Lay concepts of health and illness from a developmental perspective

Abstract

The concepts of children, adolescents and their mothers with regard to different aspects of health and illness in general and five specific diseases were explored in this study. An exploration with fully standardised questions and open answers was subjected to a content analysis. A reliable rating system was developed to score the sophistication of the answers. The study included 99 Ss of the age groups 5, 8, 12 and 16 years, as well as 48 mothers of the children. Many children and adolescents were able to define health positively (well-being) and not merely as the absence of illness. The definition of illness in general was frequently composed of somatic symptoms and disorders, feeling poorly and things one would like to accomplish but can't. The causality explanations of illness in general were dominated by contagion. The concepts of the older children and the mothers were richer, more elaborated, less concrete and less action-oriented than those of the younger children. However, abstract formulations and complex aspects of illness were very rarely expressed. In addition, concepts regarding the characteristics (definition, symptoms, causality, treatment and prevention) of five diseases (cold, measles, heart infarction, cancer and AIDS) were measured. The pattern of results was strongly influenced by age. By and large, the development of most disease concepts was linear with significant differences between age groups. Conversely, within a given age group, significant differences were found in the cognitive level of disease characteristics, either with respect to the same disease or between different diseases (“horizontal shifts”).