1. EFFECTS OF CHRONIC ILLNESS ON SELF-IMAGE IN ADOLESCENTS: An Integrative Literature Review
Krista Stillson, BS | School of Nursing | DePaul University
Objective
Results
Results
After examination of the literature, the effects on self- image were shown to be attributed to the visible manifestation of the disease process. Subjects reported the following effects:
Lowered self-esteem
Subjects reported feeling “not normal”, dissatisfied and self- conscious with physical appearance.
Social anxiety
Chronically ill subjects reported engaging in lower levels of peer contact and experiencing higher levels of social anxiety than healthy subjects related to physical differences.
Stress
Individuals reported feeling stressed about having to explain their differences/illness to others.
Depression
Due to dissatisfaction of appearance and dealing with difficulties they must deal with in comparison to peers.
Mood disorders
Psychosocial problems, somatization and obsessive - compulsive traits.
Frustration
As a result of feeling “abnormal” compared to healthy peers.
Embarrassment
Subjects were unhappy with their appearance and felt humiliated by their differences from their peers.
Loneliness
Feeling alone or as a burden to other because of their illness.
Lower joy in life
Chronically ill subjects rated their life ”worse” than healthy patients.
Decreased confidence
Feeling that their differences hold them back at school or from perusing desired career path.
The purpose of this literature review is to synthesize the research on the effects of chronic illness on self-image in the adolescent by answering the following research questions:
What is the impact of chronic illness on self-image in adolescents?
How does altered self-image fit into the risk and resistance framework?
The diseases addressed in this review are: asthma, beta thalassemia, celiac disease, asthma, diabetes, obesity, bladder extrophy, epilepsy, irritable bowel disease and cerebral palsy.
Figure 1. Diagram of Search Results and Study Selection
Background
Chronic illness can pose more than just pathological effects on an individual. During the vulnerable developmental stage of adolescence, the psychological effects of disease can be equally as damaging. In adolescence, manifestations of chronic illness can cause a distorted self-image which may potentiate negative outcomes such as depression, anxiety and low self-esteem. For this reason, it is important for nurses to be aware of the psychological impact that can accompany disease and use interventions to counteract such effects. Implementation of coping interventions can help the adolescent form a healthier self-image and negate psychological distress.
Psychological Effect
Frequency
Lowered self-esteem 2
Social anxiety 4
Stress
Depression 3
Mood Disorder
Frustration
Embarrassment
Loneliness
Lowered joy in life
Decreased Confidence 5
Methods
Conclusion
Reviewed articles were aggregated from CINAHL, ProQuest, PubMed and PsycInfo, by using search terms such as chronic, chronic illness, chronic disease, chronic pain, chronic psychosocial, self- image, self-concept, self-perception, self-esteem, identity, adolescent’s and adolescence.
The findings from the literature suggest that the effects of chronic illness on self-image in the adolescent can be severe and warrant medical intervention. The forthcoming challenge is to identify the types of interventions that would be successful and encourage healthcare professionals to implement them. To aid the achievement of this goal, the risk and resistance framework can be used as a guide to develop potential interventions.
Table 1. Frequency table