Children living with chronic illness are faced with everyday challenges that frequently force them to cope in different ways. According to Midence (1994), ten to twenty percent o all children in the United States suffer from a chronic illness. The most common chronic childhood diseases are asthma, congenital heart disease, chronic kidney disease and sickle cell disease. Children are often quite vulnerable and lack education and experience about coping, especially coping with such difficult life issues.
Learning how children cope and where they derive their coping skills and education will allow others to understand how they handle the stress of living with a chronic illness. Coping is the way one adapts to stress and includes both the positive and negative responses to stressful situations. Coping can either be in the form of direct action, where one physically attempts to change the environment, or cognitive modes, where one manipulates thoughts or feeling to contend with a problem (Olsen, Johansen, Powers, Pope & Klein, 1993).
For the purpose of this paper, the previous definition of coping will help the reader understand that children’s coping strategies can occur in either of these two forms. A cross-sectional study by Olsen et al. (1993) investigated whether children with a chronic illness used cognitive strategies as frequently as healthy children. They also examined whether children living with chronic illness utilized cognitive responses different than those used by healthy children coping with other common stressful events in daily life.
Olson et al. studied 175 children between the ages of 8-18 years old who attended special summer camps for their chronic Illness. They derived three different illness groups consisting of children with asthma, diabetes, juvenile arthritis. A control group consisted of 145 children from the public school population that were rated healthy children by the investigators. The results of Olson’s study suggested that children with chronic illness spontaneously utilize cognitive coping strategies as often as healthy children.
Coping strategies tended to increase with age while catastrophizing often decreased. The most common coping strategy was positive self-talk with the most common decatastrophizing strategy being focusing on negative effects or fear. The results also suggested variations in coping for different events. For example, children with chronic illness demonstrated greater use of cognitive coping strategies than healthy children for one type of painful event but not for another.
Older chonrically ill children utilized more complex coping strategies than healthy children and were especially more advanced in the group with Juvile Arthritis. Overall, for all groups of chronically ill children, the presence of more severe illness did not indicate change in their main or overall cognitive coping strategy. Gender effects coping strategies in children with chronic illness but had little impact on children with common problems.
Boys with chronic illness reported using cognitive restructuring and self-blame more often than girls were as girls reported using more emotional regulation and social support. In dealing with common problem, both boys and girls used strategies equally. These findings seem to indicate that gender effects coping only with regard to illness-related problems. Also, that coping is a process that differs between individuals and across situations but that also has some stable components.