Peer Support Group for Adolescents With Chronic Illness

This study assessed the effects of a monthly peer support group for adolescents with cancer and other hematological diseases These adolescents shared activities and experiences with nondisabled high school students At the group's conclusion, the adolescents reported that the group helped them cope with their illness and improved the quality of their daily lives Nondisabled students reported that the group favorably affected their attitudes about, and intended behavior toward, peers with chronic illnesses These results suggest that such groups can provide important benefits for individuals with chronic illnesses as well as for their nondisabled peers.     

Coping With Stress Through Texting: An Experimental Study

PurposeTexting is used by many adolescents and has the potential to improve well-being, as youth can reach out for support immediately after experiencing a stressful situation. Many studies have examined whether texting is associated with well-being, but few have used experimental designs, preventing causal claims.MethodsIn this experimental study, 130 adolescents (M_age = 12.41) participated with a same-gender friend whom they texted regularly. Both adolescents completed a task that elicited stress and then engaged in one of the following randomly assigned activities: texting their friend, watching a video on a cellphone (passive-phone condition), or sitting quietly (no activity condition). Participants reported their mood and stress levels after the stress task and again after the activity. Heart rate variability was measured throughout.ResultsParticipants who texted their friend reported higher moods (b = ?.80, standard error [SE] = .24, p < .001, η_p² = .09) and lower stress at the end of the study than those in the no activity condition (b = .51, SE = .25, p = .046, η_p² = .04) and higher moods than adolescents in the passive-phone condition (b = ?.74, SE = .25, p = .004, η_p² = .08). No differences were noted between the passive-phone and no activity conditions. There were no differences in heart rate variability between the three conditions. The effects of texting on mood, self-reported stress, and heart rate variability did not differ by gender.ConclusionsBoth boys and girls may benefit from texting a friend after experiencing a stressful event.     

Depressive Symptoms in Adolescents With a Chronic Illness

Adolescents with various chronic illnesses were compared to healthy comparison controls and the normative population on self-reports of symptoms of depression. Overall, a higher percentage of adolescents with a chronic illness reported symptoms of moderate to severe depression; the frequency was highest in those adolescents with sickle cell disease. Adolescents who rated their chronic disease as moderate or severe reported more depressive symptoms than did those adolescents who rated their illness as mild. Within the limitations of our study, we recommend that future investigations examine patterns and symptoms of depression in adolescents coping with the stressors of a chronic illness.     

A Social Skills Development Model: Coping Strategies for Children with Chronic Illness

The problems of children with chronic illness generally extend beyond immediate medical concerns Some of these children experience concomitant psychosocial problems This article describes a family-focused social skills development model which has been used in the children's mental health field to improve children's social interaction, impulse control, and social problem-solving skills In this model, skill training can be focused directly on the child, the family, or both, depending on the resources available, the individual family situation, and whether the child is receiving inpatient or outpatient services Possible preventative and remedial applications of this social skills development model for children and families with chronic illness are discussed.     

Spiritual Coping and Psychosocial Adjustment of Adolescents With Chronic Illness: The Role of Cognitive Attributions,Age, and Disease Group

PurposeSpiritual coping is an important determinant of adjustment in youth with chronic illness, but the mechanisms through which it affects outcomes have not been elucidated. It is also unknown whether the role of spiritual coping varies by age or disease group. This study evaluated whether general cognitive attributions explain the effects of spiritual coping on internalizing and externalizing problems in adolescents with cystic fibrosis and diabetes and whether these relationships vary by age or disease group.MethodsIn this cross-sectional study, adolescents (N = 128; M = 14.7 yrs) diagnosed with cystic fibrosis or diabetes completed measures of spiritual coping and attributional style. Adolescents and their caregivers reported on adolescents' internalizing and externalizing problems.ResultsOverall, positive spiritual coping was associated with fewer internalizing and externalizing problems. Negative spiritual coping was related to more externalizing problems, and for adolescents with cystic fibrosis only, also internalizing problems. Optimistic attributions mediated the effects of positive spiritual coping among adolescents with diabetes. The results did not vary by age.ConclusionsAn optimistic attribution style may help explain the effects of positive, but not negative, spiritual coping on adjustment of youth with diabetes. Youth with progressive, life-threatening illnesses, such as cystic fibrosis, may be more vulnerable to the harmful effects of negative spiritual coping. Future research should examine whether addressing spiritual concerns and promoting optimistic attributions improves adolescents' emotional and behavioral functioning.     

