Documente Academic
Documente Profesional
Documente Cultură
Fall, 2018
Abstract
LIVING WITH CHRONIC DISEASE AS AN ADOLESCENT
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The present text explores the concept of adolescents diagnosed with chronic illnesses and
how these diagnoses impact their overall emotional and mental health. Living with a chronic
illness, at any age, is a challenge. Adolescence is an extremely vulnerable time, a period of rapid
growth and developmental changes, which places them at a high risk for impaired socialization,
coping mechanisms and poor mental health. This text analyzes adolescents living with Asthma,
Type I Diabetes, Cerebral palsy, Sickle cell anemia, Cystic fibrosis, Cancer, and Congenital heart
problems. The goal of this review is to increase awareness within the healthcare community to
improve patient care of adolescents living with chronic illness. With this information, healthcare
professionals can implement more effective care interventions in order to better target adolescents’
emotional health and overall quality of life. This literary review identified a widespread need for
Introduction
Adolescents living with a chronic illness are a unique portion of the population. Roughly
“three out of 10 adolescents (31 percent) between the ages of 12 and 17” in the United States are
living with a chronic illness that greatly impacts their life (Park, 2013, p. 1). The developmental
period for adolescence is a stressful and emotionally insecure time as teens search for ways to
shape their own identity. Living with a chronic disease creates even more challenges to their
emotional health such as missing school, social events, and feeling misunderstood due to their
intense medical needs. This literary review explores the different impacts on adolescents’
emotional health for those living with a chronic illness, as well as what interventions exist to help
The adolescent population is a unique group due to their already present vulnerability as
they search for their identity. Living with a chronic illness can make adolescence more difficult
as they try to adapt and cope with their additional health burdens (Ferro & Boyle, 2013).
According to both studies conducted by Ferro & Boyle and Iosifyan & Arina & Flahault, it was
conclusive that those suffering from chronic illness had poor self-concept and lacked effective
coping mechanisms. These findings place teens at increased risk for developing mental health
issues including depression, anxiety, and substance abuse (Ferro & Boyle, 2013; Iosifyan & Arina
& Flahault, 2016). In the study conducted by the Journal of Cross-Cultural Psychology, it was
found that adolescents with asthma who used avoidant coping strategies, such as ignoring their
condition completely or restricting their lifestyle choices because of fear, showed higher
depression and anxiety scores (Iosifyan et al., 2016). In Goldberg’s & Wiseman’s study, it was
found that education on proper coping skills, to both the parent and adolescent, helps to minimize
emotional distress and help the parent manage their child’s health effectively (2016). While
findings for Ferro & Boyle noted the risk for mental health issues as only mildly significant, it still
identified the potential for a lower quality of life, long-term negative mental health effects, and a
need for a stronger universal data tool for measuring mental health (2013). In this sensitive
For adolescents with a chronic illness, there are additional obstacles to socializing with
peers, building self-esteem, and emotional development. The Journal of Adolescent Health stated
that one in five students live with a chronic illness, many of whom reported that it restricted their
everyday activities and impaired their socialization (Denny et al., 2013). Due to the impact of
chronic health conditions, adolescents suffer from poor socialization and as a result have a
LIVING WITH CHRONIC DISEASE AS AN ADOLESCENT
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tendency to avoid social activities. This leads to “poor school attendance or lack of participation
in recreational peer-group activities” (Denny et al., 2013). Similarly, in a personality trait study
of adolescents living with congenital heart disease (CHD), the majority of those with CHD had
lower scores of extraversion compared to their healthy peers likely due to “lower activity levels”
Currently, many studies are exploring both the availability and effectiveness of resources
in assisting children with chronic illnesses on their emotional health. A prevalent resource
identified throughout the research was the use of peer mentoring. In a study conducted by Douma
& Scholten & Maurice-Stam & Grootenhuis, the goal of peer mentoring is to “prevent and/or
reduce psychosocial problems by teaching the use of active coping skills with [cognitive
behavioral therapy] techniques” (Douma et al., 2018, p. 2). Conducted through an online forum,
the study discovered that the use of proper and early interventions in children and adolescents
show improved overall psychosocial functioning (Douma et al., 2018). In addition, the Journal of
Health Psychology explored the effectiveness of peer mentoring through video chats with older
adolescents who also suffer from a chronic illness and found that there are benefits to any child
regardless of their current social support. The study stated that “peers who have a similar lived
experience offer a unique understanding… and thus provide social support that is qualitatively
different to the social support provided by others in one’s [usual] social network” (Ahola et al.,
2018, p. 796).
