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Title: The utility of social cognition models in explaining adherence to self-care behaviours amongst adolescents and young adults with food allergy
Author: Jones, Christina Jane
Awarding Body: University of Brighton
Current Institution: University of Brighton
Date of Award: 2012
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Anaphylaxis can be triggered by a number of allergens the most common being food, medications, insect venom and latex. Due to the sudden onset and potentially fatal nature of anaphylaxis, successful management requires prompt and appropriate use of emergency medication. A failure to follow recommended medical advice remains a barrier to the control of many medical conditions, and food allergy and anaphylaxis are no exception. Studies have shown that use of emergency medication for anaphylaxis, by both health professionals and patients, is suboptimal. Identification of the nature and extent of health professionals' and patients' poor management of anaphylaxis enabled better understanding of the factors influential in the successful management of anaphylaxis, and guided the application of two Social Cognition Models in this area. This thesis explores the Health Belief Model (HBM) and the Common Sense Model (CSM) to determine if either can explain adherence to self-care behaviours (SCBs) amongst adolescents and young adults with food allergy. A systematic review was conducted of peer reviewed articles to identify health professionals' and patients' poor management of anaphylaxis. Based on these findings, two further systematic reviews were undertaken investigating the effectiveness of HBM and CS M-interventions in improving adherence. Original data was collected in a cross-sectional study of food allergic participants aged 13- 19 years with a prescription of auto-injectable epinephrine recruited from hospital allergy clinics. A postal self-completion questionnaire explored their health beliefs and illness perceptions derived from the models. Clinical and demographic information was collected based on findings from the first systematic review. The systematic review of anaphylaxis management found that poor management was frequently attributed to lack of knowledge and practical ability. However, adherence to preventive SCBs such as allergen avoidance and carrying emergency medication were rarely measured. The HBM and the CSM were found to have been successfully applied to eight and two adherence-related interventions respectively. In the population of 188 allergic adolescents investigated in this study, the HBM, specifically the constructs perceived severity, benefits and barriers, explained the greatest proportion of variance in adherence to SCBs. Gender and having an anaphylaxis management plan were also found to explain variance in adherence behaviours (all ps<.OS). The application and investigation of psychological model constructs proved useful in this population of food allergic individuals and identified targets for future interventions. The results show a strong beneficial link between adherence and possessing a management plan and provide evidence for promoting their use in food allergic individuals. Interventions designed to elicit personal barriers to adherence and address perceptions of severity surrounding food allergy may be more effective than a focus on knowledge and practical ability in improving adherence to SCBs.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: A000 Medicine