A Social Skills Development Model: Coping Strategies for Children with Chronic Illness

The problems of children with chronic illness generally extend beyond immediate medical concerns Some of these children experience concomitant psychosocial problems This article describes a family-focused social skills development model which has been used in the children's mental health field to improve children's social interaction, impulse control, and social problem-solving skills In this model, skill training can be focused directly on the child, the family, or both, depending on the resources available, the individual family situation, and whether the child is receiving inpatient or outpatient services Possible preventative and remedial applications of this social skills development model for children and families with chronic illness are discussed.     

The Construction of Illness on Entertainment Television: Coping With Cancer on thirtysomething

In this study, we use textual interpretation and criticism to examine the year-long fictional portrayal of a personal ordeal with ovarian cancer on the prime-time weekly dramatic series thirtysomething. The analysis revealed seven major themes that conveyed value-laden messages about living and coping with this disease; the meanings of these messages, in turn, contribute to the development of an ideological construction of illness. "Take-home messages" include emphasis on cancer as a disease of the family, the destigmatization of people with cancer, and the centrality of communication as a coping strategy. Issues that were excluded, missed opportunities for health messages, and future policy-related concerns are also discussed.     

The Role of Illness Factors and Patient Satisfaction in Using Online Health Support Groups

Drawing on the behavioral model of health services use and the PRECEDE-PROCEED model, this research explores various correlates of participation in online health support groups based on the 2007 Health Information National Trend Survey data. Results show that controlling for demographics, emotional health and family cancer history were significant correlates, whereas perceived general health status approached statistical significance, and personal cancer history and cancer worry were not significant. Moreover, patient–provider communication satisfaction approached statistical significance, and patient satisfaction with received health care was not statistically significant. Theoretical and practical implications of these results are discussed.     

Coping and Adjustment in Children With Primary Immunodeficiency Disorders and Kidney Diseases: The Role of Illness Severity

The purpose of this study was to assess illness severity and its relation to psychosocial factors in children with primary immunodeficiency disorders (PIDD) and kidney diseases (KD), two chronic health conditions having received little empirical study in the pediatric psychology literature. A secondary goal was to assess families' use of physicians for psychosocial support. Participants included 64 caregiver–youth (youths aged 8–20 years) dyads. Children with diagnoses of PIDD or KD were placed into one of three illness severity groups (mild, moderate, severe) based on objective ratings and compared with a healthy comparison group. Results indicated that children with mild illness reported less adaptive coping, and their caregivers reported more maladaptive coping compared to the other groups. In addition, children in the mild severity group were reported to have higher levels of internalizing behavior problems. Physicians were being utilized at a high rate by all groups regarding families's concerns of psychosocial issues. These findings have a number of clinical implications, including the importance of intervention for children and their caregivers across illness severity levels and the need for adequate education for physicians regarding psychosocial issues.     

Preventing Mental Health Problems in Children With Chronic Illness or Disability

Children with special health needs have an added risk for mental health problems These problems may be preventable in many cases by focusing on the development of competence in children and their family members in adapting to the chronic condition demands Five strategies for developing competence are discussed (a) encourage normal life experience (b) increase coping skills (c) increase use of social support (d) coordinate the delivery of care and (e) empower families Examples of programs employing these strategies that have been evaluated are presented.     

