Minding the gap and moving forward in children's long‐term conditions: A vital role for health psychology

Children with a long-term condition and their families are confronted with multiple biopsychosocial challenges. In this editorial,weoutline the scope of theproblem and then look at some examples of interventions for children with a long-term condition and how health psychology can inform and influence these. Health psychology theories are often not very well applied or reported, and there is considerable scope for more health psychology input in this area (Prestwich et al., 2014). We discuss relevant issues and suggest directions for future research in which health psychologists might apply subjectspecific theory and knowledge to further research and practice in the paediatric domain. One in 10 children will develop a long-term condition that limits their daily life substantially and demands extended care, supervision, and self-management strategies (Yeo & Sawyer, 2005). These conditions include diabetes, neurodegenerative conditions, such as multiple sclerosis (MS), cancer, sickle cell disease, asthma, obesity, and chronic pain. The first two conditions are drawn on in this editorial as examples of long-term conditions, but many of the issues raised apply equally to other conditions. A recent study showed that the prevalence of at least one long-term condition over a 6year period was >50% during childhood (Van Cleave, Gortmaker, & Perrin, 2010). In addition to experiencing a poorer quality of life (Moreira et al., 2013), evidence suggests that children and adolescents with long-term conditions have significantly higher rates of mental health problems compared to healthy children (Ferro & Boyle, 2015; Pinquart & Shen, 2011). Chronic physical health concerns in children and young people (6to 20year-olds) also have a significant impact on parental stress and family functioning (Lewandowski, Palermo, Stinson, Handley, & Chambers, 2010) and commonly imply a substantial economic load for families (Groenewald, Essner, Wright, Fesinmeyer, & Palermo, 2014). Themajority of these conditions require daily self-management including medication administration and dietary and physical activity requirements. A recent WHO report (Davies, 2012) called for more research into patients’ needs, and into potential healthcare service interventions to support children and young people (1to 20-year-olds) with a long-term condition. Children with a long-term condition have been frequently overlooked in the health psychology literature, and little research has directly and systematically drawn fromhealth psychology theories. For example, limited knowledge exists regarding behavioural methods for managing symptoms and disease progression in conditions with severe degenerative consequences for children such as MS. Whilst there is no cure for this condition, physical activity has been shown to alleviate MS symptoms such as mobility limitations, fatigue, pain, and depression, which then improve children’s quality of life (Charvet et al., 2014). In fact, children with MS, who reported greater amounts of moderate physical activity, had fewer fatigue symptoms and smaller lesions in the brain