Conceptions of Illness by Children with Juvenile Rheumatoid Arthritis: A Cognitive Developmental Approach

Investigated the conceptions of illness and accuracy of understandingabout their disease for children with juvenile rheumatoid arthritis(JRA). 54 children between the ages of 6 and 17 were interviewedindividually about various aspects of JRA, with results suggestingthat accuracy and illness conceptions could be reliably measured.As predicted, children's understanding about their disease followeda developmental progression, with older children demonstratinga more sophisticated understanding of JRA than younger children(significant differences between age groups on 3 of the 5 questions).Multiple regression analysis indicated that conceptual level(p < .001) was a better predictor of the child's accuracyof knowledge than was age (ns). Despite the developmental progression,there were a significant number of children functioning belowthe level expected for their age. In fact, the majority (75%)of children exhibited an understanding of JRA at the concreteoperational level of cognitive development. The within-subjectvariability and striking misconceptions argue for ongoing evaluationof each child's understanding as a way to improve educationalefforts.