Coping in children and adolescents aged 8-16 years old with food allergy, and the development and validation of the Coping Scale for Food Allergy (CS-FA)

Abstract

Children and adolescents with food allergy (FA) face complex and substantial lifestyle changes to successfully manage their condition, and are the age group with the highest proportion of visits to hospital emergency departments and fatal reactions. Research has shown the associations between effective coping and better health outcomes. However, this has not yet been examined in children and adolescents with FA. This thesis presents four studies exploring how children and adolescents aged 8-16 with FA cope. A mixed-method approach guided the research, and the control-based model of coping (Compas et al., 2001) underpinned the identification and analysis of coping strategies. A systematic review was first conducted, which identified a range of coping strategies employed by children and adolescents with FA. However, only two published studies had coping as the primary aim, and only three studies included children below 11 years old. Semi-structured interviews were then conducted with 8-16 year olds which provided a greater insight into the coping strategies used. Some differences in coping associated with autonomy were identified, and so analysis was conducted on the 8-11 and 12-16 year olds separately. However, the types of coping strategies used between the two age groups, and the reasoning behind their uses, remained largely similar. The final study utilised the findings from the first three studies to inform the development of a Coping Scale for Food Allergy (CS-FA) which shows good preliminary reliability and validity. Future research should consider investigating the impact of FA education, peer support, and the role of parental influence on the development and use of coping strategies, and if strategies differ between different types of FA. Clinicians could use the CS-FA to open dialogue with their patients to further understand how they are coping with FA, and where challenges may lie.