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Matthie N, Ross D, Sinha C, Khemani K, Bakshi N, Krishnamurti L. A Qualitative Study of Chronic Pain and Self-Management in Adults with Sickle Cell Disease. J Natl Med Assoc 2018; 111:158-168. [PMID: 30266214 DOI: 10.1016/j.jnma.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/06/2018] [Accepted: 08/30/2018] [Indexed: 01/08/2023]
Abstract
Acute, intermittent vaso-occlusive pain is the hallmark of sickle cell disease (SCD) and is associated with substantial morbidity and impaired quality of life (QOL). The subgroup of adults with SCD who transition from recurrent, acute pain to chronic, persistent pain have even greater QOL impairment and higher rates of healthcare utilization. Self-management is central to SCD management; however, its role in chronic pain management is not established. This qualitative study was conducted to answer the following research questions: (1) What is the chronic pain experience of adults with SCD? (2) What self-management strategies do adults with SCD use for chronic pain? and (3) Do adults with SCD have any needs in the self-management of chronic pain? Eighteen Black adults with SCD completed a demographics questionnaire and an interview. The majority of the participants were 21-30 years of age (mean 33.5, SD 7.6), female (61.1%), employed at least part-time (61.1%), single/never married (72.2%), and had a SCD type of sickle cell anemia (55.5%). Interview analysis revealed three major themes: (1) the chronic pain experience; (2) strategies for managing chronic pain; and (3) challenges and needs in managing chronic pain. Study findings can be used to support chronic pain management among adults with SCD. Further research is needed to devise and implement effective strategies for the prevention and management of chronic SCD pain.
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Affiliation(s)
- Nadine Matthie
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Diana Ross
- Emory University, School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Cynthia Sinha
- Emory University, School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Kirshma Khemani
- Emory University, School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Nitya Bakshi
- Emory University, School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
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Stigma and Pain in Adolescents Hospitalized for Sickle Cell Vasoocclusive Pain Episodes. Clin J Pain 2018; 34:438-444. [DOI: 10.1097/ajp.0000000000000553] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Cecilio SG, Pereira SADS, Pinto VDS, Torres HDC. Barriers experienced in self-care practice by young people with sickle cell disease. Hematol Transfus Cell Ther 2018; 40:207-212. [PMID: 30128428 PMCID: PMC6098173 DOI: 10.1016/j.htct.2017.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/23/2017] [Indexed: 12/02/2022] Open
Abstract
Objective To identify barriers to the self-care practice of young people with sickle cell disease. Method This qualitative study was conducted with 17 individuals with sickle cell disease aged between 13 and 24 years in Belo Horizonte, MG, Brazil in March and April 2017. An interview investigated the barriers to self-care practice and the feelings associated with sickle cell disease. Data were transcribed and analyzed according to Bardin's perspective using the following steps: (1) pre-analysis, (2) exploration of the material, and (3) treatment of the results (inference and interpretation). Results Five thematic categories emerged: (1) feelings: anger, sadness, and fear; (2) bullying and stigmatization: challenges regarding walking, speaking, or behaving, as well as patient labels; (3) cognitive factors: doubts related to medication, hydration, heredity and maternity; (4) medication compliance: fear of the side effects suffered and anger triggered by the obligation to use the medication; (5) family issues: complaints of not earning the mothers’ trust to live independently. Conclusion The barriers to self-care in young people with sickle cell disease indicate difficulties related to emotional, behavioral, and environmental aspects. Understanding these factors will favor a better adaptation of youths to the context of sickle cell disease.
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Leger RR, Wagner LD, Odesina V. Stigma in adults with sickle cell disease and family members: Scale development and pilot study in the USA and Nigeria. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: 10.1016/j.ijans.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rohde JA, Wang Y, Cutino CM, Dickson BK, Bernal MC, Bronda S, Liu A, Priyadarshini SI, Guo L, Reich JS, Farraye FA. Impact of Disease Disclosure on Stigma: An Experimental Investigation of College Students' Reactions to Inflammatory Bowel Disease. JOURNAL OF HEALTH COMMUNICATION 2017; 23:91-97. [PMID: 29283816 DOI: 10.1080/10810730.2017.1392653] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Inflammatory bowel disease (IBD) is a serious chronic illness that affects 1 in 200 people in the United States with the majority of new cases of IBD diagnosed in young people under the age of 35. Despite the growing number of people who are diagnosed each year, the consequences of health-related stigma faced by young people grappling with the effects of IBD are understudied. This experimental investigation explored the existence of enacted stigma among college students, a population that faces many social and psychological challenges due to the added emotional stresses brought about by the transition from high school and adolescence to college and adulthood. Results indicate that enacted stigma among college students toward other students with IBD decreases when disclosure of the disease is present. Results also suggest that greater knowledge of the nature and symptoms of IBD positively correlates to decreased stigma.
