his thesis explores the experience of dialysis in young adults across three
papers: the first paper, a systematic literature review, evaluates the
evidence for direct and indirect relationships between social support and adherence to treatment regimens – including prescription, medication, dietary restriction, and fluid intake. It reviews the quantitative evidence, finding no consistent relationship between these two variables. The second paper presents findings from an empirical study, qualitatively exploring the lived experience of dialysis in patients aged 18-35 years. This cross
-sectional study was undertaken according to the principals of interpretative phenomenological analysis (IPA), with semi-structured interviews undertaken with four male patients. Two interconnected aspects of experience were identified, forming two broad categories of themes: biographical disruption and biographical repair. Biographical disruption described the immediate and ongoing negative impact that dialysis had on patients’ lives, including failure to complete
developmental tasks and difficulty maintaining a place within social networks. Patients also perceived multiple barriers to initiating and sustaining intimate relationships (e.g. sexual dysfunction and body-image disturbance). Biographical repair revealed a process of adjustment and
adaptation, with patients finding new meaning in life on dialysis through efforts to reconnect with lost peers and seek alternative interests.
This study suggested that age – and developmental life-stages – are important determinants of illness experience and outcome. The third paper discusses implications for theory and clinical practice emerging from the first two papers. It emphasises the importance of considering the intersection between illness and age in both research and clinical
contexts. The difficulties that young people have in maintaining a place within social networks is discussed in relation to social support structures, whilst the difficulties faced in establishing and maintaining intimate relationships are also considered within a developmental framework. This
paper also contains personal reflections on the research process and outcomes.