How are parents affected when their child has an appearance-altering injury?

In the UK, around 6400 children experience a burn injury every year. This can have a profound impact on a child's psychological and physical wellbeing—but how are parents affected when their child suffers a burn? Catrin Griffiths explores the effect of a child's burn injury on parents' coping skills and wellbeing, and highlights the importance of adequately assessing parents' needs and providing appropriate support

The role of psychological inflexibility in the tripartite influence model for women: A single body image inflexibility pathway to disordered eating behaviours

This study was conducted by conceptualising, designing and implementing new knowledge at the forefront of body image inflexibility (a construct derived from Acceptance and Commitment Therapy (ACT)) and disordered eating. The study design was adjusted in the light of emergent issues and understandings. The thesis involved a review of the literature which investigated disordered eating and the factors known to influence disordered eating such as body image inflexibility. A critical understanding of the current state of knowledge in this field of theory and practice has been provided. Overall the literature review suggested that body image inflexibility is an important factor to examine when investigating the predictors of disordered eating behaviours. The current study involved the creation and interpretation of new knowledge through original research and advanced scholarship by using a quantitative online survey and latent structural equation modelling (SEM) to test an adapted version of the Tripartite Influence Model with the inclusion of body image inflexibility with 378 adult women. In the method, the range of study design methods and statistical analyses that were considered for this study were outlined. A rationale was provided for the chosen study design and statistical analysis, in order to demonstrate a critical understanding of the methodology of enquiry. The results identified that body image inflexibility represented a single pathway which fully mediated the relationship between women’s body image and their engagement in disordered eating behaviours. Body image inflexibility also fully mediated the relationships between internalisation of the thin ideal and disordered eating and between friend pressure and disordered eating. Perceived pressure to be thin from friends, partners, 15 family and the media also had distinct relationships in the model. Perceived pressure from friends was significantly related to body image inflexibility. Both pressure from partners and pressure from the media had direct relationships with internalisation of the thin ideal and also with disordered eating behaviours. Pressure from family had a direct relationship with body image. Internalisation of the thin ideal and body image had significant mediational roles in the model. Internalisation of the thin ideal fully mediated the relationship from partner pressure to body image inflexibility, from media pressure to body image inflexibility and from partner pressure to body image. Internalisation of the thin ideal partially mediated the relationship between media pressure and body image. Body image fully mediated the relationships between media pressure and body image inflexibility, and between family pressure and body image inflexibility. Body image partially mediated the relationship between internalisation of the thin ideal and body image inflexibility. The results have highlighted the importance of including body image inflexibility as a mediating variable in theoretical models of disordered eating and as a psychological construct to target in treatment interventions for disordered eating. In the discussion, an independent judgement of issues and ideas within the field of disordered eating and psychological flexibility research and practice was provided. Finally a critical reflection on the current study and its strengths and weaknesses was then outlined

Developing young person’s Face IT: Online psychosocial support for adolescents struggling with conditions or injuries affecting their appearance

© The Author(s) 2015. A participatory action approach with potential users and clinical experts was employed to design and evaluate the acceptability of young person’s Face IT (YP Face IT), an online intervention incorporating cognitive behavioural therapy and social skills training for adolescents with appearance-related anxiety as a result of a visible difference. Workshops with adolescents and clinicians informed a prototype YP Face IT which underwent a usability analysis by 28 multidisciplinary health professionals and 18 adolescents, before 10 adolescents completed it at home. Acceptability data obtained online and via interview were analysed using content analysis. Participants found YP Face IT acceptable and believed it would provide much needed and easy access to psychosocial support. They requested that it should be made widely available either as a self-management tool requiring minimal supervision from a health professional or to compliment therapist-led care

