Christine Eiser

Cancer is a very rare disease in children. There have been impressive gains in survival in recent years, and these have been achieved through the use of chemotherapy and national and international clinical trials. The diagnosis of cancer in a child imposes considerable stress on the whole family. In the immediate time after diagnosis, parents must learn about the disease and its treatment, explain what is happening to the child, and make arrangements for the care of other children in the family. For the child, treatment is associated with many side effects depending on the specific drugs used. In addition, the child is prone to infection and therefore is likely to miss a lot of school and other activities. For all these reasons, physicians and families have become aware that cancer has huge implications for the quality of the child's life. This book is an attempt to describe how quality of life is affected at different stages of the disease process. Comprehensive reviews are provided of the impact on the child's physical activity, social life, and school and educational achievements. Special consideration is given to children with leukemia (one of the more common cancers) and brain tumors. Cancer does not just affect the child but every member of the family. Consequently there is coverage of the effects on parents and also healthy brothers and sisters. To the extent that improvements in survival have been achieved by national and international collaboration between clinicians, it is concluded that efforts to improve the quality of these children's lives is dependent on collaboration between clinicians, nurses, and behavioral scientists at national and international levels. This book should provide an impetus for such collaboration.

The pattern of childhood illness has changed significantly during this century. Many frightening conditions such as polio and tuberculosis have essentially been eradicated. Other conditions that were once fatal have now achieved the status of chronic disorders, for example, leukemia, cancer, and cystic fibrosis. Technological advances which have resulted in the medical treatment of these conditions have, however, created a gamut of psychological problems for the children and their families. Recognition of these problems has lagged behind other advances in pediatric medicine. The emergence of a specialist area of pediatric psychology (Wright, 1975) has largely been responsible for the mushrooming of research in the area. In much early work, the emphasis was on the impact of chronic illness on children and their families. Reactions at times of greatest trauma, especially diagnosis or death, were particularly well documented. Issues relating to day-to-day aspects of child care, involving questions of discipline or protectiveness, have received much less attention. As far as the sick child is concerned, there has been much investigation of academic and intellectual development, as well as of personality changes that might accompany illness.

Cancer is a very rare disease in children. There have been impressive gains in survival in recent years, and these have been achieved through the use of chemotherapy and national and international clinical trials. The diagnosis of cancer in a child imposes considerable stress on the whole family. In the immediate time after diagnosis, parents must learn about the disease and its treatment, explain what is happening to the child, and make arrangements for the care of other children in the family. For the child, treatment is associated with many side effects depending on the specific drugs used. In addition, the child is prone to infection and therefore is likely to miss a lot of school and other activities. For all these reasons, physicians and families have become aware that cancer has huge implications for the quality of the child's life. This book is an attempt to describe how quality of life is affected at different stages of the disease process. Comprehensive reviews are provided of the impact on the child's physical activity, social life, and school and educational achievements. Special consideration is given to children with leukemia (one of the more common cancers) and brain tumors. Cancer does not just affect the child but every member of the family. Consequently there is coverage of the effects on parents and also healthy brothers and sisters. To the extent that improvements in survival have been achieved by national and international collaboration between clinicians, it is concluded that efforts to improve the quality of these children's lives is dependent on collaboration between clinicians, nurses, and behavioral scientists at national and international levels. This book should provide an impetus for such collaboration.

The presence of a chronically sick or handicapped child in the family places considerable physical and emotional strain on parents, healthy siblings, and even extended relations. This book, drawing on theoretical and practical sources, acknowledges the potential for distress involved in caring for a sick child but also emphasizes the coping resources and skills that can be, and frequently are, adopted by families. The author demonstrates that the consequences of chronic childhood disease vary systematically with the development of the child, and suggests ways in which coping resources can be developed and promoted.

The author draws extensively on the published research findings in child health psychology, and also on her own experience of working with paediatric medical and nursing staff. The emphasis throughout her book is on coping, and helping families to cope, with the stresses imposed by chronic childhood illness. Frequent hospital admissions, pain and its evaluation and control, adjustment and sources of support, communication, education and programmes for intervention, all of these topics are discussed sensitively and with authority.

"Double Take" is a drug education package produced by the Department of Health and Social Security (United Kingdom). This video package was distributed at no cost to all secondary schools catering to students from eleven years onwards in England and Wales during 1986. This book reports the results of a research evaluation of this educational package, particularly in terms of its acceptability to teachers and pupils. The evaluation discussed in this book was conducted deliberately within the context of organizational and methodological restrictions. The primary concern was less with the potential effectiveness of "Double Take" under optimal conditions. Rather, the investigators were interested in the ways in which teachers themselves chose to adopt and integrate the package within existing courses and with the restrictions of pupils in their schools.