Throughout the literature researched, there were three main inconsistencies found. Some
articles did not take into account gender differences of the participants in the studies. This created
a gap in the data, by not accounting for the difference in socialization aspects and coping skills
that different genders experience during adolescence and puberty. Moreover, the literature
LIVING WITH CHRONIC DISEASE AS AN ADOLESCENT
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inconsistencies, cultural impacts and findings were not considered when analyzing the
adolescents’ attitude towards their emotional well-being. The final inconsistency among the
sources is that there was no standardized method utilized in collecting data related to assessing
levels of socialization and coping skills. By not using a standardized assessment tool, self-concept
was found to have significant variability when analyzing the data findings.
Among the articles researched, limitations and threats to validity were present. First, all of
the literature reviewed were qualitative studies with relatively small sample sizes. In addition, the
participants were not randomized, and did not reflect widespread demographics. A majority of the
studies were interview based; a limitation to this was the presence of the parents in the interview
room, which may have skewed the honesty and accuracy of the child’s responses.
Conclusion
In conclusion, this literature review explored how living with a chronic disease impacts the
emotional health of the adolescent patient population. It was determined that adolescents suffering
from chronic illness have a tendency to withdraw from social activities and have overall poor
socialization skills in comparison to their healthy peers (Denny et al., 2013). This literary review
aimed to increase healthcare providers’ awareness of the impairment on social development that
can come from frequent hospitalizations and long-term care. A perfect reflection of this need for
provider awareness was determined in a study conducted by Pediatric Blood & Cancer that stated,
“existing literature suggests that children and adolescents… request peer support to promote
coping, and [that] this is an unmet need” (Christiansen et al., 2015, p.726).
Recommendations
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Throughout the literary review, it was discovered that a system is needed to quantitatively
collect and analyze the data regarding the impact of chronic illness on the emotional health of
adolescents. Until an established method is developed, health care providers must increase their
awareness, health care providers will be able to offer adolescents with chronic illnesses the
appropriate resources and identify early signs of ineffective coping. It is also recommended to
increase the availability and use of peer mentoring programs as they have been found to be
extremely helpful on adolescents emotional health (Douma et al., 2018; Ahola et al., 2018).
Lastly, in addition to peer mentoring, children living with a chronic disease may benefit from
volunteerism. The International Journal of Nursing Studies found that adolescents with Sickle
Cell Disease who have the opportunity to volunteer may benefit through increased feelings of self-
esteem, self-worth, and improved social interactions (Poku & Caress & Kirk, 2018). In conclusion,
promote healthcare provider awareness, and increase implementation of peer mentoring groups
and volunteer opportunities for all adolescents suffering from chronic disease.
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References
Ahola Kohut, S., Stinson, J., Forgeron, P., van Wyk, M., Harris, L., & Luca, S. (2018). A
qualitative content analysis of peer mentoring video calls in adolescents with chronic
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Christiansen, H. L., Bingen, K., Hoag, J. A., Karst, J. S., Velázquez, M. B., & Barakat, L. P.
standard of care in pediatric oncology. Pediatric Blood & Cancer, 62, S674–S749.
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Denny, S., de Silva, M., Fleming, T., Clark, T., Merry, S., Ameratunga, S., … Fortune, S. A.
(2014). The prevalence of chronic health conditions impacting on daily functioning and
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Douma, M., Scholten, L., Maurice-Stam, H., & Grootenhuis, M. A. (2018). Online
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LIVING WITH CHRONIC DISEASE AS AN ADOLESCENT
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