Investigations on the effectiveness of self-management programs for adolescents with chronic physical illness with the intent of improving therapy adherence and health outcomes

Abstract

Research on self-management programs for adolescents with chronic conditions is limited. Adult studies demonstrate that effective self-management interventions can reduce morbidity, hospital visits and healthcare costs. Adolescence is crucial period for developing self-management skills to improve autonomy and health outcomes. The aim of this thesis is to investigates the effectiveness of self-management program for adolescents aged 15-18 years with a chronic condition as they transition from paediatric to adult health services. A systematic review of literature investigating the effectiveness of self-management programs for adolescents with a chronic condition demonstrated limited knowledge about what constitutes an effective self-management program for this patient group. Chapter 4 reports the findings of a retrospective analysis of a modified self-management program implemented within routine clinical care, demonstrated promising clinical outcomes and satisfaction among adolescents who participated in the self-management program and sound methodology for larger scale randomised controlled trial. Chapter 5 describes a study protocol for the prospective randomised controlled trial using both quantitative and qualitative research methods described in Chapter 6. This program is directed at improving self-management in an adolescent cohort aged 15-18 years with a physical chronic condition being treated in a specialist paediatric hospital. Chapter 6 reports on the analysis of the early outcomes of a two-site, longitudinal, nurse-led 12-month, randomised controlled trial conducted in adolescents with a chronic condition outlined in Chapter 5. The preliminary analysis showed promising evidence of a self-management program that can be integrated into clinical care to assist adolescents with developing self-management skills. This thesis provides evidence supporting the potential benefits of tailored, developmentally appropriate self-management programs for young people.