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An Exploratory Study of Relationship Dimensions in Treatment Adherence in Adolescents With Chronic Renal Disease.

Schwartz, Anthony Leo. (1999) An Exploratory Study of Relationship Dimensions in Treatment Adherence in Adolescents With Chronic Renal Disease. Doctoral thesis, University of Surrey (United Kingdom)..

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Objectives: The aim of this exploratory research study was to examine psychological variables that have an influence on treatment adherence in young people with renal disease. Method: A pilot study (n=4) examined core themes regarding living with and managing a chronic condition. The main exploratory study examined how relationship issues between patients, parents and professional staff influence treatment adherence in a sample of adolescents (n=16) between the age of 11 to 19 years. These participants were undergoing either pre-dialysis, peritoneal dialysis, haemodialysis or post-transplant treatment. A correlational design examined the association between variables. Psychological variables included self-esteem, locus of control, and treatment-specific constructs. Contextual variables included the family and work environments, in particular features of conflict and concordance of views. Outcome criteria of adherence were objective physical and biochemical measures (weight gain, level of phosphate, potassium, and cyclosporin), and subjective adherence ratings. Results: Indications were that individual as well as inter-relationship factors were associated with objective treatment adherence. Internal locus of control correlated with treatment adherence, and chance locus of control and family environment factors of conflict and disorganisation were correlated with non-adherence. Subjective measures of adherence were related to family structure (with single-caregiver families rating higher on non-adherence). Health care professionals’ work environment was linked to the young person’s subjective adherence, with adherence associated with higher co-worker cohesion and supervisor support. Ratings by children and doctors of the same treatment-specific constructs were not congruent, although they were more closely matched if the child-doctor relationship was considered to be positive. Conclusion: In this exploratory Study with a small sample, it was found that inter-relationship dimensions are important in the treatment of young people with renal disease. This was indicated by quantitative analysis, illustrative material, and by using personal construct methods. Further research studies to examine relationship dimensions in treatment adherence are indicated. Ideally these should be longitudinal studies with a large sample and multi-centre in nature.

Item Type: Thesis (Doctoral)
Divisions : Theses
Authors : Schwartz, Anthony Leo.
Date : 1999
Additional Information : Thesis (Psych.D.)--University of Surrey (United Kingdom), 1999.
Depositing User : EPrints Services
Date Deposited : 14 May 2020 14:03
Last Modified : 14 May 2020 14:09

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