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Affiliation(s)
- Jacob A Rohde
- a School of Media and Journalism , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Yue Wang
- b Boston University, College of Communication , Boston , Massachusetts , USA
| | - Chelsea M Cutino
- b Boston University, College of Communication , Boston , Massachusetts , USA
| | - Bonnie K Dickson
- b Boston University, College of Communication , Boston , Massachusetts , USA
| | - Marisa C Bernal
- b Boston University, College of Communication , Boston , Massachusetts , USA
| | - Serena Bronda
- b Boston University, College of Communication , Boston , Massachusetts , USA
| | - Aizhou Liu
- b Boston University, College of Communication , Boston , Massachusetts , USA
| | | | - Ling Guo
- c Boston Medical Center, Section of Gastroenterology , Boston , Massachusetts , USA
| | - Jason S Reich
- c Boston Medical Center, Section of Gastroenterology , Boston , Massachusetts , USA
| | - Francis A Farraye
- c Boston Medical Center, Section of Gastroenterology , Boston , Massachusetts , USA
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Survey of Physician Perspective towards Management of Pain for Chronic Conditions in the Emergency Department. ACTA ACUST UNITED AC 2017; 1:55-70. [PMID: 34528027 DOI: 10.22606/mcmr.2017.13002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sickle cell disease (SCD) pain is often acute-on-chronic, likening it to other chronic acute-on-chronic pain conditions. Pain treatment of SCD was already reported as inadequate prior to the current opioid epidemic, but attitudes underlying treatment were understudied. Understanding these attitudes prior to the current epidemic would be revealing. Therefore in 1997, before the current opioid epidemic, we surveyed physicians' attitudes toward pain management and treatment preferences for acute pain exacerbations in the Emergency Department in SCD versus those of chronic pancreatitis and chronic low back pain, two other acute-on-chronic pain diseases. Thirty-nine residency trainees were surveyed in a level one triage hospital. Resident estimates of the rate of opioid addiction in SCD were higher than estimates in both chronic pancreatitis and chronic low back pain. Most residents relied on their personal clinical experience rather than external sources of data or knowledge as the most important driver when they managed chronic pain. This survey research shows that, predating the current opioid epidemic, there was both a backdrop of opioid-phobia and a bias against treating SCD pain compared to other chronic pain conditions among our sample. Repeating this survey research among current training physicians, along with surveys of other attitudes, would provide useful comparisons.
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57
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Identifying Social-Behavioral Health Needs of Adults with Sickle Cell Disease in the Emergency Department. J Emerg Nurs 2017; 43:444-450. [DOI: 10.1016/j.jen.2017.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/29/2017] [Accepted: 04/08/2017] [Indexed: 11/17/2022]
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Blake A, Asnani V, Leger RR, Harris J, Odesina V, Hemmings DL, Morris DA, Knight-Madden J, Wagner L, Asnani MR. Stigma and illness uncertainty: adding to the burden of sickle cell disease. Hematology 2017; 23:122-130. [PMID: 28766464 DOI: 10.1080/10245332.2017.1359898] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Alphanso Blake
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | - Vikram Asnani
- Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston 7, Jamaica
| | | | - June Harris
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | | | - Daileann L. Hemmings
- Department of Health Sciences and Nursing, University of Hartford, West Hartford, CT, USA
| | | | - Jennifer Knight-Madden
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
| | | | - Monika Rani Asnani
- Sickle Cell Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston 7, Jamaica
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Jenerette CM, Brewer CA, Silva S, Tanabe P. Does Attendance at a Sickle Cell Educational Conference Improve Clinician Knowledge and Attitude Toward Patients with Sickle Cell Disease? Pain Manag Nurs 2017; 17:226-34. [PMID: 27283268 DOI: 10.1016/j.pmn.2016.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 04/20/2016] [Accepted: 05/03/2016] [Indexed: 11/19/2022]
Abstract
Sickle cell disease (SCD) is a genetic disease associated with both chronic pain and acute painful events referred to as vaso-occlusive crises. Individuals with SCD suffer from a multitude of medical complications in addition to pain. Patients often are stigmatized as "drug-seeking" and receive inadequate pain management. The purpose of this study was to compare clinicians' SCD knowledge and attitudes toward patients with SCD before attending a 2-day conference on SCD (T1) with knowledge and attitudes immediately postconference (T2) and 2 months postconference (T3). A prospective, descriptive survey design was used. The authors administered surveys to assess SCD knowledge and clinicians' attitudes toward patients with SCD at three time points: T1 (N = 59), T2 (N = 38), and T3 (N = 30). SCD knowledge was measured using a 20-item survey, and clinicians' attitudes toward patients with SCD were measured with the General Perceptions About Sickle Cell Patients Scale, which included items on four independent subscales: positive attitudes, negative attitudes, concern-raising behaviors, and red-flag behaviors. The authors compared changes in knowledge and attitude scores between T1-T2 and T1-T3. Overall, knowledge scores were significantly improved (p < .001) and significantly increased between T1-T2 (p < .0001) and T1-T3 (p = .01). Negative attitudes trended lower over the three time points (p = .07), but a significant decrease in the negative attitudes score was only noted for T1-T3 (Z = -2.16.17, p = .03). Attendance at an educational SCD conference was an effective means to improve knowledge and decrease negative attitudes among clinicians. These differences were maintained at 2 months postconference.
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Affiliation(s)
- Coretta M Jenerette
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Cheryl A Brewer
- Private Diagnostic Clinic PLLC, Duke Medicine, Durham, North Carolina
| | - Susan Silva
- Duke University School of Nursing, Durham, North Carolina
| | - Paula Tanabe
- Duke University Schools of Nursing and Medicine, Durham, North Carolina
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McDonald MA, Creary MS, Powell J, Daley LA, Baker C, Royal CD. Perspectives and Practices of Athletic Trainers and Team Physicians Implementing the 2010 NCAA Sickle Cell Trait Screening Policy. J Genet Couns 2017; 26:1292-1300. [PMID: 28578465 DOI: 10.1007/s10897-017-0107-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 05/02/2017] [Indexed: 11/25/2022]
Abstract
Sickle cell trait (SCT) is usually benign. However, there are some conditions that may lead to SCT-related problems and put athletes with the trait at particular risk. In 2010 the National Collegiate Athletic Association (NCAA) issued a policy that required all Division I (DI) student-athletes to confirm their SCT status or sign a liability waiver to opt out of testing. Athletic trainers and team physicians play key roles in the policy implementation and we examined their perceptions and practices. Between December 2013 and March 2014 we interviewed 13 head athletic trainers and team physicians at NCAA Division I colleges and universities in North Carolina. We used an interview guide with open-ended questions covering knowledge of SCT, historical screening and education practices, current implementation, and policy benefits and challenges. Participants were knowledgeable about SCT and thought the policy was beneficial in providing SCT health information to and for student-athletes. Schools varied in provision of genetic counseling, offering the waiver, SCT tests administered, and other aspects. Challenges included: insufficient guidance from the NCAA; financial considerations; and misunderstanding of the relationships of race and ancestry to SCT risk. Athletic staff found the policy valuable, but felt it needs clarity and standardization.
