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Title: Psychological factors in arthritis and diabetes among adolescents
Author: Frazer, Sharon
ISNI:       0000 0004 5995 0254
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2015
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The thesis comprises two pieces of research: A systematic literature review which synthesises the literature examining the psychosocial variables related to glycaemic control in adolescents with type 1 diabetes, and an empirical paper which explores the lived experience of adolescents who take methotrexate to manage their Juvenile Idiopathic Arthritis (JIA). The systematic review comprised searches of three electronic databases (Cumulative Index to Nursing & Allied Health Literature [CINAHL], Psychinfo and Medline) which yielded 1136 separate records. Eligibility assessment criteria were applied, resulting in fifty-five articles which were assessed for quality prior to data extraction. A meta-analysis and narrative synthesis of the eight most frequently occurring psychosocial variables related to metabolic control is presented. A vast number of disparate psychosocial variables were presented within the literature. A scan of the correlation coefficients in the extracted data indicated no variables showed strong associations with glycaemic control. Narrative and meta-analysis of the eight variables most frequently measured in the literature showed weak to moderate associations with metabolic control in adolescents with type 1 diabetes, however heterogeneity within results suggests issues with study quality. Tentative conclusions suggest that psychosocial variables are largely unrelated to glycaemic control with the exception of internalising behaviours; suggesting psychosocial interventions seeking to improve self-management through glycaemic control should focus on reducing the internal distress of the adolescent. The review highlighted the need to consistently utilise validated, reliable assessment measures in future research. The empirical paper used qualitative methodology to explore the in-depth, lived experience of teenagers who take methotrexate to manage their symptoms of Juvenile Idiopathic Arthritis. A topic guide was used to facilitate individual interviews with six female participants aged 13-17 who were taking or had taken methotrexate within the last year. Analysis of interview transcripts using Interpretative Phenomenological Analysis yielded three master themes: 'Who am I, and who am I to you?: Relationships with self and others', 'Methotrexate: Friend, foe or forgotten', and 'Surviving on the battlefield: Attack, retreat and defeat'. Themes are discussed in relation to existing literature in JIA and chronic illness in childhood, with inconsistencies and new content highlighted. The clinical implications of the research are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available