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Lysandrou M, Quaye N, Landes K, Crawford RD, Desai P, Creary S, Schnell PM, Cronin RM. Evaluating self- vs interviewer-administered screening for depression in sickle cell disease. Blood Adv 2024; 8:699-702. [PMID: 38113469 PMCID: PMC10844810 DOI: 10.1182/bloodadvances.2023012083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
| | - Nives Quaye
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
| | - Kristina Landes
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
| | - Regina D. Crawford
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
| | - Payal Desai
- Hematology, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Susan Creary
- Center for Child Health Equity Outcomes and Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH
| | - Patrick M. Schnell
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH
| | - Robert M. Cronin
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
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2
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Smith WR, McClish DK, Bovbjerg VE, Singh HK. Development and validation of the sickle cell stress scale-adult. Eur J Haematol Suppl 2022; 109:215-225. [PMID: 35585659 PMCID: PMC9531901 DOI: 10.1111/ejh.13789] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/28/2022]
Abstract
Disease‐specific stress can partly explain Sickle Cell Disease (SCD) healthcare utilization. We developed and validated two measures of adult SCD‐specific stress for research and clinical care. A large cohort of adults with SCD completed both the 3‐item Likert‐scale adapted from a previous disease stress measure and a 10‐item Likert‐scale questionnaire drafted specifically to measure SCD stress. They concurrently completed a psychosocial and health‐related quality of life scale battery, then subsequently daily pain diaries. Diaires measured: daily intensity, distress and interference of pain; self‐defined vaso‐occlusive crises (VOC), opioid use, and types of healthcare utilization for up to 24 weeks. Analyses tested Cronbach's alpha, correlation of the three‐item and 10‐item stress scales with the concurrent battery, with percentages of pain days, VOC days, opioid use days, and healthcare utilization days, and correlation of baseline stress and 6‐month stress for the 10‐item scale. Cronbach's alpha was high for both the 3‐item (0.73) and 10‐item (0.83) SCD stress scales, test–retest correlation of 0.55, expected correlation with the concurrent battery, and correlation with diary‐measured healthcare utilization over 6 months. The correlations with the 3‐item scale were stronger, but only statistically significant for depression‐anxiety. The correlation between the two stress scales was 0.59. Both the 3‐item and the 10‐item stress scales exhibited good face, construct, concurrent, and predictive validity as well as moderate test–retest reliability. Further scale validation should determine population norms and response to interventions.
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Affiliation(s)
- Wally R Smith
- Section of Research, Division of General Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Donna K McClish
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Viktor E Bovbjerg
- College of Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Harjot K Singh
- Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA
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3
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Jonassaint CR, Lukombo I, Feldman R, Driscoll J, Eack SM, Abebe KZ, De Castro L. Differences in the prevalence of mental health disorders among Black American adults with sickle cell disease compared to those with non-heritable medical conditions or no medical conditions. Br J Haematol 2021; 196:1059-1068. [PMID: 34859423 DOI: 10.1111/bjh.17962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
Our aim was to determine differences in the prevalence of mental health disorders between Black Americans living with sickle cell disease (SCD) and Black Americans with other, non-heritable medical conditions, or no medical conditions. We examined the prevalence of mental health disorders among a non-institutionalized, community sample of Black adults in the US from the National Survey of American Life. We compared the odds of mental health disorders between Black American adults with SCD and those with other medical conditions, or no medical condition. Among the SCD group, 38·8% reported at least one mental health disorder: 17·6% endorsed a mood disorder, 24·7% an anxiety disorder, 2·4% an eating disorder, and 11·8% a childhood disorder. Compared to those with other medical conditions, Black Americans with SCD had greater poverty, more children in the household, and were less likely to be married/cohabitating (all P < 0·05). Yet, Black Americans with SCD were not at greater odds of having a mental health disorder compared to those with other medical conditions. When compared to the group with no conditions, however, individuals with SCD had 2·57 greater odds of mood disorder (95% confidence interval: 1·43-4·65; P = 0·002). The effect remained when controlling for socioeconomic status, marital status, and perceived physical health. In this study, almost 40% of Black American adults with SCD presented with a mental health disorder. Prevalence of mental health disorders was similar among those with non-heritable medical conditions, but those without a medical condition had a lower prevalence than in SCD. Among Black Americans, there appear to be unmeasured factors, common across medical conditions, that are linked to mental health disorders.