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Affiliation(s)
- Mary Anne McDonald
- Center on Genomics, Race, Identity, Difference, Duke University, Durham, NC, USA
| | - Melissa S Creary
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Jill Powell
- Center on Genomics, Race, Identity, Difference, Duke University, Durham, NC, USA
| | - Lori-Ann Daley
- Center on Genomics, Race, Identity, Difference, Duke University, Durham, NC, USA
| | - Charlotte Baker
- Institute of Public Health, Florida A&M University, Tallahassee, FL, USA
| | - Charmaine Dm Royal
- Center on Genomics, Race, Identity, Difference, Duke University, Durham, NC, USA. .,Department of African and African American Studies, Duke University, Durham, NC, USA.
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61
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The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population. Pain 2017; 158:1687-1696. [DOI: 10.1097/j.pain.0000000000000964] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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62
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Matthie N, Jenerette C. Understanding the Self-Management Practices of Young Adults with Sickle Cell Disease. JOURNAL OF SICKLE CELL DISEASE AND HEMOGLOBINOPATHIES 2017; 2017:76-87. [PMID: 30505880 PMCID: PMC6269114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Because self-management is central to sickle cell disease (SCD) management, this descriptive study of 18 young adults with SCD, ages 19-39, was conducted to understand their pain experience and to identify the specific home activities they use for pain prevention and management prior to care-seeking. Participants completed two baseline surveys and one semi-structured, individual interview. Content analysis of the interview transcripts yielded two themes: difficulty in describing pain and living with pain. Participants used pharmacological and non-pharmacological strategies to alleviate pain and avoid disease complications but report barriers to using these strategies. Healthcare providers should use study findings to provide appropriate care to and improve pain outcomes for young adults with SCD. In addition, interventions aimed at addressing barriers and optimizing self-management are needed.
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Affiliation(s)
- Nadine Matthie
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
| | - Coretta Jenerette
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, USA
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Jenerette CM, Pierre-Louis BJ, Matthie N, Girardeau Y. Nurses' attitudes toward patients with sickle cell disease: a worksite comparison. Pain Manag Nurs 2016; 16:173-81. [PMID: 26025791 DOI: 10.1016/j.pmn.2014.06.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/05/2014] [Accepted: 06/05/2014] [Indexed: 11/26/2022]
Abstract
Individuals with sickle cell disease (SCD) have reported being stigmatized when they seek care for pain. Nurse attitudes contribute to stigmatization and may affect patients' response to sickle cell cues, care-seeking, and ultimately patient outcomes. The purpose of this cross-sectional, descriptive, comparative design study was to determine whether there are significant differences in nurse attitudes toward patients with SCD by worksite-medical-surgical units compared with emergency departments/intensive care units (ED/ICU). The sample consisted of 77 nurses (36 nurses from the ED/ICU and 41 from medical-surgical units) who completed an anonymous online survey. No significant differences were noted in attitudes by worksite, with nurses from both sites demonstrating high levels of negative attitudes toward patients with SCD. Findings suggest that nurses from both worksites need additional education about SCD and care of this vulnerable, patient population.
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Affiliation(s)
- Coretta M Jenerette
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Bosny J Pierre-Louis
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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Harrison SE, Walcott CM, Warner TD. Knowledge and Awareness of Sickle Cell Trait Among Young African American Adults. West J Nurs Res 2016; 39:1222-1239. [DOI: 10.1177/0193945916665089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sickle cell trait (SCT) places individuals at risk of passing an abnormal hemoglobin gene to biological children and is associated with rare but serious complications. The present study sought to examine knowledge of SCT and awareness of personal trait status among 258 young African American adults. Participants were surveyed regarding demographics, medical history, and sources of sickle cell information before completing a trait knowledge questionnaire. Overall, participants possessed significant misinformation about the condition. Women and those who had learned about sickle cell from families displayed higher levels of knowledge. Most participants were uncertain of personal trait status, and many did not wish to be informed of it. Health care providers should be alert that individuals with SCT may be unaware of their condition and potential reproductive and health implications. Screening and reporting procedures should be examined to ensure individuals have access to and control of this vital health information.
