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Title: The self-management of chronic conditions and the experience of cyber-victimisation in the United Kingdom
Author: Alhaboby, Zhraa Azhr
ISNI:       0000 0004 7961 4389
Awarding Body: University of Bedfordshire
Current Institution: University of Bedfordshire
Date of Award: 2018
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Background The victimisation of people with chronic conditions and disabilities has physical, mental and psychosocial consequences. Although this victimisation is documented, victims usually struggle to get the proper support. Research focusing on cyber-victimisation of people with long-term conditions is limited and lacks qualitative elements. Aims This study aimed to understand the impact of cyber-victimisation among individuals living with chronic conditions in the UK. Methods A mixed-method design was adopted using a mixed-method online survey, followed by in-depth interviews with victims. The participants were encouraged to share their voices as experts in their own experiences. This was supported by short interviews with general practitioners (GPs) as the gatekeepers to the health system and one of the supportive channels available to victims. A systematic review was completed and published, which helped to identify gaps in the literature. Primary data was collected from 55 victim support groups, patient-support groups, and via social media. The challenges in recruiting victims for this sensitive topic were identified and published to guide future research. The theoretical framework underpinning the study incorporated the Biographical Disruption model, Self-Management and Social Support. Results Quantitative data from 152 participants showed that almost one in every two people with chronic conditions was cyber-victimised (45.39%). In total, 76.81% of victims had a self-reported disability, and the relationship between cyber-victimisation and disability was statistically significant. Furthermore, 61.11% of victims reported that experiencing cyber-victimisation had affected their self-management plan. The highest impact was on lifestyle changes such as exercise, diet, avoiding triggers, and avoiding excessive smoking or alcohol drinking. This was followed by changes to medications and follow up with healthcare professionals. Indeed, 69% of victims perceived a worsened self-efficacy scale for health condition self-management following cyber-victimisation. In general, formal support was rated poor, with only 24.53% of victims having spoken to their GPs with variable responses. Six themes emerged from the qualitative data: Biomedical Events (overall health - physical complaints), Impact on Mental Health (psychological and psychiatric effects - helplessness), Multi-level Impact (existing vulnerability - disruption and reprioritisation), The Impact of Complexity (complex situation - struggle for support), Social Network Involvement (social isolation and victim blaming - controversial social support - misrepresentation of self), and Disability Discrimination (inclusion, culture and hate - tax and disability benefits). The participating GPs thought that cyber-victimisation had both mental and physical impact on people with chronic conditions, with concerns over online health forums use. GPs' responses were influenced by individual variations. Conclusion Cyber-victimisation against people with chronic conditions is prevalent. It is a traumatic event that was introduced after the biographical disruption and working to cope with long-term conditions. It triggered significant fear, had a devastating impact and depleted victims of social support. The impact was multifaceted, and the results from the survey and interviews were convergent. They were also confirmed by the GPs' input. The outcomes provided an in-depth understanding of the impact of cyber-victimisation on such marginalised groups. To initiate change, the results were summarised in a health promotion design that was informed by the participants and gatekeepers, and improved for dissemination. Further context-specific, condition-specific, participatory, and multidisciplinary work are indicated.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: chronic conditions ; self-management ; biographical disruption ; cyber-victimisation ; disability discrimination ; cyber-harassment ; L310 Applied Sociology