Illness anxiety and somatic health concerns of northern rural Scottish young people

Abstract

Objectives Over 20 per cent of northern Scottish young people from relatively remote areas had indicated health concerns in an earlier survey. This study reports findings of further investigations of concerns related to physical illnesses or somatic symptoms, and bases their understanding within the context of young people's own perspectives.

Design Individual, semi-structured interviews were set up in which participants led a discussion of their personal health concerns, and responded to a list of common health concerns generated by their peers. Data was analysed by two independent coders using a framework including the concern topic, cause of or factors related to each concern, and responses made to each concern.

Setting Five northern Scottish secondary schools different in geography, community size, local economy, and proximity to an urban centre were selected for participation, and a total of 37 young people (mean age 14.5 and 16.5) from two class levels volunteered to be interviewed.

Results Over half of the sample indicated anxiety about physical concerns, symptoms or disease. These included concerns over acquiring serious illness, managing chronic illnesses, managing weight, becoming ill from environmental poisons and coping with common ailments. They were embedded within personal contexts involving other health beliefs, health resources, and social worlds.

Conclusions Parameters of developmental adjustment triggered by health concerns were implicit in these discussions. These included the tasks of acknowledging personal limitations, coping with lack of control, choosing between personal and social choices affecting body image and behaviour related to physical wellbeing. Participants did not feel that adult-generated health education agendas have addressed these concerns nor their impact on development, and several suggestions are made to remedy this deficit.

Keywords

rural adolescence illness anxiety chronic disease body image

Get full access to this article

View all access options for this article.

References

Watt IS , Franks AJ , Sheldon TA Rural health and health care. BMJ 1993: 306: 1358-9.

Cloke P. , Milbourne P. , Thomas C. Living in different ways? Deprivation, marginalization and changing lifestyles in rural England. Transactions of the Institute of British Geograplzels 1997: 22: 210-30.

National Youth Bureau. Deprivation in rural areas: Young people's perspectives. Leicester: National Youth Bureau Reports, 1990.

Anderson K. , Plant M. , Plant M. Association between drinking, smoking and illicit drug use among adolescents in the Western Isles. J Substance Misuse 1998 : 3:13-20.

Glendinning A. , Hendry L. , Shucksmith J. Lifestyle, health and social class in adolescence . Soc Sci Med 1995: 41: 235-48.

Sweeting H. , West P. The health of 11 year olds in the west of scotland. Results from the first stage of the 11 to 16 study: Teenage health. MRC Medical Sociology Unit, Glasgow, 1997.

Lishner DM , Richardson M. , Levine P. , Patrick D.

Access to primary health care among persons with disabilities in rural areas. A summary of the literature. J Rural

Health 1996:12:45-53.

Hendry LB , Shucksmith J. , Love JG , Glendinning A. Young people's leisure and lifestyles. London: Routledge,1993.

Galt M. Illicit drug availability in rural areas and attitudes towards their use: Young people talking. Health Ed J 1997: 56: 17-34.

10.

Hendry LB , Glendinning A. , Reid M. , Wood S. Lifestyles, health, and health concerns of rural youth, 1996-1998. Edinburgh: Report to Department of Health, Scottish Office, 1998.

11.

Reid M. , Todd C. , Moore M. Health needs reported by chronic low back pain patients from general practice . Cambridge: Report to Cambridgeshire and Huntingdon Health Commission, 1994.

12.

Ruta DA , Garratt AM , Wardlaw D. , Russell IT Developing a valid and reliable measure of health outcome for patients with low back pain. Spine 1994: 19: 1887-96.

13.

Mearns D. , Thorne B. Client-centred counselling in action. London: Sage,1988.

14.

Reason P. Human inquiry in action: Developments in new paradigm research. London: Sage, 1988.

15.

Hendry LB , Reid M. Social relationships and health: The meaning of social 'connectedness' and how it relates to health concerns for rural Scottish adolescents. J Adolescence 2000: 23: 705-19.

16.

Ryan S. , Kang M. , Riley A. Use of health care services by rural and urban adolescents: the role of regular source of care and health need. J Adol Health 1998: 22: 141.

17.

McCabe S. Expanded emergency medical services for the provision of primary care in remote rural areas. Health Bulletin 2000: 58: 215-6.

18.

Furnham A. Explaining health and illness: lay perceptions on current and future health, the causes of illness, and the nature of recovery. Soc Sci Med 1994: 39: 715-25.

19.

Stainton-Rogers W. Explaining health and illness: an exploration of diversity. London: Wheatsheaf , 1991.

20.

Billig M. , Condor S. , Edwards D. et al. Ideological dilenunas: a social psychology of everyday thinking . New York: Sage, 1988.

21.

Frankel S. , Davidson C. , Smith GD Lay epidemiology and the rationality of responses to health education. Br J Gen Pract 1991: 41: 119-33.

22.

Sweeting, H. Reversals of fortune? Sex differences in health in childhood and adolescence. Soc Sci Med 1995: 40: 77-90.

23.

Caflisch M. , DeGuillenchmidt C. , Alvin P. Fuzzy symptoms in adolescents. Annales de Pediatrie 1998: 45: 295-302.

24.

Kowpak M. Adolescent health concerns: a comparison of adolescent and health care provider perceptions. J Am Acad Nurse Pract 1991: 3: 122-8.

25.

MaKay L. , Diem E. Health concerns of adolescent girls. J Pediatric Nurs 1995:10: 19-21.

26.

Ryle A. , Evans CD Some meaning of body and self in eating-disordered and comparison subjects . Br J Med Psy 1991: 64: 273-83.

27.

Woodman M. Addiction to perfection. Toronto: InnerCity Books,1982.

28.

Must A. , Jacques PF , Dallal GE , Bajerna CJ et al. Long-term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. N Eng J Med 1992: 327: 1350-5.

29.

Neitzert CS , Davis C. , Kennedy SH Personality factors related to the prevalence of somatic symptoms and medical complaints in a healthy student population . Br J Med Psy 1997: 70: 93-101.

30.

Egger HL , Costello EJ , Erkanli A. et al. Somatic complaints and psychopathology in children and adolescents: Stomach aches, musculoskeletal pains, and headaches. J Am Acad Child Psy 1999: 38: 852-60.

31.

Last CG , Hansen C. , Franco N. Anxious children in adulthood: a prospective study of adjustment. J Am Acad Child Psy 1997: 36: 645-52.

32.

Portegijs Pjm , Jeuken Fmh , van der Horst F. , Fraan HF et al. A troubled youth: relations with somatization, depression and anxiety in adulthood. Fam Prac 1996: 13:1-11.

33.

Weiler RM Adolescents' perceptions of health concerns: an exploratory study among midwestern youth. Health Educ Beli 1997: 24: 287-99.

34.

Kaufman KL , Cromer B. , Daleiden EL et al. Recurrent abdominal pain in adolescents: psychosocial correlates of organic and nonorganic pain. Child Health Care 1997: 26: 15-30.

35.

Esters IG , Cooker PG , Ittenbach RF Effects of a unit of instruction in mental health on rural adolescents' conceptions of mental illness and attitudes about seeking help. Adolescence 1998: 130: 469-76.

36.

Hauser ST , DiPlacido J. , Jocobson AM , Willett J. et al. Family coping with an adolescent's chronic illness: an approach and three studies. J Adolescence 1993: 16: 305-29.