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Evensen CT, Treadwell MJ, Keller S, Levine R, Hassell KL, Werner EM, Smith WR. Quality of care in sickle cell disease: Cross-sectional study and development of a measure for adults reporting on ambulatory and emergency department care. Medicine (Baltimore) 2016; 95:e4528. [PMID: 27583862 PMCID: PMC5008546 DOI: 10.1097/md.0000000000004528] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Documented deficiencies in adult sickle cell disease (SCD) care include poor access to knowledgeable providers and inadequate treatment in emergency departments (EDs).The aim of this study was to create patient-reported outcome measures of the quality of ambulatory and ED care for adults with SCD.We developed and pilot tested SCD quality of care questions consistent with Consumer Assessments of Healthcare Providers and Systems surveys. We applied psychometric methods to develop scores and evaluate reliability and validity.The participants of this study were adults with SCD (n = 556)-63% aged 18 to 34 years; 64% female; 64% SCD-SS-at 7 US sites.The measure used was Adult Sickle Cell Quality of Life Measurement information system Quality of Care survey.Most participants (90%) reported at least 1 severe pain episode (pain intensity 7.8 ± 2.3, 0-10 scale) in the past year. Most (81%) chose to manage pain at home rather than the ED, citing negative ED experiences (83%). Using factor analysis, we identified Access, Provider Interaction, and ED Care composites with reliable scores (Cronbach α 0.70-0.83) and construct validity (r = 0.32-0.83 correlations with global care ratings). Compared to general adult Consumer Assessments of Healthcare Providers and Systems scores, adults with SCD had worse care, adjusted for age, education, and general health.Results were consistent with other research reflecting deficiencies in ED care for adults with SCD. The Adult Sickle Cell Quality of Life Measurement Quality of Care measure is a useful self-report measure for documenting and tracking disparities in quality of SCD care.
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Affiliation(s)
| | - Marsha J. Treadwell
- Department of Hematology/Oncology, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, CA
- Correspondence: Marsha J. Treadwell, UCSF Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 (e-mail: )
| | - San Keller
- American Institutes for Research, Chapel Hill, NC
| | | | | | - Ellen M. Werner
- Blood Epidemiology and Clinical Therapeutics Branch, Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Wally R. Smith
- Division of General Internal Medicine, Virginia Commonwealth University, Richmond, VA
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Derlega VJ, Maduro RS, Janda LH, Chen IA, Goodman BM. What motivates individuals with sickle cell disease to talk with others about their illness? Reasons for and against sickle cell disease disclosure. J Health Psychol 2016; 23:103-113. [PMID: 27235142 DOI: 10.1177/1359105316649786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This interview study documented how individuals with sickle cell disease make decisions about who to talk with concerning their illness based on psychological and interpersonal issues that are important to them. Reasons for sickle cell disease disclosure to specific persons were self-related (receiving support, venting feelings), other-related (educating others about sickle cell disease, forewarning others about sickle cell disease-related problems, someone asked for information about the disease), or situational (mostly focusing on another person being physically close or available to talk to). Reasons for sickle cell disease nondisclosure to specific persons were self-related (fear of rejection, being stereotyped, maintaining privacy) or other-related (lack of support, not worrying someone).
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67
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Wesley KM, Zhao M, Carroll Y, Porter JS. Caregiver Perspectives of Stigma Associated With Sickle Cell Disease in Adolescents. J Pediatr Nurs 2016; 31:55-63. [PMID: 26534838 DOI: 10.1016/j.pedn.2015.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 09/24/2015] [Accepted: 09/27/2015] [Indexed: 11/18/2022]
Abstract
UNLABELLED Patients and families affected by various medical conditions report experiencing health-related stigma, which contributes to detrimental physical, psychological, and social outcomes. Sickle cell disease (SCD) is a genetic disorder that affects 89,000 individuals in the United States and is often associated with negative stereotypes and incorrect assumptions. The present study explored the perception of stigma as reported by caregivers of adolescents with SCD. DESIGN AND METHODS Focus groups were conducted with 20 caregivers of patients with SCD. Focus groups were audio recorded and transcribed. The data were coded independently by two authors, and then reviewed conjointly until consensus was reached. RESULTS Caregivers reported the perception of stigma in academic, medical, community, and family settings. They also reported internalized stigma including negative feelings toward having a child with SCD, feeling upset with others, and seeing negative emotions in their child due to SCD. Caregivers reported a general lack of knowledge about SCD across settings. CONCLUSION These results demonstrated that stigma may affect individuals with SCD across multiple settings. These results also highlighted areas for intervention, with a focus on increasing communication and education toward medical providers, schools, and communities. PRACTICAL IMPLICATIONS Interventions can utilize technology, social media, and advertisement campaigns. Additionally, support groups for patients with SCD may help decrease stigma and validate patients' experiences.
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Affiliation(s)
| | - Mimi Zhao
- The University of Mississippi, Oxford MS
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68
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Mulchan SS, Valenzuela JM, Crosby LE, Diaz Pow Sang C. Applicability of the SMART Model of Transition Readiness for Sickle-Cell Disease. J Pediatr Psychol 2015; 41:543-54. [PMID: 26717957 DOI: 10.1093/jpepsy/jsv120] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 11/22/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study aimed to examine the applicability of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) model for adolescents and young adults (AYA) with sickle-cell disease (SCD). METHODS 14 AYA with SCD (14-24 years old) and 10 clinical experts (6-20 years of experience) completed semi-structured interviews. AYA completed brief questionnaires. Interviews were coded for themes, which were reviewed to determine their fit within the SMART model. RESULTS Overall, most themes were consistent with the model (e.g., sociodemographics/culture, neurocognition/IQ, etc.). Factors related to race/culture, pain management, health-care navigation skills, societal stigma, and lack of awareness about SCD were salient for AYA with SCD. CONCLUSIONS Findings suggest the SMART model may be appropriate in SCD with the consideration of disease-related stigma. This study is a step toward developing a disease-specific model of transition readiness for SCD. Future directions include the development of a measure of transition readiness for this population.
