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Coping with life transitions in young adults with celiac disease. Presented by Dr Suzanne Dupuis-Blanchard, PhD RN Canadian Celiac Association National Conference - Moncton, NB May 26 th , 2007. Overview of session. Notions on transitions Coping with transitions Examples
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Coping with life transitions in young adults with celiac disease Presented by Dr Suzanne Dupuis-Blanchard, PhD RN Canadian Celiac Association National Conference - Moncton, NB May 26th, 2007
Overview of session • Notions on transitions • Coping with transitions • Examples • College / university • Social relationships • Travel • Forum for discussion
What is a transition? • When one’s current reality is disrupted • A passage from one state to another • Can last 6-12 months • Crisis likely to occur at 6 months
Types of transitions Developmental (ex: life cycle) Situational (ex: changes in role, relocation) Health-illness (ex: illness, rehab) Organizational (ex: change in the environment)
For young adults Developmental transitions Health/illness transition Situational transition Result of these…
Factors that influence transitions • Personal conditions • Meaning and expectations attached to the transition • Cultural beliefs and attitudes • Level of knowledge • Prior transition skills • Support (family and friends) • Economic security
Community conditions • Level of support (work, health professionals) • Advice and answers to questions • Societal conditions • Stereotypes and marginalization
Initiating transition Disrupted reality Reality reconstructuring Found identity Reality Uncertainty Process of transitions Resolution of uncertainty and reconstruction of reality
To facilitate transitions • Awareness that changes are occurring • Engagement in the process of transition • Realization that changes and differences in identities, roles, relationships, abilities and patterns of behavior will or are happening • Recognition of emotions: anxiety, insecurity, frustration, depression, low self-esteem and loneliness
Coping with transitions Awareness that previous reality is no longer available Confronting circumstances Acknowledging the irreversibility Engaging in information seeking Deciding to pursue health behaviours (conviction) Prior coping strategies
Two levels of adaptation • Behavioural • Actions • Cognitive • How you think
Examples • Transitions in young adults • Going away to college / university • Cooking • New friends / parties • Ongoing social relationships • Friends • Work • Dating / Life partner • Family life • Travel
Doctor: “Oh, you just have to eliminate gluten from your diet; it’s simple, no medication, no surgeries, a diet is all you need”. Here’s how to survive…
College / University Learn to cook gluten-free; get familiar with food ingredient lists; plan for leftovers; freeze Plan ahead for lunch: sandwich, salads, soups Going out? Bring your own bread and cookies Ask, ask, ask Practice explaining celiac disease in simple words Living in dorms: meet with food services; special permission for toaster in room; more space; kitchenette
Social relationships Plan ahead; call and ask Don’t become a “closet” celiac Make suggestions: pick the restaurant; bring a food you can eat When in doubt: ask
Travel Plan ahead; check web sites for information on stores, restaurants Bring food with you; peanut butter, bread, fruits, vegetables Stop by a restaurant when not busy and ask questions for future meals Find grocery stores; locate health food stores Rent a room with kitchenette Contact local Celiac chapter
Other tips… Keep a food diary for ideas Beware of hidden contamination Don’t let celiac disease define who your are!
The importance of being gluten-free… • To prevent complications • Neurological manifestations (migraines, tingling) • Cancer • Osteoporosis • Depression • Infertility
Take a deep slow breath… • There is no cure, but there is no need for prescribed medication; • There is no cure, but you know recovery is possible; • There is no cure, but you know that you alone are in charge of that recovery; • How much better can it get?
…and spread the ‘gluten’ news to family members In a study of 13 000 people (adults and children): - 1:133 (with no risk factors) had CD - 1:22 (first degree relative) had CD - 1:39 (second degree relative) had CD Reference: Treem, W.R. (2004). Emerging concepts in celiac disease. Current Opinion in Pediatrics, 16, 552-559.
Forum for discussion Do you have any suggestions or comments that could help the person sitting next to you?
Thank you! Dr Suzanne Dupuis-Blanchard, PhD RN School of Nursing Université de Moncton Moncton, NB E1A 3E9 Phone: (506) 858-4260 suzanne.dupuis-blanchard@umoncton.ca