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Children and Adolescents Living with Mobility Impairment
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: This thesis aims to describe perceived overall well-being, coping strategies, experiences of intimacy and sexuality, and global and dimension-specific self-esteem among children and adolescents with mobility impairment.

Methods: The study included 141 children and adolescents aged 7–18 years with mobility impairment. Data was gathered by comprehensive semi-structured interviews and the self-report inventories “Children’s Coping Strategies Checklist” (CCSC) and “I Think I am”. Perceived overall well-being was measured by the nine-grade visual “Snoopy scale”. Motor function and pain were measured by the BL motor assessment, and independence or dependence by Katz Index of Independence in Activities of Daily Living.

Results: The majority reported a favourable level of perceived overall well-being and positive global and dimension-specific self-esteem. Lower global self-esteem was significantly related to: greater age, being a first-generation immigrant, having an acquired disease or injury and experience of pain, while lower level of perceived overall well-being was significantly related to all of these in addition to not living with both parents. Generally, children and adolescents identified themselves as sexual beings and most expressed future aspirations as living together with partner having children. However, many had limited or no experience of partner-related intimacy and sexual activities, and socio-demographic and disability characteristics had a marginal influence. A history of sexual abuse was reported by 7% in the age cohort 13–18 years. A four-dimensional model of coping strategies including “active coping”, “distraction”, “avoidance” and “support seeking” strategies provided an adequate fit to the CCSC data. Three of the four strategies, all except “avoidance”, were significantly related to several demographic and disability features. Well-being was not significantly related to coping strategies, although the higher the trust in the strategies, the higher the estimation of well-being.

Conclusion: The understanding of vulnerability factors as well as identification of coping strategies among children and adolescents with mobility impairment is essential for providing proper care, treatment and support during childhood and adolescence.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2008. , 82 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 378
Keyword [en]
adolescents, children, coping, disability, intimacy, mobility impairment, self-esteem, sexual abuse, sexuality, well-being
National Category
Clinical Science
Identifiers
URN: urn:nbn:se:uu:diva-9289ISBN: 978-91-554-7286-3 (print)OAI: oai:DiVA.org:uu-9289DiVA: diva2:172546
Public defence
2008-10-24, Robergsalen, Akademiska sjukhuset, ing. 40, 4 tr, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2008-10-03 Created: 2008-10-03 Last updated: 2009-06-08Bibliographically approved
List of papers
1. Well-being among children and adolescents with mobility impairment in relation to demographic data and disability characteristics
Open this publication in new window or tab >>Well-being among children and adolescents with mobility impairment in relation to demographic data and disability characteristics
2005 In: Acta Paediatrica, ISSN 0803-5253, Vol. 94, 616-623 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-97551 (URN)
Available from: 2008-10-03 Created: 2008-10-03Bibliographically approved
2. Coping strategies among Swedish children and adolescents with mobility impairment in relation to demographic data, disability characteristics and well-being
Open this publication in new window or tab >>Coping strategies among Swedish children and adolescents with mobility impairment in relation to demographic data, disability characteristics and well-being
2007 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 8, 1184-1189 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The first aim of the present study was to evaluate the applicability of a four-dimensional model of coping strategies, which includes 'active coping', 'distraction', 'avoidance' and 'support seeking' strategies, on children and adolescents with mobility impairment. The second aim was to identify coping strategies in this group. Finally, we analysed the relation between coping strategies and demographic data, disability characteristics and well-being.

Methods: Children and adolescents aged 7–18 years with mobility impairment (n = 133) were interviewed, and demographic and disability characteristics were recorded. The Children's Coping Strategies Checklist, a 52-item self-report inventory, was used to characterise dispositional style in coping.

Results: The four-factor model of coping strategies provides an adequate fit to the data of the sample studied. Three of the four coping strategies, all except 'avoidance', were significantly related to several demographic and disability features. Well-being was not significantly related to any of the four coping strategies, although the higher the trust in the strategies, the higher the estimation of one's own well-being.

