Psychological assistance and the quality of life for families with adolescents suffering from chronic somatic diseases

Abstract

In modern conditions the number of children and adolescents with chronic somatic diseases is continuously increasing. At the same time psychological assistance is considered as one of the leading components of systemic rehabilitation, which can contribute to improving the quality of life and family relationships. However, the goals of a psychologist in a multi-disciplinary hospital for children and adolescent are not always accepted by medical staff and remain unused within rehabilitation process. This study was aimed at finding psychological deficits which reduce the quality of life of adolescents with chronic somatic diseases, and which could become the focus of the psychological assistance. The study sample included 90 adolescents each of whom had a clinically verified diagnosis of chronic somatic disease and was treated as inpatient of a multidiscipli-nary medical institution for children in the city of Tomsk. The age of the respondents ranged from 13 to 16 years. The following diseases were revealed among the adolescents: diabetes mellitus, vegetative-vascular dystonia, gastritis and gastroduodenitis. Research methods. To study the quality of life we used the method of SF-36. To evaluate attitudes, behavior and methods of upbringing through the eyes of a child, we implemented the questionnaire "Adolescents about parents" by E. Schaefer (1965) adopted by L.I. Wasserman, I.A. Gor'kova, E.E. Romitsina (1994). To assess the level of anxiety in adolescents, the questionnaire "Multidimensional Evaluation of Child Anxiety" was used (by E.E. Malkova, 2007). The results of psychological diagnostics revealed reliable differences between the indices of the quality of life of adolescents and the assessment of their relationship with their parents. A relation was found between the positive attitude of a mother and the level of quality of life. Statistically significant links between the severity of the hostility of a mother and the quality of life were established. Statistical significant links between the levels of anxiety of various kinds and quality of life were revealed. Statistical analysis of the data confirmed the assumption of a significant impact of relationships with parents on the quality of life of adolescents with chronic somatic diseases. In addition there are interrelations between parent-child relationships and the crisis period of learning about the diagnosis, as well as between the nosological affiliation of a disease, the personal characteristics of an adolescent including self-esteem, level of anxiety, peculiarities of family interaction, family composition, and adherence to treatment. Thus, even at the initial stage of the disease and until sustainable compensation parents play a key role in the formation of a regimen, diet, and medication which was adequate to the prescription of a doctor. In a situation of low efficiency of parents in this context, compensation may not be achievable. Therefore, the optimization of parent-child relationships become the central task of a psychologist at the stage of achieving control over diseases of high vital risk. Psychological counseling should be carried out in several areas including the work with adolescents, their parents, as well as the pediatric services of hospitals and polyclinic departments. This study has practical value being a basis for the optimization of psychological assistance aimed at stabilizing the quality of life of adolescents with chronic somatic diseases and for improving family interaction.