دانلود رایگان مقاله انگلیسی تاثیر بیماری پوستی در عزت نفس کودک - الزویر 2018

abstract

Background: Pediatric skin disorders can affect children’s self-esteem, relationships with caregivers and peers, and performance in school and activities. Objective: This review describes common pediatric congenital and acquired dermatologic disorders and the impact that these disorders can have on children’s self-esteem. Methods: A review of current, English-language literature was conducted with use of the PubMed database. Search terms included atopic dermatitis, acne, infantile hemangiomas, port wine stains, congenital melanocytic nevi, hidradenitis suppurativa, and self-esteem. Results: During infancy and toddlerhood, skin disorders such as infantile hemangiomas primarily affect the attachment between child and caregiver. School-aged children with port wine stains and atopic dermatitis report increased bullying, teasing, and social isolation. Acne and hidradenitis typically affect older children and teens and these conditions are associated with increased risks of depression and suicidal ideation. Effective management of these conditions has been shown to increase patients’ self-esteem. Conclusion: Pediatric dermatologic disorders impact self-esteem throughout childhood. In addition to the surgical and medical management of these disorders, clinicians can also take an active role in the assessment and improvement of the psychosocial impact of these skin disorders

Conclusion

Both congenital anomalies and acquired skin disorders impact the self-esteem of pediatric patients. In general, the appearance of birthmarks and acquired skin disorders such as AD that have onset before the age of 3 years primarily affect the parent-child attachment (Chernyshov, 2016; Dweck, 2009). Older children (i.e., school age and adolescents) tend to be more negatively affected by visible differences at a time when peer relationships gain importance and selfconcept matures (Chernyshov, 2016; Dweck, 2009). Early and effective management of both congenital and acquired conditions can improve a child’s self-esteem (Chernyshov, 2016; Krowchuk et al., 1991; Troilius et al., 1998).

To assist in minimizing the impact of these dermatologic disorders on self-esteem, clinicians should be equipped to assess and discuss patients’ self-esteem in a clinical practice. To open a conversation about the psychosocial effects of skin disease, physicians may ask children or their parents to rate their satisfaction with their skin on a scale from 1 to 10 with 10 being very satisfied and 1 not at all (Nguyen et al., 2016). Physicians should also ask school-age children if peers make fun of, bother, or hurt them (Glew et al., 2005).

After assessment of the impact of the skin disorder on self-esteem and psychosocial function, physicians can support healthy psychosocial development by providing educational materials regarding the skin disorder to dispel any misconceptions about the skin disease for the patient, family, school, and community (Dieterich-Miller and Safford, 1992). Physicians can aid in equipping children with responses that reframe the skin disorder in a positive light such as referring to a CMN as a beauty mark and with responses that diffuse attempts at teasing or bullying patients by redirecting peer attention to a different subject (Nguyen et al., 2016). Parents should nurture their child’s strengths and emphasize his or her achievement of normal development to foster a well-rounded sense of self (DieterichMiller and Safford, 1992; Marik and Hoag, 2012). Physicians can also connect patients and families with advocacy groups, support groups, and specialized summer camps for children with skin disorders (Marik and Hoag, 2012; Nguyen et al., 2016). Finally, professional support from counselors, psychologists, or psychiatrists may be necessary for patients with poor psychosocial functioning (Marik and Hoag, 2012).

Using these tools, clinicians can assess self-concept, monitor social and behavioral development, and help patients and families cope with skin disorders. These steps can help proactively guide families to bolster positive self-concept and self-esteem (Dieterich-Miller and Safford, 1992; Nguyen et al., 2016). Addressing the psychosocial impact of skin disorders can set the stage for healthy mental and emotional development for the rest of children’s lives.