Chronic
Illness and Transplantation
Issues and the Adolescent
Adolescence,
alone, is a stressful developmental process even for physically healthy teens.
Chronic illness occurring during adolescence further complicates adolescent
development. The chronic disorder, treatment requirements,
hospitalization, and surgery (when necessary) all intensify concerns
about physical appearance, interfere with the process of gaining
independence, and disrupt changing relationships with parents and
friends. Also, adolescent developmental issues complicate a teen's
transition toward taking responsibility for managing their illness and
learning to comply with recommended treatment.
Developmental
complications of chronic illness:Adolescents who are faced with acute or chronic illness are
more likely to experience increased concerns and fears when their
illness or healthcare needs conflict with the following normal
developmental issues:
-
body
image issues
Adolescents are normally focused on the physical
changes occurring in their bodies. Chronic illness intensifies these
concerns with fears or distortions related to their illness (such as
fearing a surgical scar will interfere with physical attractiveness
or the ability to wear certain clothes).
-
Encourage
adolescents to share their concerns related to their body and
how it may be affected by their illness or treatment.
-
Inform
adolescents about anticipated physical effects of medications
and treatment. Encourage discussion about ways to reduce or cope
with the effects.
-
developing
independence
Chronic illness frequently interferes with an
adolescent's comfort in becoming less dependent on parents.
Parents of chronically ill adolescents often are more resistant to
adolescent's efforts to act independently. Some ways to address the
conflict between normal development of independence, while still
addressing healthcare
needs of the chronic illness include the following:
-
Involve
adolescents in health-related discussions (i.e., current concerns
about their illness, treatment choices).
-
Teach
adolescents self-care skills related to their illness.
-
Encourage
adolescents to monitor and manage their own treatment needs
as much as possible.
-
Encourage
the development of coping skills to address problems or concerns
that might arise related to their illness.
-
relationships
with peers
Chronic illness and treatment often interfere with time
spent with peers or in the school setting, which is
the adolescent's primary social environment. Self-esteem issues
related to acceptance of one's self and concerns about acceptance
by others are intensified by chronic illness and related treatment
needs. To address these concerns, consider the following:
-
Encourage
spending time with friends as much as possible.
-
Discuss
concerns about what to share with friends.
-
Help
adolescents find ways to respond if teased by peers.
-
Encourage
humor.
-
Encourage
and assist friends in being supportive.
Non-compliance
with medical treatment and teens:As adolescents with chronic illness learn more about their
illness and are encouraged to take responsibility for its management,
attempts to make their own decisions about management are common. Trials
of decreasing their medication or not taking it without consulting a
physician often occur. While this behavior may be developmentally normal,
it may create the need for additional healthcare intervention.Angry or self-conscious feelings related to having a chronic
illness, or poor judgment in how to cope with their feelings about their
illness, might also affect compliance with recommended treatment or
management techniques. For example, adolescent diabetics are more likely
to use poor judgment in making food choices when they are with their
friends. It is important for parents and healthcare professionals
working with adolescent patients to help the adolescent develop
emotionally healthy ways of living with their chronic illness and its
management requirements. Some ways to help adolescents deal with the
complications chronic illness often imposes on development may include
the following:
-
Encourage
adolescents to share their ideas and concerns with healthcare
professionals.
-
When
an adolescent's chronic illness reaches an unstable state due to
non-compliance of treatment recommendations, encourage discussion of
what happened rather than reprimand non-compliance.
-
Teach
and encourage use of problem-solving skills related to their
illness. Ask questions such as: "What do you think you would you do
if......?"or "What do you think would happen if........?" Encourage
adolescents to ask you the same kinds of questions.
-
Seek
mental health services when:
-
an
adolescent seems overwhelmed with emotional issues related to
living with a chronic illness.
-
a
pattern of non-compliance continues.
-
an
adolescent's development regresses, overly dependent behavior
continues, and/or the adolescent withdraws from or gives up interest
in age-appropriate activities.
Transplant-related
issues and adolescents:The need for an organ transplant is difficult to understand,
accept, and cope with for anyone. The emotional and psychological stress
impacts all family members.
For
adolescents who are developing the ability to think in new ways and
explore new thoughts, the idea of facing transplantation stimulates
thoughts, concerns, and questions about their bodies, their relationships,
and their lives.
Important
factors in helping adolescents cope effectively with a transplantation
experience include the following:
-
Be
honest with your teen about his/her illness and his/her healthcare
needs.
-
Include
your adolescent in discussions and decision-making related to the
need for transplantation, the benefits, and the risks involved. This
is very important to helping him/her cope with the process and
life after transplant.
-
Supportive
communication is vital. Encourage your adolescent to ask questions
and express
his/her fears and feelings about how this affects his/her life.
-
Concerns
about death and the possibility of dying are difficult to talk about.
However, it is important to address this topic with adolescents
in any life-threatening situation.
-
Encourage
hopefulness.
-
Encourage
humor, as it helps to reduce stress.
-
Encourage
friends to visit your teen in the hospital, when possible.
-
Enlist
the help of mental health professionals in addressing fears, feelings,
and behaviors that are problematic for your adolescent, or for other
family members.
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Pediatric Primary Care
Adolescent Medicine (Pediatrics)
Combined Approach to Weight Management
Adolescent Mental Health