Adolescent’s subjective perceptions of chronic disease and related psychosocial factors: highlights from an outpatient context study

Abstract

BackgroundAdolescents with chronic disease (CD) can be more vulnerable to adverse psychosocial outcomes. This study aims: 1) to identify differences in psychosocial variables (health-related quality of life, psychosomatic complaints, resilience, self-regulation and social support) among adolescents who feel that CD affects or does not affect school/peers connectedness (measured by self-reported participation in school and social activities); and 2) to assess the extent to which psychosocial variables are associated with connectedness in school and peer domains.MethodsA cross-sectional study was conducted in 135 adolescents with CD (51.9% boys), average age of 14 ± 1.5 years old (SD = 1.5). Socio-demographic, clinical, and psychosocial variables were assessed, using a self-reported questionnaire, which included the Chronic Conditions Short Questionnaire, KIDSCREEN-10 Index, Symptoms Check-List, Healthy Kids Resilience Assessment Module Scale, Adolescent Self-Regulatory Inventory, and Satisfaction with Social Support Scale. Descriptive statistics, GLM-Univariate ANCOVA and Logistic Regression were performed using the IBM Statistical Package for Social Sciences (SPSS), version 22.0. The significance level was set at p < 0.05.ResultsThirteen to eighteen percent of the adolescents felt that CD affected participation at school (PSCH) and participation in leisure time with friends (PLTF). These adolescents presented lower results for all psychosocial study variables, when compared with adolescents who did not feel affected in both areas of participation. From the studied psychosocial variables, the most important ones associated with PSCH (after controlling for age, gender, diagnosis, and education level of father/mother) were self-regulation and psychosomatic health. Concerning the PLTF, social support was the sole variable explaining such association.ConclusionsThe present study pointed out the association between psychosocial variables; and living with a CD and school/peers connectedness. The need to focus on the assessment of the effects of a CD on adolescents’ lives and contexts is suggested, as well as on the identification of vulnerable adolescents. Such identification could help to facilitate the maximization of social participation of adolescents with CD, and to plan interventions centered on providing support and opportunities for a healthy youth development. For that purpose, a complex and multifactorial approach that includes clinicians, schools, family, and peers may be proposed.

Essential Hypertension Onset in a 12-Year-Old Adolescent

“…It has caused the adolescent to be emotionally disturbed and started to default his treatment. Previous studies have shown that excessive rules and high demand for changes in a child and adolescent with a chronic illness will lead to emotional instability and depression (Compas et al 2012;Santos et al 2016). In our case, eventually, we were able to regain back his confidence and self-esteem by engaging well with his opinion and worries.…”

“…Furthermore, the sensitivity and specificity of the tests are low, which will not benefit the mass screening in terms of its cost effectiveness. Excessive investigations will also lead to further emotional burden to the child and parents in view of frequent blood takings and imaging procedures that will consume more time, energy and cause more worries (Compas et al 2012;Flynn et al 2017;Rao 2016;Rodriguez-Cruz 2017;Santos et al 2016). Therefore, clinical correlation during the initial assessment is indeed superior in deciding specific investigation.…”

“…The child and adolescent with chronic illness usually have been labelled as a high-risk group for non-compliance towards medications and follow up (Eden et al 2011;Mattoo 2019b). This stigma can lead to poor self-esteem and demotivation, which will finally end up with treatment failure (Compas et al 2012;Raj & Kumar 2010;Santos et al 2016). The stigma of non-compliance is evolved further whenever the child is not responsive to the first line of antihypertensive agents.…”

Major depression and psychiatric comorbidity in Turkish children and adolescents with cystic fibrosis

“…Coincidentally, diets and medications may be troublesome for adolescents if they perceive them as a threat to their independence. As a result, nonadherence to treatment is encountered in a considerable number of adolescent patients . Overprotection by the family may also exacerbate the issues faced by the child.…”

“…As a result, nonadherence to treatment is encountered in a considerable number of adolescent patients. [9][10][11] Overprotection by the family may also exacerbate the issues faced by the child. Accordingly, such adjustment problems and psychological factors may contribute to an increased risk of depression in children and adolescents with CF.…”