Disclosure

Friendships may facilitate an adolescent's adjustment to a chronic disease or their ability to cope with a difficult medical treatment (2,15,16). However, this is very difficult if peers are unaware of their friend's condition. For some young people with chronic illness the fear of disclosing their illness and the impact they perceive this will have on how others respond to them means that they will sometimes try to keep their diagnosis secret. However disclosure can be a great relief and can foster both practical and emotional support. It is also an important skill to develop for later life, as they may want to disclose their condition to partners and potential employers. A review of the literature (17) reported that conditions under which is best to disclose illness are not yet fully understood. In some cases it has been found that disclosure to classmates as a whole resulted in little or no impact on the popularity of the child (18) and in other cases has adversely affected relationships (19). Disclosure to close friends however for children with HIV resulted in improved functioning compared to that of children who had not disclosed their HIV status (20). On balance it would appear that disclosure of a young person's chronic illness to carefully chosen friends can be helpful and can provide a sense of relief that their condition is no longer secret and support can be elicited (2). Health professionals may need to offer advice and support to facilitate the process of disclosure since some young people may not possess the skills and confidence to ensure a successful outcome, which may hinder future disclosure.

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