Christine Eiser - Overview
Approximately 15% of children under 15 years of
age suffer from a chronic disease. These conditions include asthma, diabetes,
epilepsy or cancer among others. In all cases, children experience on-going
medication, regular hospital appointments and check-ups. Large-scale studies
in the US and UK have described how these children are at risk of compromised
development in social and psychological functioning, behaviour, and education.
Early work focused on describing the deficits or problems that characterised
children with chronic disease. With time the emphasis has shifted to recognising
the wide range of outcomes that can occur. This shift has been achieved
in part as a result of the significant improvements in survival that have
occurred among children treated for cancer. Indeed, cancer has become
a model for understanding the psychological consequences of chronic disease
more generally.
Our focus in Sheffield is on determining the medical, family and social
variables that contribute to psychological well-being and quality of life
in children treated for cancer. On the one hand, children undergo lengthy
and aggressive medical treatment, but at the same time, are encouraged
to go to school and take part in normal out-of-school activities. Parents,
therefore face difficult decisions in maintaining the necessary vigilance
while also allowing the child to achieve appropriate independence. In
recognising this, our theoretical models are drawn from ‘normal’ developmental
psychology. Currently, theoretical models regarding the role of parenting
in promoting autonomous behaviour are being used to predict quality of
life in children over 2 years from diagnosis.
Complementary work focuses on children with a CNS tumour. Considerable
work has documented the learning difficulties experienced following treatment.
Interventions involving families and schools are being used to teach children
strategies to deal with their learning difficulties.
In parallel with this work, additional studies are being conducted concerning
learning in children following premature birth, and interventions to improve
glycaemic control in diabetes.
This combination of work will contribute to a greater understanding of
the impact of chronic disease on the child’s general functioning and long-term
achievement, and provide clinical guide-lines regarding appropriate management
of the child.
Our specific aims include
i) Emphasise and evaluate quality of life in addition to survival
ii) Improve the standard of care available to all children with cancer
across Europe;
iii) Make recommendations regarding the overall standard of care expected
and the resources required
iv) Raise the profile of children with cancer
v) Provide an evidence base from which to give families sensitive and
accurate counselling regarding the implications of different treatments
and stages of treatment