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Affiliation(s)
| | | | - Lori E Crosby
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and
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69
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Dzierzynski N, Stankovic Stojanovic K, Georgin-Lavialle S, Lionnet F. [Issues and difficulties in the relationship between patients and caregivers in painful sickle cell vaso-occlusive crisis]. Rev Med Interne 2015; 37:111-6. [PMID: 26617292 DOI: 10.1016/j.revmed.2015.10.352] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/20/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022]
Abstract
Sickle cell patients in acute pain situation experiment cognitive, behavioral and emotional changes that can accentuate their pain and disrupt communication with caregivers. On the other hand, caregivers have to face pain assessment difficulties and their own psychological reactions to their patient's pain. The gap between the patient's experience and caregiver's evaluation can lead to conflict and non-adherence treatment, and have a direct impact on the sickle cell disease prognosis. There is nothing inevitable about these phenomena, whose knowledge allows the action and opens up prospects for improving the management of sickle cell disease pain. This article is a narrative review updating the interactions between acute pain and some configurations, such as the inability to discern emotions, catastrophizing, post-traumatic stress or feeling ostracized. The overestimation of patient's addiction by caregivers also influences the pain itself. Open communication, as well as some treatments, medicated or not, a consistent institutional organization and a multidisciplinary approach altogether have an analgesic role by acting on pain cognitive and emotional components.
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Affiliation(s)
- N Dzierzynski
- Service de psychiatrie, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France.
| | - K Stankovic Stojanovic
- Service de médecine interne, centre de la drépanocytose, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France
| | - S Georgin-Lavialle
- Service de médecine interne, centre de la drépanocytose, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France
| | - F Lionnet
- Service de médecine interne, centre de la drépanocytose, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France
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Edwards ER, Mottarella K. Perceptions of the Previously Convicted: The Influence of Conviction Type and Therapy Participation. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2015; 59:1358-1377. [PMID: 24903277 DOI: 10.1177/0306624x14536899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The present study explores individuals' desires for social distance from violent versus non-violent offenders and investigates whether disclosure of the offender's therapy completion influences this desire for distance. The study also investigates relationships between participants' desires for social distance and their perceptions of therapy effectiveness with offenders. Using a 2 × 2 factorial design, 150 undergraduate participants completed measures of social distance and perceived offender therapy effectiveness. Overall, respondents indicated higher desires for social distance from offenders convicted of violent versus non-violent crimes. Respondents also reported lower desire for social distance when the offenders reported completing therapy, even when their perception of therapy effectiveness was low. The results of this study have implications for treatment development. Results attest to the value of preparing incarcerated offenders with an accurate expectation of levels and patterns of stigma to be faced upon release and also speak to the value of disclosing treatment completion, especially in the context of healthy interpersonal relationship development and maintenance.
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71
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Matthie N, Hamilton J, Wells D, Jenerette C. Perceptions of young adults with sickle cell disease concerning their disease experience. J Adv Nurs 2015; 72:1441-51. [PMID: 26350494 DOI: 10.1111/jan.12760] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 01/19/2023]
Abstract
AIM To describe the perceptions of young adults with sickle cell disease concerning their disease experience. BACKGROUND Sickle cell disease is a lifelong, genetic condition with both acute and chronic painful exacerbations. Little is known of the experiences of young adults with sickle cell disease. DESIGN This study used a qualitative, descriptive design with semi-structured, life review interviews. METHODS Between August 2010-September 2012, purposive sampling was used to recruit participants with a known sickle cell disease diagnosis who were ages 18-35 years, were being seen in an outpatient sickle cell clinic and were English speaking. Participants provided demographic information and responded to two interviews. A content analysis was then used to interpret participants' narratives of their experiences of living with sickle cell disease. RESULTS/FINDINGS A sample of 29 young adults with sickle cell disease consisted of 79·3% females, 35·6% employed full-time or part-time, 71·6% single/never married and 57·8% with sickle cell anaemia. Their mean age was 25·8 with 13·2 years of education. Four major interview themes were identified: (1) struggles to maintain or achieve good quality of life or life satisfactions; (2) strategies to maintain self-care; (3) interruptions to family, work and social roles; and (4) difficulties accessing needed health care. CONCLUSION Young adults face many challenges while living with sickle cell disease. With a better understanding of their disease experience and how it influences their quality of life, researchers can begin tailoring appropriate interventions to improve health outcomes in this vulnerable, minority population.
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Affiliation(s)
- Nadine Matthie
- University of North Carolina at Chapel Hill, School of Nursing, North Carolina, USA
| | - Jill Hamilton
- Johns Hopkins University, School of Nursing, Baltimore, Maryland, USA
| | - Diana Wells
- University of North Carolina at Chapel Hill, School of Medicine, North Carolina, USA
| | - Coretta Jenerette
- University of North Carolina at Chapel Hill, School of Nursing, North Carolina, USA
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Forrester AB, Barton-Gooden A, Pitter C, Lindo JLM. The lived experiences of adolescents with sickle cell disease in Kingston, Jamaica. Int J Qual Stud Health Well-being 2015; 10:28104. [PMID: 26341889 PMCID: PMC4560734 DOI: 10.3402/qhw.v10.28104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/14/2022] Open
Abstract
Aim To explore the lived experiences of adolescents with sickle cell disease, in Kingston, Jamaica. Method A descriptive qualitative design was used for this research. In-depth interviews were conducted with six adolescents with sickle cell disease at a Sickle Cell Unit operated by the University of the West Indies. Interviews were audiotaped, transcribed, and thematically analyzed. Results The majority of the adolescents demonstrated a positive self-concept. They reported strong family, school, and peer support which made them feel accepted. All were actively engaged in social activities such as parties, but had challenges participating in sporting activities. Various coping strategies were utilized to address challenges of the disease including praying, watching television, and surfing the Internet. Conclusion Sickle cell disease can be very challenging for the adolescent, but with positive self-concept and increased social support, especially from family and peers, these adolescents were able to effectively cope with their condition and live productive lives.
