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Title: Young people living with epilepsy in Singapore : psychosocial adaptation and self-esteem: a mixed-methods study with implications for social work practice
Author: Chew Fong Hsia, Judith
ISNI:       0000 0004 6056 7375
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2016
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Social work practice in hospitals involve supporting young people and their families to cope successfully with demands arising from living with a chronic medical condition such as epilepsy. Epilepsy is a common neurological disorder in young people characterised by its episodic and chronic nature; studies have. showed that young people tend to have poorer psychosocial outcomes compared to healthy peers. However, there are several limitations in current literature regarding young people's experiences of epilepsy. This includes the . exclusion of young people's perspectives in quantitative and qualitative studies, an extensive focus on pathology marked by an absence of a strengths perspective, the lack of studies examining a combination of individual and family factors that facilitate positive adaptation, and a majority of studies conducted in the West. In order to develop social work interventions relevant to the needs of young people with epilepsy in Singapore, further research is necessary. Aim The aim of this study was to examine young people's perspectives on living with epilepsy. Together with individual and family factors influencing self-esteem, meanings young people ascribed to their experiences were explored within the context of stress, coping and resilience. Methods The rationale for using a mixed-method approach was to provide a comprehensive understanding of young people's experiences by expanding the breadth of inquiry. In the first strand of this explanatory sequential design, survey data was collected from 152 young people at a neurology clinic within KK Women's and Children's Hospital, Singapore (KKH) to examine the relationship between illness severity and self-esteem. Additionally, the effects of potential mediators - perceived stress, negative illness perception, coping and family resilience - were investigated. The second strand was conducted as a follow up to gain a deeper understanding of young people's experiences and to illustrate quantitative results. Semi-structured interviews conducted with 15 young people explored aspects of their experiences of living with epilepsy. Results Except for young people's coping behaviours, three variables - perceived stress, negative illness perceptions, and family resilience - were found to be significant mediators. Results demonstrated perceived stress and negative illness perceptions mediated the relationship between illness severity and young people's self-esteem. However, family resilience was a significant mediator only for young people who continued to have seizures despite medication. Findings from young people's interviews provided in-depth descriptions of stressful circumstances encountered, health and illness beliefs, and family processes. Interconnectedness between illness severity and its impact on key developmental tasks, such as independence, autonomy, and social development, were emphasised. Seizures and illness-related demands disrupted their day-to-day functioning and challenged their abilities to meet these tasks. Family processes that facilitated resilience included family connectedness, beliefs and effective communication processes. Conclusion Integrated results from both quantitative and qualitative strands provided a more comprehensive understanding of young people's experiences of living with epilepsy. Although they experienced challenges arising from their illness, particularly when medications were ineffective in preventing seizures, young people demonstrated resilience and did not necessarily have low self-esteem. Taken together, young people's experiences within the context of stress, coping and positive adaptation, emphasise the importance of targeting individual and family variables when developing social work interventions to support those in need.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available