Millstein S G, Adler N E, Irwin C E
Pediatrics. 1981 Dec;68(6):834-9.
This study examined conceptions of illness in young adolescents. A group of 77 urban junior high school students aged 11 to 15 years were asked for their definitions of illness. Themes occurring in definitions of illness were identified and coded according to a previously developed coding scheme. Evidence in support of a developmental process underlying conceptions of illness was found by examining adolescents' definitions and comparing them with child and adult norms established in prior research. Results for adolescents showed the frequency of use of specific themes to fall between child and adult norms. The strongest evidence in support of a developmental trend was seen in definitions of illness pertaining to changes in daily activities. However, the relative frequency of adolescents' definitions was more like that of children than adults, indicating that whereas adolescents used a greater frequency of adult-like themes, they did so within a framework more descriptive of children. Qualitative aspects of definitions of illness showed age-linked differences with adolescents generating more adult-like, conceptually sophisticated definitions than children. In addition to developmental differences, similarities in definitions of illness were also found; among all age groups the most common delineators of illness were physical symptoms. Psychosocial themes were less frequently mentioned. Clinicians who discuss with their adolescent patients the ways in which illness affects social interaction may be communicating more effectively than practitioners who focus solely on signs and symptoms of physical disease.
本研究调查了青少年对疾病的认知。一组77名年龄在11至15岁的城市初中生被要求给出他们对疾病的定义。根据先前制定的编码方案,对疾病定义中出现的主题进行识别和编码。通过检查青少年的定义并将其与先前研究中确立的儿童和成人标准进行比较,发现了支持疾病概念背后存在发展过程的证据。青少年的结果显示,特定主题的使用频率介于儿童和成人标准之间。在与日常活动变化相关的疾病定义中,看到了支持发展趋势的最有力证据。然而,青少年定义的相对频率更像儿童而非成人,这表明虽然青少年使用了更高频率的类似成人的主题,但他们是在一个更具儿童描述性的框架内这样做的。疾病定义的定性方面显示出与年龄相关的差异,青少年给出的定义比儿童更具成人化、概念更复杂。除了发展差异外,还发现了疾病定义中的相似之处;在所有年龄组中,疾病最常见的界定因素是身体症状。心理社会主题较少被提及。与青少年患者讨论疾病如何影响社会互动的临床医生可能比只关注身体疾病体征和症状的从业者沟通更有效。