Renovating romance : experimentation in English narrative fiction, 1645-1665

This thesis investigates the significance of literary experimentation in the years 1645-1665, a period of profound social and political change and of prolific romance production. It studies twelve English romances written in the long interregnum between 1645 and 1665, from William Sales’s Theophania (c.1645) to John Crowne’s Pandion and Amphigenia (1665). The texts discussed include heroic romances, parodies, political romans à clef and Christian fiction, in prose and verse. The thesis argues that English romances embarked on a conscious programme of generic renewal that responds to social and political upheaval. The thesis marries close textual analysis of romance with a reading of how generic transformation articulates social and political change. Each of the chapters centres on a transhistorical feature of romance: the representation of combat, the monarch, gender disguise ending in marriage, the hero’s body and the triumph of virtue. Taken together, each of these topics underpins forms of social authority: aristocratic honour and a warrior caste, the power of Elizabethan and Stuart monarchy, the social regulation of desire, the cultural primacy of masculinity, and a Christian articulation of moral duty and sacrifice. The chapters examine the transformation of each feature with reference to a variety of contemporary texts, such as news books, political tracts, medical theories, contemporary French literature, parody and religious writing as well as earlier fiction. In doing so, the thesis engages with wider studies of mid-century textual culture and suggests that in absorbing these discourses, romance registers a myriad of social and political transformations. The thesis responds to a number of constructions of romance production in this period. In following the contours of the romance publishing market of the long interregnum it adopts a longer periodisation than the formal duration of the republic 1649-1660, and in doing so opens up the texts as responsive to multiple discourses of power. By reading long-interregnum narratives in tandem with a broad range of texts from different genres, the thesis emphasises the hybrid and absorptive nature of romance in this period. The study unearths connections between the texts that have not hitherto been registered within a critical taxonomy that bifurcates interregnum fiction as heroic romance and roman à clef

Development of new psychometric instruments to measure appearance distress during adolescence: The adolescent appearance distress scales

Measures of adolescent appearance distress have focused on weight and body shape, excluding other aspects of appearance. The absence of a psychometrically sound, general measure of appearance distress has limited evaluation of interventions and curtailed investigation of psychological processes in adolescent appearance adjustment. This paper describes the development of scales assessing adolescent appearance distress to address this dearth of appropriate measures, validated through cross-sectional design involving 617 adolescents. Two scales were developed, comprising 13 items for younger adolescents and 17 items for older adolescents. Two similar factors were generated for each scale, “fear of negative appearance evaluation” and “salience and investment in appearance.” A third factor was identified for older adolescents, “social appearance comparison.” Sound psychometric properties were demonstrate

Designing and evaluating the acceptability of Realshare: An online support community for teenagers and young adults with cancer

© 2014 SAGE Publications. A participatory action approach was used to design and evaluate the acceptability of the Realshare online community. Pre and post-intervention focus groups were conducted and participants were asked to test out Realshare during two intervention periods: when a facilitator was present and when one was not. Focus group data and forum messages were thematically analysed. The themes identified related to participants' website design requirements, how they used the community and the evaluation of Realshare after having used it. Amendments were made to Realshare throughout the project. Realshare is available to young oncology patients in the South West of England

The development and validation of the CARe Burn Scale: Child Form: a parent-proxy-reported outcome measure assessing quality of life for children aged 8 years and under living with a burn injury

Purpose: Patient-reported outcome measures (PROMs) identify patient needs and therapeutic progress. This paper outlines the development and validation of the CARe Burn Scale: Child Form, a parent-proxy-reported outcome measure that assesses quality of life in children aged 8 and under living with a burn injury. Methods: A literature review and interviews with 12 parents of children with a burn and seven health professionals informed the development of a conceptual framework and draft PROM. Cognitive debriefing interviews with 18 parents and eight health professionals provided feedback to ascertain content validity, and 311 parents took part in field testing. Rasch and traditional psychometric analyses were conducted to create a shortened version. Further psychometric analyses with 133 parents tested the shortened CARe Burn Scale in relation to other parent-proxy measures. Results: The final conceptual framework included 5 domains: Social and Emotional Difficulties, Social and Emotional Well-Being, Wound/Scar Discomfort, Wound/Scar Treatment and Physical Abilities. Two scales fulfilled Rasch and traditional psychometric analyses, providing evidence of construct validity, acceptability, and reliability. Three scales did not fulfil the Rasch criteria and were retained as checklists. Compared to other parent-proxy measures, individual CARe Burn Scales correlated moderately with similar constructs and had low correlations with dissimilar constructs, indicating evidence of criterion validity (concurrent and discriminant). Conclusions: The CARe Burn Scale: Child Form can be used to measure children’s quality of life after having a burn injury which can inform rehabilitation and surgical decision-making