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Affiliation(s)
- Andrea Brown Forrester
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
| | - Antoinette Barton-Gooden
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
| | - Cynthia Pitter
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
| | - Jascinth L M Lindo
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica; ;
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73
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Motivations of women with sickle cell disease for asking their partners to undergo genetic testing. Soc Sci Med 2015; 139:36-43. [DOI: 10.1016/j.socscimed.2015.06.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 06/16/2015] [Accepted: 06/24/2015] [Indexed: 01/16/2023]
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74
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Adeyemo TA, Ojewunmi OO, Diaku-Akinwumi IN, Ayinde OC, Akanmu AS. Health related quality of life and perception of stigmatisation in adolescents living with sickle cell disease in Nigeria: A cross sectional study. Pediatr Blood Cancer 2015; 62:1245-51. [PMID: 25810358 DOI: 10.1002/pbc.25503] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 02/10/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sickle cell disease impacts the physical, emotional and psychological aspects of life of the affected persons, often times exposing them to disease associated stigma from the society and alters the health related quality of life (HRQoL). This study compared the HRQoL of adolescents with sickle cell disease with their healthy peers, identified socio-demographic and clinical factors impacting HRQoL, and determined the extent and effects of SCD related stigma on quality of life. PROCEDURE We conducted a cross-sectional survey among 160 adolescents, 80 with SCD and 80 adolescents without SCD. Socio-demographic and clinical data were collected using a pre-tested questionnaire. HRQoL was investigated using the Short Form (SF-36v2) Health Survey. SCD perceived stigma was measured using an adaptation of a perceived stigma questionnaire. RESULTS Adolescents with SCD have significantly worse HRQoL than their peers in all of the most important dimensions of HRQoL (physical functioning, physical roles limitation, emotional roles limitation, social functioning, bodily pain, vitality and general health perception) except mental health. Recent hospital admission and SCD related complication further lowered HRQoL scores. Over seventy percent of adolescents with SCD have moderate to high level of perception of stigmatisation. Hospitalisation, SCD complication, SCD stigma were inversely, and significantly associated with HRQoL. CONCLUSIONS Adolescents living with SCD in Nigeria have lower health related quality of life compared to their healthy peers. They also experience stigma that impacts their HRQoL. Complications of SCD and hospital admissions contribute significantly to this impairment.
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Affiliation(s)
- Titilope A Adeyemo
- Department of Haematology & Blood Transfusion, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Lagos, Nigeria
| | | | | | - Oluwaseyi C Ayinde
- Department of Biomedical Sciences, Aston University, Birmingham, United Kingdom
| | - Alani S Akanmu
- Department of Haematology & Blood Transfusion, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Lagos, Nigeria
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Molter BL, Abrahamson K. Self-Efficacy, Transition, and Patient Outcomes in the Sickle Cell Disease Population. Pain Manag Nurs 2015; 16:418-24. [DOI: 10.1016/j.pmn.2014.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 06/03/2014] [Accepted: 06/03/2014] [Indexed: 12/22/2022]
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Derlega VJ, Janda LH, Miranda J, Chen IA, Goodman BM, Smith W. How Patients' Self-Disclosure about Sickle Cell Pain Episodes to Significant Others Relates to Living with Sickle Cell Disease. PAIN MEDICINE 2014; 15:1496-507. [DOI: 10.1111/pme.12535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Overlapping biological mechanisms underlying sickle cell disease, stress, and depression: a stress-vulnerability framework. Harv Rev Psychiatry 2014; 22:205-15. [PMID: 24887328 DOI: 10.1097/hrp.0000000000000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After participating in this activity, learners should be better able to:1. Evaluate the overlap between sickle cell disease (SCD) and depression.2. Identify sources of psychological stress and biological vulnerabilities toward developing depression in patients with SCD.3. Assess the potential mechanisms underlying SCD, stress, and depression.Depression is a common co-occurring disorder in persons with sickle-cell disease (SCD). Individuals with this chronic illness may be particularly vulnerable to depression. In addition to risk factors for depression specifically related to SCD, these individuals typically experience further psychological stress due to multiple risk factors in their environment. To date, however, little research has focused on the co-occurring biological mechanisms across these conditions and how those mechanisms may interact to produce depressive symptoms. In this review we use a stress-vulnerability framework to describe the sources of psychological stress and the SCD factors that increase the risk of depression. We suggest that several biological factors, such as nitric oxide and cytokines, may play an important role in co-occurring stress, SCD, and depression. The interaction of these factors may be of particular importance for understanding the comorbidity of SCD and depression. Implications for current treatment and future research are discussed.
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Treadwell MJ, Bell M, Leibovich SA, Barreda F, Marsh A, Gildengorin G, Morris CR. A Quality Improvement Initiative to Improve Emergency Department Care for Pediatric Patients with Sickle Cell Disease. JOURNAL OF CLINICAL OUTCOMES MANAGEMENT : JCOM 2014; 21:62-70. [PMID: 26412961 PMCID: PMC4580258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determine whether a quality improvement (QI) initiative would result in more timely assessment and treatment of acute sickle cell-related pain for pediatric patients with sickle cell disease (SCD) treated in the emergency department (ED). METHODS We created and implemented a protocol for SCD pain management in the ED with the goals of improving (1) mean time from triage to first analgesic dose; (2) percentage of patients that received their first analgesic dose within 30 minutes of triage, and (3) percentage of patients who had pain assessment performed within 30 minutes of triage and who were re-assessed within 30 minutes after the first analgesic dose. RESULTS Significant improvements were achieved between baseline (55 patient visits) and post order set implementation (165 visits) in time from triage to administration of first analgesic (decreased from 89.9 ± 50.5 to 35.2 ± 22.8 minutes, P < 0.001); percentage of patient visits receiving pain medications within 30 minutes of triage (from 7% to 53%, P < 0.001); percentage of patient visits assessed within 30 minutes of triage (from 64% to 99.4%, P < 0.001); and percentage of patient visits re-assessed within 30 minutes of initial analgesic (from 54% to 86%, P < 0.001). CONCLUSIONS Implementation of a QI initiative in the ED led to expeditious care for pediatric patients with SCD presenting with pain. A QI framework provided us with unique challenges but also invaluable lessons as we address our objective of decreasing the quality gap in SCD medical care.
