CHILDRENS UNDERSTANDING OF THE CANCER EXPERIENCE

Children's understanding of the cancer experience is dependent on deve lopmental changes in knowledge of illness, attitudes of staff to infor ming children, and the way in which families cope with the diagnosis. Previous work has often failed to acknowledge the differential impact of cancer as a function of the child's age. This review therefore addr esses the issue from the perspectives of 1) preschoolers, 2) school-ag ed children, 3) adolescents, 4) adult survivors, and 5) healthy siblin gs. At all ages, the emphasis has been on cognitive understanding, wit h less consideration given to the emotional or social consequences of the disease. Research is limited by the nonavailability of appropriate measuring instruments and the use of parents as informants rather tha n children themselves. There is a need to develop measures that take i nto account the developmental status of the child. Preliminary work of an instrument focusing on adolescents is presented. Theoretical persp ectives that emphasize how children integrate the cancer experience wi th their everyday lives are called for Understanding how children view the cancer experience has implications for explaining the disease to children and concerning ethical issues involving children's rights to accept or withdraw from treatment.