The purpose of this research was to study the cognitive development and explanation of the causes of illness as perceived by hospitalized children, especially the influence of experience with disease and educational level on the explanations. 50 Brazilian children aged five to nine, hospitalized with different diagnoses, took part in the research. Cognitive development and ideas of the cause of illness were evaluated within a Piagetian framework. As in previous studies, the children processed the information in a foreseeable cognitive sequence. However, these hospitalized children reflected a delay in the acquisition of conservation and voiced explanations with few subjective elements, devoid of references to the actual disease. The causes of illness that were mentioned were similar to those quoted by children in other countries. The relation between the complexity of the explanations and the number of hospitalization episodes was statistically significant. Most of the sample, regardless of age and cognitive level, ascribed becoming ill to disobedience, a possible mechanism for self-protection against a feeling of helplessness. These results point to implications that should be taken into account when pediatric patients are approached.
Causality; physician-patient relations; children's explanations; cognitive level; hospitalized children
