRONICALLY ILL CHILDREN 11.6% BLIND CHILDREN 16.6% CHILDREN WITH EPILEPSY 28.6% CHILDREN WITH ORGANIC BRAIN SYNDROMES WITHOUT CONVULSIONS 37.5% CHILDREN WITH EPILEPSY AND WITH ORGANIC CEREBRAL DAMAGE 58.3%

7. In order to prevent disorders, a holistic approach in treatinga chronically ill child is necessary. This approach aims at eliminating or alleviating adverse effects a diseaseand treatment can have on child’s mental development.

8. RIJEKA Clinical Hospital Centre Rijeka Pediatric clinic Department of pediatric surgery Department of child orthopedics Department of child rehabilitation Dept. of child clinical psychology “Hospital school” As a part of holistic approach to treatment of children in hospital psychologists take care of a child’s mental health.

9. Psychosocial Treatment

10. Psychological Help During Hospital Stay

11. psychological help and supportduring hospital stayfollowing procedures are adopted: • Taking part in communicating the diagnosis and giving support in understanding and accepting it (parent/child) • Psychological preparations for invasive medical procedures • Psychological techniques in treating pain • Preventive measures against hospitalism • Counselling when leaving the hospital (parent/child) • Psychological help and support to a dying child and its family (parents, siblings)

12. CONTINUING PSYCHOLOGICAL MONITORING • IN AMBULATORY CARE • (regular meetings with a psychologist) • Direct contact with a child and parents: • Guiding through the process of accepting the disease • Counselling on necessary lifestyle changes along with the treatment • Encouraging compliance (co-operation during the treatment) • Anticipated guidance in psychosocial functioning of a child and its family • Counselling and teaching parents about skills of supportive parenthood (preventing overprotection and excessive permissiveness)

13. CO-ORDINATION AMONG MEDICAL, • EDUCATIONAL AND • OTHER INSTITUTIONS • Close co-operation with “Hospital school” • Co-operation with non-hospital social environments • (e.g. kindergarten, school,sports clubs, etc.) • Keeping informed and connecting with support • groups/organizations for specific illness

14. Psychological help and support is offered to children affected by chronic or lifetime diseases:

15. In 2008, this approach included 416 children during hospital stay 153 children in ambulatory care (monitoring) THE NEEDS GREATLY EXCEED THE POSSIBILITY OF REALISATION.

16. GOOD PSYCHOLOGICAL ADAPTATION TO A LIFE WITH A CHRONIC DISEASE IS A PROCESS, NOT A MOMENT OR AN EVENT. Psychological help and support is an indispensable part of this process. Therefore, we aim at providing a holistic approach for every ill child...