Factors and Coping Strategies that Impact Children and Adolescents with Alopecia Areata: An Exploratory Factor Analysis
Date
2014-05
Authors
Wolf, Janice J.
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Abstract
People are often curious, and concerned when encountering individuals who are losing or have lost all of their hair. While hair loss is mostly associated with individuals undergoing chemotherapy, alopecia areata (AA) also causes individuals to lose the hair on their scalp and elsewhere on the body. This loss can be particularly devastating to children and adolescents, and can affect their psychological well-being. This research proposed to explore the factors that impact children and adolescents with AA as well as the coping strategies they use. A mixed method research design was used to combine survey data with interview transcripts and field notes to capture a more detailed picture of AA and its effect on children and adolescents. The 56-question survey included nine demographic items, four independent variable items (age, gender, age of onset, duration of diagnosis) and 43 dependent variable items (28 assessing impact factors, 15 assessing coping strategies). The interview protocol included seven questions with field notes that helped to document observations indicating appearance, emotions, and body language. Two exploratory factor analyses revealed five impact factors and five types of coping strategies, which linked to both the literature overview and qualitative findings. The impact factors identified were: Confidence/Self-Esteem, Psychological Effects, Appearance/Acceptance, Socialization, and Communication. The coping strategies identified were: Physiological, Cover-up/Avoidance, Outside Support, Social Network, and Family Support. Female participants reported significantly greater difficulty adjusting and managing AA than did their male counterparts. No significant differences were present based on having AA for a short time or a long time. Younger participants expressed significantly lower psychological impacts than did mid-level or older participants. Participants with later onset of AA reported having a significantly more difficult time adjusting to their new appearance than those having earlier onset. The item offering the greatest frequency of response overall was the support of family and friends. The prompt, My family help support me received a 98% (agree/strongly agree) response. The least frequently cited response was to the question, I have had individual counseling for my AA at 22.4% (agree/strongly agree). The emergent themes from the qualitative analysis centered on the topics of: Acceptance, social issues, and coping. Providing education and awareness can help alleviate misconceptions about this condition.
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Keywords
Education, Nursing, Special education, Alopecia Areata, Children and Adolescents, Coping Strategies, Exploratory Factor Analysis, Impact Factors