Abstract: Interactional and Educational Challenges for College Students With Invisible Chronic Physical and Mental Conditions

◆ Jennifer A. Butler Modaff, University of Wisconsin–La Crosse
◆ Daniel P. Modaff, University of Wisconsin–La Crosse

The Centers for Disease Control and Prevention (2018) reported that chronic mental and physical conditions impact students in a variety of ways including daily functioning and ability. Carroll et al. (2016) found that undergraduate students with chronic illness have a 16% graduation rate versus a 50% graduation rate for students without chronic illness. First year students with health issues are also at “more significant need for assistance in addressing social, physical, and emotional barriers; dealing with stress of self-managing health tasks and issues; and accessing disability services for appropriate accommodations” (Davis & Paro, 2020, pp. 15-16). Past research has explored the experiences of college students with chronic conditions from a variety of methodologies, including interviews (Frost et al., 2019; Woodhead et al., 2021), online surveys (Hamilton et al., 2023; Woodhead et al, 2021), and email-based surveys at regular intervals (Ravert et al., 2017). However, student-driven, longer-term qualitative data is needed to explore how students with chronic conditions describe the challenges they face in attempting to manage their conditions and succeed in college. The current study gathered qualitative data in the form of daily journal entries (digital audio or written) over a 14-day period (pre-pandemic) from 23 college students around the U.S. who self-identified as having a chronic physical or mental condition. Data were analyzed using thematic analysis (Braun & Clark, 2006), which generated 171 codes. Those codes were reduced to five themes: chronic conditions as impediments to education (i.e., cognitive, physical, and emotional challenges to academic success that the students experienced internally), difficulties with peers (i.e., the complexities around the choice to disclose to peers or not, feelings that they had no choice but to disclose, and peers who did not understand their conditions or the extent of them), missing education-related obligations (i.e., missing classes and school-related meetings and activities), complications with professors (i.e., perceptual complications based on fears/anxieties regarding the professor or relational complications based on prior interactions with the professor), and accommodation and testing concerns (i.e., despite having institutional accommodations, students would regularly not use them for a variety of reasons such as problems with the office facilitating accommodations, problems concerning exams, and not wanting to expose their conditions). The themes were discussed through the lens of communication theory of resilience (Buzzanell, 2019). Communication theory of resilience defines resilience as a fundamentally communicative and constitutive process “through which people reintegrate and actively construct their new normal through language, interaction, networks, and attention to their identities and identifications” (Buzzanell, 2019, p. 68). Resilience is activated when a trigger event creates upheaval, a sense of disruption, loss, or chaos, in a person’s life. While Buzzanell (2017) described the process activated by trigger events as an ongoing “dynamic activated when humans experience distress and disaster” (p. 103), we envision the management of student chronic illness as resiliency work with a focus primarily on distress rather than disaster.