Die intrapsigiese funksionering van die kind met asma in die middelkinderjare

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Date
2003-05
Authors
Brand, Albertus
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Publisher
University of the Free State
Abstract
English: The primary aim of this study was to establish whether the intrapsychic functioning of the child with asthma in late middle childhood significantly differs from that of the child without asthma. The physiological aspects of asthma were briefly discussed with specific reference to its definition, incidence, diagnoses, aetiology and treatment. An explanation was given of relevant developmental aspects during middle childhood, which could possibly be influenced by chronic diseases, in order to establish a framework against which the intrapsychic aspects of children with asthma could be further investigated. An effort was made to clarify the term intrapsychic from the available literature with specific reference to children with asthma. In the empirical research a non-recurrent cross-sectional design was used. The research group consisted of learners in their late middle childhood, representative of all population, language and socio-economic groups from schools in the North West Province, Free State, Gauteng and Mpumalanga. From an availability sample of 1067 learners two further groups were identified, namely those with asthma and a random sample of relatively healthy children proportionally representative of the background variables (gender, language and age). Apart from a general health questionnaire and biographical questionnaire, the test battery consisted out of subscales from the following measuring instruments: the Piers-Harris Children’s Self-Concept Scale, Locus-of-Control Scale for Children, Social Support Appraisal Scale, Child Symptom Inventory, Behavioral and Emotional Rating Scale and Stress Response Scale. Acceptable reliability and validity indices for all the measurements were obtained. The data obtained from these scales was used to evaluate the intrapsychic functioning of the study sample regarding self-concept, handling of stress, locus of control, perception of social support, emotional functioning and psychiatric symptoms. The statistical significance of differences in functioning was established by means of Hotelling’s T² tests, followed up with post hoc t-tests and calculated for effect sizes. Finally a discriminant analyses was performed in order to validate the results of the study. Statistically meaningful differences between children with asthma and relative healthy children in the late middle childhood years were found for five of the 20 dependant variables. Children with asthma during the middle childhood years showed a significantly higher perception of support from three social structures (viz. peer group, family and teachers), a stronger acknowledgement of behaviour problems and a higher incidence of generalized anxiety disorder. Contradictions in the literature were found regarding the other dependant variables and more research is deemed necessary. It appears from the empirical results that the majority of children with asthma still portray healthy psychological functioning, in spite of a possible higher risk for comorbid psychosocial problems. Finally recommendations were made for future research.
Afrikaans: Die primêre doel van hierdie studie was om vas te stel of die intrapsigiese funksionering van die kind met asma betekenisvol verskil van dié van die kind sonder asma. Die fisiologiese aspekte betrokke by kinders met asma is kortliks beskryf deur te verwys na die definiëring, insidensie, diagnosering en etiologie van asma asook die behandeling daarvan by kinders. ‘n Uiteensetting is verskaf van relevante ontwikkelingsaspekte gedurende die middelkinderjare, wat moontlik deur chroniese siektetoestande beïnvloed mag word, ten einde ‘n raamwerk daar te stel waarbinne enkele intrapsigiese aspekte betrokke by kinders met asma ondersoek kon word. Daar is voorts gepoog om vanuit die beskikbare literatuur die begrip intrapsigies verder te operasionaliseer met spesifieke verwysing na kinders met asma. In die empiriese ondersoek is van ‘n eenmalige dwarssnitontwerp gebruik gemaak. Die populasie het bestaan uit ‘n verteenwoordigende steekproef van kinders in hul laat-middelkinderjare onder alle bevolkingsgroepe, sosio-ekonomiese strata asook verskillende taalgroepe uit die Noordwes-provinsie, Vrystaat, Gauteng en Mpumalanga. Uit ‘n beskikbaarheidsteekproef van 1067 leerders is twee verdere groepe kinders identifiseer, naamlik dié met asma asook ‘n ewekansige steekproef van relatief gesonde kinders proporsioneel verteenwoordigend van die agtergrondsveranderlikes (geslag, taal en ouderdom). Benewens ‘n algemene gesondheidsvraelys en biografiese vraelys, het die toetsbattery uit subskale van die volgende meetinstrumente bestaan: die Piers-Harris Children’s Self-Concept Scale, Locus-of-Control Scale for Children, Social Support Appraisal Scale, Child Symptom Inventory, Behaviour and Emotional Rating Scale en Stress Response Scale. Bevredigende betroubaarheids- en geldigheidsindekse is vir al die meetinstrumente verkry. Die verkreë data is gebruik om die intrapsigiese funksionering van die ondersoekgroep ten opsigte van selfkonsep, streshantering, lokus van kontrole, belewing van ondersteuning, emosionele funksionering asook psigiatriese simptomatologie te bepaal. Die statistiese beduidenheid van verskille in funksionering is bepaal met behulp van Hotelling se T² toets opgevolg deur post hoc t-toetse en effekgroottes is bereken. Laastens is ‘n diskriminant-analise uitgevoer ten einde die resultate van die ondersoek te valideer. Statisties beduidende verskille tussen die eksperimentele en kontrolegroep kinders het voorgekom ten opsigte van vyf van die 20 afhanklike veranderlikes. Kinders met asma in die middelkinderjare toon hiervolgens ‘n betekenisvol sterker belewing van ondersteuning deur enkele sosiale strukture (te wete die portuurgroep, gesin en onderwysers), ‘n beter vermoë om gedragsprobleme te erken en verantwoordelikheid daarvoor te aanvaar asook ‘n hoër insidensie van veralgemeende angsversteuring. Ten opsigte van ander afhanklike veranderlikes bestaan teenstrydighede in die literatuur en blyk meer navorsing oor hierdie onderwerp nodig te wees. Dit blyk egter uit die resultate van die empiriese ondersoek dat die meerderheid kinders met asma steeds psigologies goed funksioneer, ten spyte van ‘n moontlike groter risiko vir komorbiede psigososiale problematiek. Ten slotte is aanbevelings rakende verdere navorsing gemaak.
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Keywords
Asthma, Intrapsychic functioning, Middle childhood, Psychosocial aspects, Self-concept, Locus of control, Social support, Emotional functioning, Psychiatric symptoms, Asthma in children, Resilience (Personality trait) in adolescence, Stress in adolescence, Thesis (Ph.D. (Psychology))--University of the Free State, 2003
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