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Relationship between Executive Functioning and Adherence in Youth with Sickle Cell Disease

Wilson, Shana M
http://rave.ohiolink.edu/etdc/view?acc_num=kent1473596375016865

Abstract Details

2016, PHD, Kent State University, College of Arts and Sciences / Department of Psychological Sciences.
Executive functioning (EF) refers to the high-level processes responsible for purposeful behavior and encompasses abilities such as inhibition, planning, organization, and cognitive flexibility. Deficits in EF can influence cognitive processes as well as affective responses and behaviors. Executive dysfunction is regularly identified in pediatric chronic illness populations, including patients with sickle cell disease (SCD). Adolescents with SCD, a genetic blood disorder, face challenges in adhering to complex medical regimens as they wrestle with normal developmental issues. Despite the linkage between adherence and fewer pain crises, many adolescents have less than optimal adherence. The transition of responsibility for disease management from the parent to the adolescent during adolescence could be a likely cause of this poor adherence. Further, adolescents with EF deficits may rely more on their parents for completion of treatment recommendations. The present study examined the nature of the relationship between EF, adherence, and responsibility for treatment regimen completion in adolescents with SCD. Then, the study compared the EF-adherence relationship in the adolescents with SCD to a group of matched non-affected controls. Results indicate that adolescents with SCD have poorer executive functioning than their healthy peers. While results failed to show a significant relationship between executive functioning and adherence in either group, in the group with SCD, parents of youth with lower EF reported more involvement in completion of the SCD regimen than parents of youth with higher EF. Having an adult take responsibility for completion of the regimen may compensate for EF deficits in youth with chronic illnesses. As caregivers may not always be available to ensure proper regimen completion, adolescents should continue to be educated on the importance of adherence. All adolescents, but especially those with EF deficits, could benefit from learning helpful tactics (e.g., phone reminders, sticky notes) to assist in completing treatment recommendations. Adolescents with SCD could benefit from regular neuropsychological screening to monitor EF, especially as cerebral compromise can change the course of EF mid-illness. Further, clinicians should consider an adolescent’s EF when providing treatment recommendations. Health care professionals should educate families on the importance of parental involvement for all parts of the SCD regimen. Finally, developmental trends should continue to be considered in youth with chronic illness. Larger samples are needed to further assess the EF-adherence relationship and explore whether it is moderated by responsibility.
Beth Wildman, Ph.D. (Advisor)
John Gunstad, Ph.D. (Committee Member)
William Merriman, Ph.D. (Committee Member)
Prasad Bodas, M.D. (Committee Member)
Susan Roxburgh, Ph.D. (Other)
Psychology
executive functioning; adherence; responsibility; sickle cell disease

Recommended Citations

Citations

  • Wilson, S. M. (2016). Relationship between Executive Functioning and Adherence in Youth with Sickle Cell Disease [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1473596375016865

    APA Style (7th edition)

  • Wilson, Shana. Relationship between Executive Functioning and Adherence in Youth with Sickle Cell Disease. 2016. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1473596375016865.

    MLA Style (8th edition)

  • Wilson, Shana. "Relationship between Executive Functioning and Adherence in Youth with Sickle Cell Disease." Doctoral dissertation, Kent State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=kent1473596375016865

    Chicago Manual of Style (17th edition)

kent1473596375016865
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This open access ETD is published by Kent State University and OhioLINK.