1. Coping with life transitions in young adults with celiac disease
Presented by
Dr Suzanne Dupuis-Blanchard, PhD RN
Canadian Celiac Association National Conference - Moncton, NB
May 26th, 2007

2. Overview of session Notions on transitions Coping with transitions
Examples
College / university
Social relationships
Travel
Forum for discussion

3. What is a transition? Can last 6-12 months
When one’s current reality is disrupted
A passage from one state to another
Can last 6-12 months
Crisis likely to occur at 6 months

4. Types of transitions Developmental (ex: life cycle)
Situational (ex: changes in role, relocation)
Health-illness (ex: illness, rehab)
Organizational (ex: change in the environment)

5. For young adults Result of these… Developmental Health/illness
transitions
Health/illness
transition
Situational
transition
Result of these…

6. STRESS

7. Factors that influence transitions
Personal conditions
Meaning and expectations attached to the transition
Cultural beliefs and attitudes
Level of knowledge
Prior transition skills
Support (family and friends)
Economic security

8. Community conditions Societal conditions
Level of support (work, health professionals)
Advice and answers to questions
Societal conditions
Stereotypes and marginalization

9. Process of transitions Resolution of uncertainty and reconstruction of reality
Initiating
transition
Disrupted
reality
Reality
reconstructuring
Found
identity
Reality
Uncertainty

10. To facilitate transitions
Awareness that changes are occurring
Engagement in the process of transition
Realization that changes and differences in identities, roles, relationships, abilities and patterns of behavior will or are happening
Recognition of emotions: anxiety, insecurity, frustration, depression, low self-esteem and loneliness

11. Coping with transitions
Awareness that previous reality is no longer available
Confronting circumstances
Acknowledging the irreversibility
Engaging in information seeking
Deciding to pursue health behaviours (conviction)
Prior coping strategies

12. Two levels of adaptation
Behavioural
Actions
Cognitive
How you think

13. Examples Transitions in young adults
Going away to college / university
Cooking
New friends / parties
Ongoing social relationships
Friends
Work
Dating / Life partner
Family life
Travel

14. Doctor: “Oh, you just have to eliminate gluten from your diet; it’s simple, no medication, no surgeries, a diet is all you need”.
Here’s how to survive…

15. College / University
Learn to cook gluten-free; get familiar with food ingredient lists; plan for leftovers; freeze
Plan ahead for lunch: sandwich, salads, soups
Going out? Bring your own bread and cookies
Ask, ask, ask
Practice explaining celiac disease in simple words
Living in dorms: meet with food services; special permission for toaster in room; more space; kitchenette

16. Social relationships Plan ahead; call and ask
Don’t become a “closet” celiac
Make suggestions: pick the restaurant; bring a food you can eat
When in doubt: ask

17. Travel
Plan ahead; check web sites for information on stores, restaurants
Bring food with you; peanut butter, bread, fruits, vegetables
Stop by a restaurant when not busy and ask questions for future meals
Find grocery stores; locate health food stores
Rent a room with kitchenette
Contact local Celiac chapter

18. Other tips…
Keep a food diary for ideas Beware of hidden contamination Don’t let celiac disease define who your are!

19. The importance of being gluten-free…
To prevent complications
Neurological manifestations (migraines, tingling)
Cancer
Osteoporosis
Depression
Infertility

20. Take a deep slow breath…
There is no cure, but there is no need for prescribed medication;
There is no cure, but you know recovery is possible;
There is no cure, but you know that you alone are in charge of that recovery;
How much better can it get?

21. Take charge of your health…

22. …and spread the ‘gluten’ news to family members
In a study of people (adults and children):
- 1:133 (with no risk factors) had CD
- 1:22 (first degree relative) had CD
- 1:39 (second degree relative) had CD
Reference: Treem, W.R. (2004). Emerging concepts in celiac disease. Current Opinion in Pediatrics, 16,

23. Forum for discussion
Do you have any suggestions or comments that could help the person sitting next to you?

24. Dr Suzanne Dupuis-Blanchard, PhD RN
Thank you!
Dr Suzanne Dupuis-Blanchard, PhD RN
School of Nursing
Université de Moncton
Moncton, NB E1A 3E9
Phone: (506)