Health-Related Quality of Life in Adolescents With Chronic Illness in Jamaica: Adolescent and Parent Reports

PurposeThe aim of this study is to assess the level of agreement between adolescents’ self-assessment and parent-proxy reports on health-related quality of life (HRQOL) in Jamaican adolescents with chronic illness.MethodsA cross-sectional study was conducted, recruiting adolescents living with a chronic illness (ALCIs)—asthma, human immunodeficiency virus, insulin-dependent diabetes mellitus, or sickle cell disease and age/sex-matched healthy adolescents. Data were collected on HRQOL from adolescents and parents using the Pediatric Quality of Life Scale. Parent-adolescent agreement was determined at group level (Wilcoxon signed-rank test) and individual level (intraclass correlation coefficient).ResultsTwo hundred twenty-six (226) parent/adolescent pairs participated: 130 ALCIs and 96 healthy peers; mean age 14.9 ± 2.8 years; 58% females. Adolescents with and without chronic illness reported similar HRQOL; parent-proxies reported better HRQOL for healthy adolescents compared to ALCIs. Intraclass correlation demonstrated higher levels of parent-adolescent correlation for ALCIs than healthy adolescents (ALCIs: 0.11–0.34; healthy adolescents: 0.01–0.10). At group level, analyses demonstrated better parent-proxy rating of QOL in all of the scores with the exception of the general health score. Parent-proxies overestimated QOL for asthma and insulin-dependent diabetes mellitus but not for sickle cell disease and human immunodeficiency virus. Linear regression modeling revealed that female sex and living with chronic illness were significant predictors of agreement.DiscussionParent-proxies overestimated adolescents’ QOL compared to adolescents’ report regardless of whether the adolescent was living with a chronic illness or not. As such, health care providers should elicit feedback from the adolescent wherever possible and proxy reports should be used as complementary information rather than primary source.     

Relation Between Perceived Health and Sick Leave in Employees With a Chronic Illness

Introduction: To improve work participation in individuals with a chronic illness, insight into the role of work-related factors in the association between health and sick leave is needed. The aim of this study was to gain insight into the contribution of work limitations, work characteristics, and work adjustments to the association between health and sick leave in employees with a chronic illness. Methods: All employees with a chronic illness, between 15 and 65 years of age (n = 7,748) were selected from The Netherlands Working Conditions Survey. The survey included questions about perceived health, working conditions, and sick leave. Block-wise multivariate linear regression analyses were performed and, in different blocks, limitations at work, work characteristics, and work adjustments were added to the model of perceived health status. Changes in regression coefficient (B) (%) were calculated for the total group and for sub-groups per chronic illness. Results: When work limitations were added to the model, the B between health and sick leave decreased by 18% (5.0 to 4.1). Adding work characteristics did not decrease the association between health and sick leave, but the B between work limitations and sick leave decreased by 14%, (5.3 to 4.5). When work adjustments were added to the model, the Bs between sick leave and work limitations and work characteristics changed from 4.5 to 3.4 for work limitations and from 2.1 to 1.9 for temporary contract and from −0.8 to −1.0 for supervisor support. Conclusions: The association between health and sick leave was explained by limitations at work, work characteristics, and work adjustments. Paying more attention to work limitations, characteristics and adjustments offers opportunities to reduce the negative consequences of chronic illness.     

Communication and the Appraisal of Uncertainty: Exploring Parents’ Communication with Credible Authorities in the Context of Chronic Childhood Illness

Individuals with chronic illnesses must manage long-term uncertainty as they cope with the ways the illness influences their lives. In the context of pediatric illnesses, parents must manage uncertainty during the diagnosis and treatment of their child’s illness. It is common for children with complex chronic illnesses to see multiple specialists for the treatment of their condition. While previous research has explored parents’ uncertainty during a child’s diagnosis and during end-of-life care, less is known about these experiences when the child is referred to a team of specialists for treatment. The aim of the current study was to explore how specialists, as credible authorities, influence parents’ uncertainty during parents’ first visit to a multidisciplinary clinic for the care of their child’s complex chronic illness. Data were collected through semi-structured interviews with 29 parents after their child’s first visit to a vascular anomaly clinic at a large Midwestern children’s hospital. The results suggest parents’ communication with credible authorities facilitates effective uncertainty management primarily through the mechanism of uncertainty reappraisal. The results also suggest that specialists, as credible authorities, are a key mechanism in the appraisal of uncertainty for conditions that are often misdiagnosed and mismanaged.     

