Children living with chronic illness: an examination of their stressors, coping responses, and health outcomes.

This chapter reviews nursing research from the last decade on children and adolescents coping with chronic illnesses. Studies were identified by searches of MEDLINE and CINAHL and were included if at least one primary author was a nurse, the primary informants were children, and the focus of the study was on children's responses to illness and/or developmental stressors. Synthesis of the reviewed studies yielded typologies of illness-related and developmental stressors faced by chronically ill children, the coping strategies they commonly employed, and indices of their adjustment to illness. Although there was considerable agreement across illnesses, age ranges, and methodologies, the lack of explicitly employed developmental models or other theoretical perspectives means that very little is known about the processes by which individual characteristics, stressors, coping strategies, and outcomes are related. Recommendations for future research include the development and testing of conceptual models that will promote our understanding of how children's medical, psychosocial, and developmental outcomes can be improved, and a more systematic approach to understanding how children's maturing cognitive abilities affect their appraisal of stress and utilization of coping strategies in response to the demands of chronic illness.