Data from literature show that the prevalence of chronic diseases in children is 10-15% in the world and, equally so, in Croatia. Most often it is insulin dependent diabetes, epilepsy, bronchial asthma, locomotor system diseases, cardiac diseases, chronic colon inflammations and leukaemia.

Discovering that the child is chronically sick may be viewed as a process of mourning for the loss of health, and the disease may have negative implications for the child’s and family’s future, leading to a loss of purpose, aspirations and dreams. Such losses must be grieved, implying a process with several stages: from the initial disbelief and denial, through anger and anxiety, depression to eventual acceptance of the disease.

Furthermore, the family is under stress having to deal with difficult decisions other families do not have to make. Anxiety and care about health remain to a degree present for ever. Family dynamics and lifestyle change – children have to visit the doctor often and sometimes have to be hospitalised, have to adhere to special diets or habits, or have to undergo demanding and painful exercise and treatments. Therapy itself can cause various side effects which may interfere with the child’s everyday functioning.

How the family and the child will adapt to the disease depends on the child’s age, severity of the disease, as well as on the characteristics of the child, how the family has been functioning so far and current characteristics of the family and the social environment, i.e. school.

Possible negative effects of the disease on the sick child:

– immaturity and dependence on parents

– lower self-confidence

– behavioural difficulties

– social isolation

– conflicts in social interactions

– overmaturity

– anxiety

– depression

Possible negative effects on parents:

– difficulties in recognising child’s developmental capacities

– parents-child symbiosis or regression and distancing from relationships outside the caring dyad

– constant self-doubt about one’s capacity for child care

– constant ‘fight’ between the parents and the doctor authority over the child

– social isolation of the family

Effects on healthy siblings:

– depend on the severity of the disease and the child’s psycho-social functioning

– time and attention provided to the healthy child by parents and professionals

– they may feel responsible for the sick brother/sister

– they may feel sadness, anger, jealousy, fear and have difficulties in everyday school functioning and relating with their peers

Positive effects on the family:

– increased cohesion among family members

– deepened marital relationship

What you can do:

– learn about the disease

– talk about the disease, honestly, openly and understandably with your child

– help your child in managing his/her emotional reactions to sickness

– prepare your child for medical procedures

– encourage normal life as much as possible (going to the park, relating with peers, extra-curricular activities)

– do not be afraid to set boundaries and discipline your child

– give your child age-appropriate tasks

– maintain family routines

– take care of your own welfare

– prepare the child for others’ reactions

– let others help you

– let the child make some decisions

– introduce your child to other chronically sick children

– do not forget your healthy child/children

– closely cooperate with the school

– ask professionals in health institutions (doctors, nurses, psychologists, psychiatrists, special educators, physiotherapists) for help and advice

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