Chronic Illness Literature Research Articles

Entangled identities and psychotropic substance use.

This paper reports the findings of a grounded theory study investigating drug users' concerns and experiences of their oral health. The aim of this paper is to demonstrate how the findings relate to various strands of literature which focus on processes and discourses of recovery from problematic drug use (biographical reconstruction), the chronic illness literature (biographical disruption), public/private discourses and the myth of addiction. Data were collected from four focus groups containing a total of 25 participants, and 15 in-depth interviews. Participants were recruited from drug detoxification programmes (27), recovery units following detoxification (9) and a drug rehabilitation unit (4). Data analysis revealed that the core concern of drug users' was talking about the 'entangled' nature of their identity whilst they were on drugs. Such 'entangled identities' emerged through what appeared to be a gradual sedimentation process of drug-using habits and routines that replaced those of the everyday self. Other concerns were distancing one's self from the drug using self (involving expressions of disgust) and recovery processes (disentangling). The paper discusses each of these core problems in the light of the literature on the recovery from drug use, the chronic illness literature and the myth of addiction. It concludes by briefly reflecting on problematic psychotropic substance use as another form of biographical disruption formed on the basis of a dialectic between private discourses of the entangled self and public discourses of addiction. It suggests that further work should be conducted in these areas.

Dietary self-efficacy: determinant of compliance behaviours and biochemical outcomes in haemodialysis patients.

Despite the diversity of proposed theories, researchers are still unable to fully explain dietary compliance behaviours of dialysis patients. Dietary self-efficacy, a concept less studied in dialysis, has been linked to positive compliance outcomes in the chronic illness literature. Therefore, the aim of the present research was to determine how dietary self-efficacy is related to selected biochemical markers and self-reported behavioural outcomes in haemodialysis patients. 107 subjects participated in a cross-sectional study. Four questionnaires assessed dietary self-efficacy, compliance attitudes and behaviours, and staff-patient relationships. Laboratory outcomes were retrospectively obtained from patients' medical records and averaged for the previous 6 months. Of the behavioural measures, only dietary self-efficacy was associated with laboratory outcomes. Dietary self-efficacy was also positively related to staff-patient relationships and to patients' self-reported assessment of compliance behaviours. Women had greater dietary self-efficacy than men. The number of family members living with the respondent was inversely related to dietary self-efficacy. Results indicated that dietary self-efficacy determined both behaviours and laboratory outcomes. Patients with greater dietary self-efficacy had lower serum potassium and weight gain, showed favourable compliance attitudes and behaviours toward prescribed regimens and fostered better relationships with staff. Based on these findings we recommend an experimental approach to clarify whether maximizing dietary self-efficacy efforts is without psychological burden to patients and whether the positive effect of increased dietary self-efficacy is maintained in long-term dialysis patients.

Children's Coping with Recurrent Headache

We investigated the relationships among perceptions of control over pain, gender, and coping responses in 57 school-aged children receiving services at a specialized pediatric headache clinic. Perceptions of control and gender interacted to predict frequency of active and negative coping responses. A wide range of coping strategies was reported, but only minimal gender or perceived control differences were found in the frequency and helpfulness of individual coping strategies. Results are discussed within the context of recent stress and coping models within the pediatric chronic illness literature.