Izvorni znanstveni članak
Self-Esteem in Children and Adolescents Differently Treated for Locomotory Trauma
Suzana Jonovska
Tanja Frančišković
Ante Kvesić
Hary Nikolić
Zrinko Brekalo
Eduard Pavlović
Daliborka Dalija Bilić
Sažetak
Self-esteem involves the evaluative and affective dimensions of self-concept. It could be influenced by stress situations
such as diseases or injuries, especially in the period of puberty and adolescence. The aim of this study was to establish the
influence of isolated long tubular bone limbs’ fractures in children and adolescents and type of its treatment (conservative
or active surgical treatment-various techniques) on self-esteem of patients, as well as to establish relationships between
self-esteem, depression, anxiety and perception of the social support in the mentioned patients. This prospective
clinical trial comprehends 135 patients, 94 male and 41 female, aged 10 to 18, treated for the mentioned fractures in the
period from October 2003 until March 2005 in Departments for Pediatric Surgery of three hospitals: the Clinical Hospital
Center in Rijeka (88.8% patients), the Clinical Children’s Hospital in Zagreb (9.7%), both in Croatia, and 1.5% of the
patients in the Clinical Hospital in Mostar (Bosnia and Herzegovina). 53.3% of the patients were treated conservatively,
29.6% of them underwent the elastic stable intramedullary nailing (ESIN), while the remaining 17.1% of the patients
were treated with other surgical techniques (AO-plates or Kirschner-wire ostheosyntheses). The basic methods of work
were self-reported questionnaires: Rosenberg Self-esteem Scale (RSS), to establish the degree of self-esteem; Children Depression
Inventory (CDI), to establish existence and degree of depression; Spielberg State Trait Anxiety Inventory (STAI)-
form STAI2, to establish general anxiety; and Test of Perception of Social Support (TPSS). RSS, CDI and STAI2 were
administered twice to the patients: at baseline and after 6 months of the trauma, whereas TPSS once, after 1 month of the
trauma. Our results point at an decreased self-esteem followed by increased depression and increased general anxiety indicators
in all patients within 1 week of experienced trauma, especially in those who underwent the ESIN method,
whereas after 6 months of the experienced trauma, self-esteem significantly increased and depression and general anxiety
indicators were greatly reduced in all patients. The type of treatment of fractures has no influence on the perception of
the social support. Our results suggest that the ESIN method (regardless of its good surgical results and advantages in
relation to many other surgical techniques) reduces self-esteem more than conservatively treatment of fractures and AOplates
and K-wire ostheosyntheses. At the same time self-esteem has been recuperated faster in patients treated with
ESIN method. Thus, there is no difference in the influence of the type of the treatment of fractures on self-esteem, but in
the dynamics of its recuperation in patients according to type of treatment of fractures. Anyway, from a psychological
point of view, any type of surgical treatment could be additional stressor, so it should be practiced with criticism and according
to the strict surgical indications.
Ključne riječi
adolescents; children; locomotory trauma; different treatments; self-esteem
Hrčak ID:
27383
URI
Datum izdavanja:
10.4.2007.
Posjeta: 1.208 *