Concluding Comments

Research in the area of rheumatological disorders of childhood has reached a tertiary stage in which experimental studies are needed to confirm much of the correlational studies that have been conducted to date. There is clearly a significant need for more psychological interventions for children and adolescents with JRA. In particular, randomized, controlled clinical trials are necessary. In fact, one study examined the perceptions of youth with JRA and their parents to determine the types of psychoeducational interventions that are needed (Barlow et al. 1999). Results indicated that both children and parents are requesting greater availability, easier access, and more comprehensive psychological interventions. Specifically, both children and parents require relevant educational information about the disease from the time of diagnosis—not simply factual information about the disease but also information pertaining to the psychological and social impact of the disease. Participants noted that many interventions were designed for the parents rather than the children and that more interventions placing children in an active role are warranted. A preference for group interventions was also reported. Thus, child-focused group psychological interventions are needed to assist youth with rheumatological disorders to cope with their disease. Finally, longitudinal studies also are needed to examine the natural history of JRA and SLE so as to determine psychosocial risk factors of the disease. It is hoped that such research will enhance the quality of life for these youth and their families.

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