Conclusion: Identification of coping strategies among children and adolescents with mobility impairment should form the basis of our understanding of how they face the complexity of challenges while growing up.

Keyword
Adolescent, Children, Coping strategy, Disability, Well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97552 (URN)10.1111/j.1651-2227.2007.00387.x (DOI)000248282500018 ()17590192 (PubMedID)
Available from: 2008-10-03 Created: 2008-10-03 Last updated: 2011-01-26Bibliographically approved
3. On intimacy, sexual activities and exposure to sexual abuse among children and adolescents with mobility impairment
Open this publication in new window or tab >>On intimacy, sexual activities and exposure to sexual abuse among children and adolescents with mobility impairment
2008 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 5, 641-646 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to describe experiences of intimacy and sexual activity and exposure to sexual abuse among children and adolescents with mobility impairment, and to relate these experiences to socio-demographic data, disability characteristics and well-being. Methods: This study included semi-structured interviews with 141 children and adolescents aged 7-18 years with mobility impairment. Interpersonal experiences of intimacy and sexuality, socio-demographic data, disability characteristics and well-being were registered. Results: About half of the children and adolescents in the study had been in a boy- or a girlfriend relationship, and about a fifth had an ongoing relationship. Of the adolescents, 15% had at least one experience of a sexual relationship. Whereas no particular sexual dysfunction was reported, 15% had concerns about their future sexual activities, presumably related to mobility impairment. A history of sexual abuse was reported by 7% in the age cohort of 13-18 years. The socio-demographic and disability-related features had a marginal influence on the experiences of intimacy and sexual activities. Conclusion: Several aspects of sexual health are not fully realized for children and adolescents with impaired mobility, and there is a need for specialized sexual health care services to protect the sexual rights of this group.

Keyword
Adolescent, Children, Disability, Sexual abuse, Sexuality
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97553 (URN)10.1111/j.1651-2227.2008.00757.x (DOI)000254988600025 ()18394110 (PubMedID)
Available from: 2008-10-03 Created: 2008-10-03 Last updated: 2011-01-11Bibliographically approved
4. Self-esteem in children and adolescents with mobility impairment: impact on well-being and coping strategies
Open this publication in new window or tab >>Self-esteem in children and adolescents with mobility impairment: impact on well-being and coping strategies
2009 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 3, 567-572 p.Article in journal (Refereed) Published
Abstract [en]

AIM: The first aim was to investigate dimension-specific and global self-esteem in children and adolescents with mobility impairment and to analyse the relation between self-esteem and demographic data and disability characteristics. The second aim was to identify the impact of five self-esteem dimensions on well-being and coping strategies. METHODS: A total of 138 children and adolescents aged 7-18 years with mobility impairment took part in a semi-structured interview. Demographic and disability characteristics were recorded and motor function was assessed. Self-esteem was measured by the 'I think I am' inventory. Perceived overall well-being was measured by a nine-grade visual scale, the Snoopy scale, and coping strategies by the Children's Coping Strategies Checklist. RESULTS: Although a majority estimated a relatively high level of dimension-specific and global self-esteem, several demographic and disability factors for lower self-esteem were identified. Those who estimated their 'physical characteristics' lower used the coping strategy 'distraction' more often. Three out of five dimensions of self-esteem were positively associated with perceived overall well-being: 'physical characteristics', 'psychological well-being' and 'relationships with others'. CONCLUSION: Awareness of vulnerability factors for lower self-esteem in children and adolescents with mobility impairment offer health care professionals specific opportunities to enhance self-esteem in this group.

Keyword
Adolescents, Children, Coping, Disability, Self-esteem, Well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-97554 (URN)10.1111/j.1651-2227.2008.01081.x (DOI)000262878200028 ()18976365 (PubMedID)
Available from: 2008-10-03 Created: 2008-10-03 Last updated: 2010-12-30Bibliographically approved

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