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Affiliation(s)
| | - Michael Bell
- Children's Hospital & Research Center Oakland, Oakland, CA
| | | | | | - Anne Marsh
- Children's Hospital & Research Center Oakland, Oakland, CA
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79
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Olakunle OS, Kenneth E, Olakekan AW, Adenike OB. Knowledge and attitude of secondary school students in Jos, Nigeria on sickle cell disease. Pan Afr Med J 2013; 15:127. [PMID: 24255733 PMCID: PMC3830461 DOI: 10.11604/pamj.2013.15.127.2712] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/17/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction Knowledge about sickle cell disease among youths could constitute an important variable that influences their premarital attitude and behaviour. The study is to determine the knowledge and attitude on Sickle Cell Disease among selected secondary school students in Jos metropolis, Nigeria. Methods A cross sectional descriptive study involving 137 Secondary School Students within Jos metropolis selected by a multistage stratified sampling technique, using self administered structured questionnaire. Data were analyzed using SPSS version 17. Results A total of 137 students were interviewed, Christians 88%, modal age range 15-20 years (72%) and males (51%). Majority (83.2%) of the respondents were aware of SCDs, as an inherited disorder (80.0%), affecting the red blood cells (83.0%) but only half (54%) knew that the disease can only be diagnosed through blood test. Also, only 59% knew their genotype and 11. 1% claimed AS genotype. More than one fourth (25.5%) had wrong belief that SCD is caused by evil spirit while 76% showed wrong attitude involving stigmatization towards individuals with sickle cell disease. Conclusion Comprehensive knowledge about SCD was found to be low despite good awareness among respondents, but only few knew their haemoglobin genotype. If sickle cell disease control strategies must yield any significant results, there is a need to raise awareness about SCD, especially among students in secondary institutions in Nigeria is recommended.
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Affiliation(s)
- Olarewaju Sunday Olakunle
- Department of Community Medicine, LAUTECH Teaching Hospital Ogbomosho Nigeria ; Managing Partner, Omega-Cares Foundation, Jos, Plateau State, Nigeria
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80
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Figueiredo MS. Sexuality and sickle cell disease. Rev Bras Hematol Hemoter 2013; 35:77-8. [PMID: 23741178 PMCID: PMC3672110 DOI: 10.5581/1516-8484.20130021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 12/23/2012] [Indexed: 11/27/2022] Open
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Jenerette CM, Brewer CA, Ataga KI. Care seeking for pain in young adults with sickle cell disease. Pain Manag Nurs 2013; 15:324-30. [PMID: 23343879 DOI: 10.1016/j.pmn.2012.10.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 10/29/2012] [Accepted: 10/29/2012] [Indexed: 11/25/2022]
Abstract
In individuals with sickle cell disease (SCD), recognizing the cues to an acute pain episode and responding appropriately are important. The purpose of this mixed-methods pilot study is to identify preliminary factors that influence care seeking for pain in young adults with SCD. Responses were received from 69 young adults with SCD, age 18-35 years. The majority of respondents (88%) wait until the pain intensity is an average of 8.7 (± 1.2) on a scale of 1 to 10 before seeking care. Prominent themes influencing care seeking for pain include: trying to treat pain at home, avoiding the emergency department because of past treatment experiences, the desire to avoid admission to the hospital, and the importance of time in the lives of the young adults with SCD. Young adults with SCD need additional support from family and healthcare providers in order to make timely, appropriate decisions regarding care seeking.
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Affiliation(s)
- Coretta M Jenerette
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Cheryl A Brewer
- Duke Cancer Care Research Program, Duke Cancer Institute, Durham, North Carolina
| | - Kenneth I Ataga
- Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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82
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Moore AD, Hamilton JB, Knafl GJ, Godley PA, Carpenter WR, Bensen JT, Mohler JL, Mishel M. Patient Satisfaction Influenced by interpersonal treatment and communication for African American men: the North Carolina-Louisiana Prostate Cancer Project (PCaP). Am J Mens Health 2012; 6:409-19. [PMID: 22833311 DOI: 10.1177/1557988312443695] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to determine if a particular set of health behaviors of health care providers and African American men (AAM) influence patient satisfaction from the AAM's perspective. This descriptive, correlational study consisted of 505 AAM in North Carolina diagnosed with prostate cancer and enrolled in the North Carolina-Louisiana Prostate Cancer Project (PCaP). Analyses consisted of bivariate analyses and multiple regression. Patient-to-provider communication, interpersonal treatment, and provider-to-patient communication accounted for 45% (p ≤ .0001) of the variability in patient satisfaction. Interpersonal treatment (provider focusing on the patient) explained the greatest amount (F = 313.53, R² = .39) of patient satisfaction. Since interpersonal treatment focuses on the patient and demonstrated to be the strongest predictor in patient satisfaction, it is noteworthy to consider the emphasis that should be placed on patient-centered care. In addition, knowing important variables positively affecting patient satisfaction provides useful information for developing appropriate interventions to improve AAM health care experiences.
