SELF-CONCEPT development of school-aged children with congenital upper limb differences: A mixed-methods study.

BACKGROUND: School-aged children enter an essential phase of psychosocial development in which they begin to form their self-concept. Having a negative self-concept has a direct relationship on the gradual evolution of a child's personality which can influence academic and career success, peer interactions and relationships, generativity and life satisfaction and meaning. There is limited research examining self-concept in children with congenital upper limb differences. OBJECTIVES: Describe self-concept in school-aged children with congenital upper limb differences (CULD). METHODS: In this convergent mixed methods study, we used the Piers Harris Children's Self-Concept Scale (PHCSCS) and modified photovoice methodology to explore self-concept in school aged children with CULD. The quantitative results from the PHCSCS were merged with the qualitative findings from the 63 photographs and 63 written descriptions provided by nine children. RESULTS: Mean self-concept was 51.22 (±10.43). Mean domain scores: behavioral adjustment 52 (±8.19), freedom from anxiety 48.56 (±10.42), happiness and satisfaction 49.44 (±10.73), intellectual and school status 54.78 (±10.31), and social acceptance 49.89 (±8.64). Nine participants described five themes of self-concept: emotions, sense of accomplishments, positive view of oneself and one's physical body, hobbies, and a sense of connection. Children defined their self-concept through expressions of self-efficacy, self-image, and social identity. IMPLICATIONS: Results created a more comprehensive description of self-concept, and expanded understanding of the social identity of school-aged children with congenital upper limb difference. Future research is needed to examine the relationships between self-efficacy, self-image, and social identity to develop interventions promoting healthy self-concept development.

Self-concept development in children with limb differences: A scoping review.

Having a visible physical difference, such as a limb difference, can have a significant impact on a child's psychosocial development, as children with limb differences may experience negative psychosocial sequelae. The aim of this scoping review was to investigate the findings of literature pertaining to self-concept of children with limb differences. Using the PRISMA ScR guidelines, a literature search was conducted in Embase, CINAHL, PsycINFO and PubMed databases. Nine articles met the inclusion criteria and were included in this review. Two studies focused on evaluating self-concept, whereas the remaining seven studies focused on associated constructs of self-concept (i.e., self-perception and self-esteem). The findings of these studies indicated that the social environment directly impacted the development of psychopathology and self-concept in children with limb differences. This review demonstrated a need for a gold standard instrument with which to assess children's self-concept. CLINICAL RELEVANCE: Level IV: Evidence derived from guidelines developed from a systematic review of existing qualitative, quantitative, and mixed methods research studies.