Concerns of children with a chronic illness: a cognitive-developmental study of juvenile diabetes.

Chronically ill children become increasingly able to understand their illnesses as they develop intellectually. But cognitive development also brings the ability to grasp the meaning of a poor prognosis or functional limitations, which may take an emotional toll on the youngster. We studied this problem in a sample of children with insulin-dependent diabetes. Those who had more advanced disease concepts were more worried about their diabetes. Children saw their parents as worried primarily about current management of the disease, suggesting that youngsters' concerns about the future were difficult to discuss at home. There is a need for clinicians and parents to integrate emotional support into the education and management of chronically ill children.