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Affiliation(s)
- Angelo D Moore
- U.S Army, Tripler Army Medical Center, Honolulu, HI, USA.
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83
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Taft TH, Ballou S, Keefer L. A preliminary evaluation of internalized stigma and stigma resistance in inflammatory bowel disease. J Health Psychol 2012; 18:451-60. [PMID: 22689587 DOI: 10.1177/1359105312446768] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Illness stigmatization among inflammatory bowel diseases (IBDs) is poorly understood. We aim to characterize internalized stigma and stigma resistance in IBD patients, and evaluate their relationships to outcomes. A total of 191 IBD patients reported internalized stigma, resistance, demographic and clinical information, and several outcomes: health-related quality of life (HRQOL), psychological distress, self-esteem, and self-efficacy. Overall 36% experienced internalized stigma and 88% moderate to high stigma resistance behaviors. Internalized stigma strongly related to poorer outcomes while resistance demonstrated a weaker, opposite effect. Internalized stigma and stigma resistance are important considerations for IBD outcomes. Interventions to reduce internalized stigma and leverage resistance are warranted.
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Affiliation(s)
- Tiffany H Taft
- Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Jenerette C, Brewer CA, Crandell J, Ataga KI. Preliminary validity and reliability of the Sickle Cell Disease Health-Related Stigma Scale. Issues Ment Health Nurs 2012; 33:363-9. [PMID: 22646200 DOI: 10.3109/01612840.2012.656823] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There have been no published studies that measure health-related stigma in individuals with sickle cell disease (SCD). This study provides preliminary validity and reliability of the Sickle Cell Disease Health-Related Stigma Scale (SCD-HRSS). Using a sample of 77 young adults with SCD, ages 18-35 years, the results support the reliability of the SCD-HRSS with an overall Cronbach's alpha reliability of 0.84 and construct validity with a positive correlation between SCD-HRSS and a measure of depressive symptoms. Participants reported the highest levels of perceived stigma from the general public, then doctors, and lastly family. Limitations and directions for future research are discussed.
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Affiliation(s)
- Coretta Jenerette
- School of Nursing, The University of North Carolina at Chapel Hill, NC, USA
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85
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Situation, Background, Assessment, and Recommendation (SBAR) May Benefit Individuals Who Frequent Emergency Departments: Adults With Sickle Cell Disease. J Emerg Nurs 2011; 37:559-61. [DOI: 10.1016/j.jen.2011.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 02/09/2011] [Accepted: 02/10/2011] [Indexed: 11/20/2022]
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Self-care recommendations of middle-aged and older adults with sickle cell disease. Nurs Res Pract 2011; 2011:270594. [PMID: 21994819 PMCID: PMC3168929 DOI: 10.1155/2011/270594] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 07/02/2011] [Accepted: 07/04/2011] [Indexed: 11/17/2022] Open
Abstract
Self-care management is an important part of living with a chronic illness. Sickle cell disease (SCD) is a chronic disease with acute, painful exacerbations that often results in a shortened life expectancy. Some middle-aged and older adults with SCD lived with the disease prior to having a diagnosis and without modern advances. The purpose of this study is to share the self-care recommendations of middle-aged and older adults with SCD. Using descriptive qualitative methods, data were gathered through semistructured interviews from 11 individuals living with SCD, including 6 women and 5 men. Self-care recommendations themes included physiological, psychological, and provider-related. The self-care recommendations may be seen as an additional resource or "words of wisdom" for younger adults with SCD who can use the recommendations to better manage their own disease. Additionally, providers may be able to use these recommendations to inform their practice.
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87
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Bundy DG, Strouse JJ, Casella JF, Miller MR. Urgency of emergency department visits by children with sickle cell disease: a comparison of 3 chronic conditions. Acad Pediatr 2011; 11:333-41. [PMID: 21764017 DOI: 10.1016/j.acap.2011.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 04/25/2011] [Accepted: 04/28/2011] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Children with sickle cell disease (SCD) often receive care in the emergency department (ED), but the urgency of these frequent visits is not well understood. This study examined ED use by children with SCD by comparing the urgency of ED visits among children with SCD, asthma, and diabetes mellitus. METHODS We conducted a retrospective cohort study of Maryland ED visits for SCD, diabetes, or asthma from 2000 to 2004. ED visits resulting in hospital admission were deemed urgent. The urgency of ED visits not resulting in admission was determined using 2 methodologies: evaluation and management (E/M) coding and resource utilization. Multivariable logistic regression models were used to compare the likelihood of admission or urgent, treat-and-release ED visits across the 3 chronic conditions. RESULTS Nearly half (45%) of ED visits with a primary diagnosis of SCD resulted in admission, which was substantially higher than the 12% seen for asthma (adjusted odds ratio [AOR] 6.9, 95% confidence interval [CI], 6.4-7.4) and comparable to that seen for diabetes (41%). ED visits associated with primary diagnoses of SCD (AOR 5.9, 95% CI, 5.3-6.5) and diabetes (AOR 6.6, 95% CI, 6.0-7.3) were more likely than those associated with asthma to result in either admission or a discharge of higher urgency, as measured by E/M coding. These relationships persisted among repeat ED visitors, for visits with any diagnosis (ie, primary or nonprimary) of SCD, diabetes, and asthma, and when evaluated using the resource utilization method. CONCLUSIONS Similar to visits by children with diabetes, ED visits by children with SCD are substantially more likely than those by children with asthma to be of high urgency.
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Affiliation(s)
- David G Bundy
- Department of Pediatrics, Division of Quality and Safety, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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