Emotional Reactions to Illness

Objectives
What are the normal emotional
reactions by an adolescent to a
new medical problem?
What are the normal emotional
reactions by the family to a new
medical problem?
What can a physician do to help
family members cope with periods
of distress?
Responsibilities
How to recognize and treat low
blood sugar (hypoglycemia)
How to recognize and treat high
blood sugar (hyperglycemia)
Diabetes meal planning
How to take insulin
How to check blood glucose
and urine ketones
How to adjust insulin and food
when you exercise
The Childhood Adaptation Model to
Chronic Illness: Diabetes Mellitus
Emotional Reactions of Children
The diagnosis of chronic disease in
childhood can cause mental shock,
stress, sentiments of anger, sorrow,
and increased intensity in their
interpersonal relationships.
Emotional Reactions of Children
Elizabeth Kubler-Ross
5 stages of Grief
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
Complications
http://youtu.be/WxOuf1hfEng Young Voices: Erin's Life with Diabetes
Family Reactions
Their emotional responses
to the diagnosis have been
likened to the grief
reactions experienced as a
result of bereavement
through death.

Family Reactions
A diagnosis of childhood diabetes may
represent multiple losses to parents:
loss of the healthy child they thought
they had
loss of a certain lifestyle
loss of freedom
loss of former support systems
a loss of confidence in their ability to
protect their child from danger
the potential loss of their child's life
Chronic Sorrow
Cope well on a day-to-day basis:
worried about issues such as
maturation, reproduction,
pregnancy, marriage prospects,
possible inheritance factors and
their children's ability to cope
with the stress of marriage and a
family.
Parental Coping Strategies
1. disbelief - tried to reject the child's diabetes by questioning the
diagnosis
2. lack of information and guilt- sought reasons for
their child's diabetes and felt guilty about it
3. learning to care- recognized the demands caused
by diabetes and took responsibility for the child's care
4. uncertainty- care to be given to the diabetic child changed the
daily routines of the family
5. reorganization- parents adapt to the diagnosis of diabetes and
to the care of their diabetic child
6. normalization- getting back to normal life
How can a physician help?
Diabetes management plan -take
into account your child's schedule,
skills, preferences, lifestyle, and
growth and developmental needs.
Educate - emotional support,
preparation and education
emphasize the importance of
treatment
Recommend a support group
Refer to CDE
References
Bowes, S., Lowes, L., Warner, J. and Gregory, J. W. (2009), Chronic
sorrow in parents of children with type 1 diabetes. Journal of Advanced
Nursing, 65: 9921000. doi: 10.1111/j.1365-2648.2009.04963.x
Hema, D. A., Roper, S. O., Nehring, J. W., Call, A., Mandleco, B. L. and
Dyches, T. T. (2009), Daily stressors and coping responses of children and
adolescents with type 1 diabetes. Child: Care, Health and Development,
35: 330339. doi: 10.1111/j.1365-2214.2009.00937.x
Lowes, L. and Lyne, P. (2000), Chronic sorrow in parents of children with
newly diagnosed diabetes: a review of the literature and discussion of the
implications for nursing practice. Journal of Advanced Nursing, 32: 4148.
doi: 10.1046/j.1365-2648.2000.01418.x
Seppnen, S., Kyngs, H. and Nikkonen, M. (1999), Coping and social
support of parents with a diabetic child. Nursing & Health Sciences, 1: 63
70. doi: 10.1046/j.1442-2018.1999.00009.x