Self-Concept Development in School-Aged Children with Congenital Upper Limb Differences: A Mixed Methods Study

Abstract

Purpose: The purpose of this mixed methods study was to explore self-concept development in school-aged children with congenital upper limb differences. Background: Self-concept development has been shown to be a central point of reference for all further psychosocial development. Having a negative self-concept has a direct relationship on a child’s personality and over the course of their lifespan can influence academic and career success, peer interactions and relationships, generativity and life satisfaction and meaning. Research Design: A convergent mixed methods design. Methods: A purposive sample of nine children with congenital upper limb differences completed a 58-question survey. All participants then proceeded to collect photos and provide written descriptions each day over the course of one week, for a total of 63 photographs and 63 written descriptions. Data was merged for mixed methods integration and analysis to provide a rich description of self-concept development in school-aged children with congenital upper limb differences. Results: The mean self-concept was 51.22 (±10.43). Mean domain scores were 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). Five prominent themes arose from integrated results: emotions, sense of accomplishments, positive view of oneself and one’s physical body, hobbies, and a sense of connection. Children with CULD defined their self-concept through expressions of self-efficacy (20 photographs and written descriptions, self-image (four photographs and written descriptions), and social identity (39 photographs and written descriptions). Concordance and expansion existed within the results. Implications: Results from this study created a more comprehensive description of self-concept, including an expanded understanding of the social identity of school-aged children with congenital upper limb difference. Future research studies are needed to explore the relationships between self-efficacy, self-image, and social identity, to create middle range theories and develop interventions aimed promoting healthy self-concept development. Additional research is needed to explore the long-term psychosocial effects of the changes in children’s social context secondary to growing up during the COVID pandemic.