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Body image in young people with inflammatory bowel disease AND Healthcare professionals working with children with a dual diagnosis of type 1 diabetes and coeliac disease

Hobday, Victoria Louise (2014)
Clin.Psy.D. thesis, University of Birmingham.

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Hobday14ClinPsyD_Volume1.pdf
Hobday14ClinPsyD_Volume1.pdf
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Hobday14ClinPsyD_Volume2.pdf
Hobday14ClinPsyD_Volume2.pdf
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Abstract

Background: Inflammatory Bowel Disease (IBD) includes Crohn’s Disease, Ulcerative Colitis and Indeterminate Colitis, all characterised by chronic, gastrointestinal inflammation. Symptoms can be painful and embarrassing and treatment can result in invasive procedures, side effects and surgery. Qualitative studies suggest that body image may be affected by IBD.
Aim: To review published quantitative papers with a measure of body image in children and adolescents with IBD.
Method: Electronic databases (PsycInfo, Embase, Medline, Web of Science, CINAHL) were used to systematically review the literature, identifying 19 papers. These papers were reviewed using a critical appraisal tool.
Results: The review discusses themes relating to body image including: type of IBD
diagnosis; age at diagnosis; severity of symptoms; gender and treatment. Trends in body image are similar to healthy peers, particularly for those with mild or no symptoms. IBD can predispose the young person to risk factors, increasing their vulnerability to poor body image, including delayed growth, increase in severe physical symptoms and intrusive or demanding treatments.
Conclusion: Routine assessment of psychosocial factors, including body image, for young people with IBD is recommended. This review highlights methodological limitations in the current body of evidence, calling for further research to improve understanding of this area.

Background: The psychosocial issues and challenges for young people with a dual diagnosis of type 1 diabetes and coeliac disease and their parents have been explored and uncertainties within screening and diagnostic processes are documented. However, the experiences of healthcare professionals (HCPs) working with this group has to date remained unexplored.
Method: Twelve HCPs (doctors, nurses, dieticians) working in this field from three paediatric teams were interviewed about their experiences. Transcripts were analysed using Interpretative Phenomenological Analysis.
Results: Three superordinate themes emerged: ‘Connection and burden’; ‘Diagnoses together, but separate and uneven’; and ‘Sitting with certain uncertainty and complexity’. These represent participants‘ connection to the experience of patients and adding to their burden; a sense of disparity in managing the two conditions; uncertainty and complexity with the dual diagnosis, and a repertoire of coping strategies utilised. Positive aspects of the role (making a difference, improving health and reducing risk) along with coping strategies are likely to buffer the challenges of working with this client group.
Conclusion: Recommendations include a dual review clinic and further support for staff. Additional research on medical and psychosocial aspects of this dual diagnosis is needed to develop services to support both patients and HCPs.

Type of Work:Clin.Psy.D. thesis.
Supervisor(s):Howard, Ruth and Law, Gary U.
School/Faculty:Colleges (2008 onwards) > College of Life & Environmental Sciences
Department:School of Psychology
Subjects:BF Psychology
HV Social pathology. Social and public welfare
Institution:University of Birmingham
ID Code:5389
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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