Offline Social Relationships and Online Cancer Communication: Effects of Social and Family Support on Online Social Network Building

This study investigates how social support and family relationship perceptions influence breast cancer patients’ online communication networks in a computer-mediated social support (CMSS) group. To examine social interactions in the CMSS group, we identified two types of online social networks: open and targeted communication networks. The open communication network reflects group communication behaviors (i.e., one-to-many or “broadcast” communication) in which the intended audience is not specified; in contrast, the targeted communication network reflects interpersonal discourses (i.e., one-to-one or directed communication) in which the audience for the message is specified. The communication networks were constructed by tracking CMSS group usage data of 237 breast cancer patients who participated in one of two National Cancer Institute-funded randomized clinical trials. Eligible subjects were within 2 months of a diagnosis of primary breast cancer or recurrence at the time of recruitment. Findings reveal that breast cancer patients who perceived less availability of offline social support had a larger social network size in the open communication network. In contrast, those who perceived less family cohesion had a larger targeted communication network in the CMSS group, meaning they were inclined to use the CMSS group for developing interpersonal relationships.     

Emerging Chronic Illness: Women and Lupus in Ecuador

This article reports on an ethnographic investigation of the experiences of urban Ecuadorian women suffering from the chronic illness, lupus. Chronic illness is “emerging” in Ecuador, and cultural models and the health care delivery system are struggling to adapt to the increasing burdens brought by life-long illness. Based on extensive qualitative interviewing of lupus patients and doctors and participant observation, we identify three areas of concern including a weak health infrastructure and unequal access to care, gender models that increase the emotional burdens, and cultural understandings about illness and morality that add to social stress.     

Evaluating the Communication of Online Social Support: A Mixed-Methods Analysis of Structure and Content

ABSTRACT

Social support in online self-help groups has been found to benefit participants with emotional instability or mental illness. Many studies have employed content analysis to reveal categories of social support, claiming the prevalence of emotional and informational support can aid support seekers. In the studies, optimal matching theory is used to explain the helpfulness of these types of support. This article argues that content analysis is unpersuasive in its claim that support seekers benefit from social support; participants’ communicative behaviors should also be considered to evaluate the potential advantages and drawbacks of such groups. Drawing on a mixed-method approach of conversation analysis and content analysis, this study investigates the sequential structure and content of social support in communication in six online self-help groups for anxiety and depression (OSGADs). The main findings show that optimal matching theory may not be suitable for elucidating how support seekers receive help due to the immediate provision of social support and little interaction otherwise. In addition, results identify expressed understanding/empathy and advice as prominent support categories in OSGADs, with most thread openers requesting support indirectly.     

A Developmental Analysis of Cognitive Appraisal of Stress in Children and Adolescents With Chronic Illness

Our hypothesis was that cognitive appraisal of stress changes with cognitive development. Two systems of scoring categories. Evaluation of Stakes and Evaluation of Action, were developed that explained predictable trends in the organization of appraisal in the direction of maturity. They were validated using interview data from 79 participants with chronic illness in 3 age groups: ages 8 to 9, l 1 to 12, and 14 to I h. Data indicated that concrete appraisals were organized around pressing events and rules, whereas formal abstract appraisals reflected the personal context of stress and internalized standards for behavior. Analysis of the emotional meaning of stress suggested that chronically ill adolescents in this sample were experiencing frustration and anger.