Using online blogs to explore positive outcomes after burn injuries

More than my appearance: a pilot evaluation of the expand your Horizon Online functionality-based writing programme for adults with visible differences

Background

Adults with conditions that affect their appearance, known as visible differences, can experience appearance concerns, social anxiety, and depression. Interventions have been developed for this population to facilitate adjustment and coping skills; however, they have limited evidence of efficacy. The Expand Your Horizon [Alleva, J. M., Martijn, C., Van Breukelen, G. J., Jansen, A., & Karos, K. (2015). Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image, 15, 81-89. https://doi.org/10.1016/j.bodyim.2015.07.001] online functionality-based writing programme was adapted for adults with visible differences.

Method

A pilot randomised controlled trial with a wait-list control group was carried out to assess preliminary intervention efficacy and gain information about the acceptability and feasibility of the programme. Forty-four adults aged 21-63 years (M = 40.21; SD = 12.05) with visible differences took part. Various facets of body image (i.e. functionality appreciation and body appreciation) as well as depression and anxiety were assessed immediately pre- and post-intervention and at three-months.

Results

Participants reported enjoying the programme, felt that the format was acceptable, and it significantly increased functionality appreciation, which was maintained at three-months. However, there were no improvements in body appreciation, depression, and anxiety.

Conclusions

In future, a full trial should be carried out with an active control group.

Congenital melanocytic naevus (CMN) through the lens: Using photo-elicitation interviews to explore adjustment in adolescents with a rare birthmark condition

Adolescents with the rare birthmarks congenital melanocytic naevi (CMN) experience physical and psychosocial challenges, many of which stem from looking different from the 'norm'. However, some adjust and have positive experiences. Understanding the lived experiences of adolescents who have adjusted to CMN can provide a holistic picture of adjustment and inform the development of support and interventions for others with the condition. Open, participant-driven photo-elicitation interviews were conducted with four White females (15-17 years) who self-identified as having adjusted to CMN. Participants chose five photographs which were used to guide the interviews (47-80 min). Interpretative phenomenological analysis (IPA) was used to analyse the transcribed interview data. Three superordinate themes were identified: 'Accepting My 'True' Self' (1), 'I am Not Alone in This' (2), and 'Developing as a Person' (3). The themes related to accepting CMN as part of their identity, developing a positive body image (e.g., body appreciation, broad conceptualisations of beauty, body image flexibility), feeling supported and accepted by family, friends, and others with CMN, and developing adaptive coping skills. Findings suggest positive body image may be important for adjustment and can be determined by an individual. The benefits of using photo-elicitation within appearance research are discussed.

Blogging with dementia: Writing about lived experience of dementia in the public domain

Public narratives around dementia have historically been negative, and have not been shaped by people with dementia themselves, but stories of living with dementia are becoming more common in the public domain. This qualitative study explored the motivations and experiences of bloggers by conducting interviews with six bloggers with dementia in the UK. Thematic analysis suggested that the asynchronous nature of blogging offered a valuable, personalised space for people with dementia to tell their own stories in their own way. Blogging as a format posed some practical challenges, but bloggers developed strategies to overcome these. Motivations for blogging were on three levels: the personal (as a journal, and as a 'room of one's own'); community (as solidarity for other people with dementia, and as comfort for families and friends) and society (as an educational and campaigning tool). Whilst the study is small, and there are many voices of people with dementia missing from the blogging community, this research demonstrates the potential for blogging by people with dementia to change public narratives and perceptions of dementia.

The invisible paradox of inflammatory bowel disease: An analysis of men's blogs

Inflammatory bowel disease is associated with stigmatising symptoms. Online support platforms eschew stigma, thus may appeal more to men who avoid traditional forms of health support. Using a critical realist netnographic approach and inductive thematic analysis, this study examined six blogs written by UK-based men to explore how inflammatory bowel disease was narrated. Three subthemes and one overarching theme - The (in)visible paradox of IBD - were developed. Findings suggest private aspects of inflammatory bowel disease risk experiential erasure, whereas public aspects lack control. Blogging facilitates the regaining of control, leading to important support connections and a re-imagining of the male inflammatory bowel disease body.

'Diabulima' through the lens of social media: a qualitative review and analysis of online blogs by people with Type 1 diabetes mellitus and eating disorders

AIMS

To perform a qualitative review of online blogs authored by people self-identifying as having Type 1 diabetes and an eating disorder or 'diabulimia', a term used by people with Type 1 diabetes to describe an eating disorder that is characterized by deliberate restriction of insulin to control weight.

METHODS

We conducted a structured qualitative review of online blogs published between 2012 and 2017 authored by people who report having Type 1 diabetes and an eating disorder or diabulimia. The subsequent thematic analysis followed a six-phase process and was conducted by two independent researchers.

RESULTS

From 147 000 search results, 11 blogs (304 posts) matched criteria for further analyses. Three key themes and 18 subthemes emerged: 1) different aspects of bloggers' relationship with insulin, including motives for omitting insulin, secrecy of insulin omission and perception of control; 2) bloggers' experiences of diabetes complications, and diabetes ketoacidosis in particular, as well as their worries about future complications; 3) strategies for recovery and triggers for relapse, which involved diabetes self-management and setting up a support system.

CONCLUSIONS

Qualitative analyses of blogs authored by people with Type 1 diabetes and an eating disorder or diabulimia have identified high levels of diabetes distress and provided insight into different motives for insulin omission and strategies for recovery. Considering the limited evidence for effective interventions, these findings may help the development of complex interventions to improve biomedical and psychological outcomes in this group.