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Affiliation(s)
- Charles R Jonassaint
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ines Lukombo
- Section of Benign Hematology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert Feldman
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jordan Driscoll
- Section of Benign Hematology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shaun M Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kaleab Z Abebe
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Laura De Castro
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Section of Benign Hematology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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4
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Understanding how psychosocial factors relate to seeking medical care among older adults using a new model of care seeking. Soc Sci Med 2021; 281:114113. [PMID: 34144482 DOI: 10.1016/j.socscimed.2021.114113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 01/07/2023]
Abstract
RATIONALE Research has identified psychosocial factors related to the use of health services among the older population; however, the specific roles by which these factors drive behavior have not been identified and empirically tested. OBJECTIVE This study tested whether previously identified psychosocial factors decrease or increase the motivational potential to seek care, the motivational sensitivity to perceived access, or the motivational sensitivity to perceived need. METHODS The 2014 U.S. Health and Retirement Study was used. Analysis was based on 2589 older noninstitutionalized respondents (age greater than 64). The dependent variable was the number of healthcare provider visits in the preceding two years. Psychosocial factors included were life satisfaction, social network indicators, optimism, pessimism, positive social support, hopelessness, loneliness, self-efficacy, health efficacy, positive affect, negative affect, and purpose in life. Covariates included age and sex. Maximum likelihood estimation of an interpretable structural model was used. RESULTS Results of the study provide evidence that psychosocial variables are related to health care seeking through both motivational potential and sensitivity parameters. Some psychosocial variables are related to multiple roles. For example, pessimism is related to a lower motivational potential and is more sensitive to access at higher levels of access, whereas hopelessness is related to a higher motivational potential and more sensitive to need and access at lower levels of each. CONCLUSIONS Findings imply psychosocial characteristics are related to health care seeking and utilization of older adults via different roles that can countervail each other, and therefore the influence of interventions can be complex. To address this, complex interventions may be required.
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Pantaleao A, DiPlacido J, Guite JW, Zempsky WT. Caregiver factors related to emergency department utilization for youth with sickle cell disease. CHILDRENS HEALTH CARE 2018. [DOI: 10.1080/02739615.2018.1454838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ashley Pantaleao
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Joanne DiPlacido
- Department of Psychological Science, Central Connecticut State University, New Britain, CT, USA
| | - Jessica W. Guite
- The Center for Behavioral Health, Connecticut Children’s Medical Center, Hartford, CT, USA
| | - William T. Zempsky
- Division of Pain & Palliative Medicine, Connecticut Children’s Medical Center, Hartford, CT, USA
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Comorbidity, Pain, Utilization, and Psychosocial Outcomes in Older versus Younger Sickle Cell Adults: The PiSCES Project. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4070547. [PMID: 28459058 PMCID: PMC5387810 DOI: 10.1155/2017/4070547] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/08/2017] [Indexed: 01/24/2023]
Abstract
Background. Patients with SCD now usually live well into adulthood. Whereas transitions into adulthood are now often studied, little is published about aging beyond the transition period. We therefore studied age-associated SCD differences in utilization, pain, and psychosocial variables. Methods. Subjects were 232 adults in the Pain in Sickle Cell Epidemiology Study (PiSCES). Data included demographics, comorbidity, and psychosocial measures. SCD-related pain and health care utilization were recorded in diaries. We compared 3 age groups: 16–25 (transition), 26–36 (younger adults), and 37–64 (older adults) years. Results. Compared to the 2 adult groups, the transition group reported fewer physical challenges via comorbidities, somatic complaints, and pain frequency, though pain intensity did not differ on crisis or noncrisis pain days. The transition group utilized opioids less often, made fewer ambulatory visits, and had better quality of life, but these differences disappeared after adjusting for pain and comorbidities. However, the transition group reported more use of behavioral coping strategies. Conclusion. We found fewer biological challenges, visits, and better quality of life, in transition-aged versus older adults with SCD, but more behavioral coping. Further study is required to determine whether age-appropriate health care, behavioral, or other interventions could improve age-specific life challenges of patients with SCD.
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Schlenz AM, Schatz J, Roberts CW. Examining Biopsychosocial Factors in Relation to Multiple Pain Features in Pediatric Sickle Cell Disease. J Pediatr Psychol 2016; 41:930-40. [PMID: 26869665 PMCID: PMC4982540 DOI: 10.1093/jpepsy/jsw003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/04/2016] [Accepted: 01/08/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine biopsychosocial variables in relation to multiple pain features in pediatric sickle cell disease (SCD). METHODS 76 children with SCD (M = 14.05, SD = 3.26), ages 8-19 years, and 70 caregivers completed measures of coping, mood, and family functioning and reported on multiple pain features via retrospective interviews during routine hematological visits. Sickle cell genotype and health care utilization were collected via medical record review. Using hierarchical regression, biological (genotype), child psychological (coping and mood), and social factors (caregiver coping and family functioning) were evaluated in relation to multiple pain features. RESULTS Genotype was associated with pain intensity, and child psychological factors were associated with pain frequency. Multiple biopsychosocial factors were related to health care utilization. CONCLUSIONS Biopsychosocial factors may have distinct relationships with pain features in pediatric SCD. Understanding these relationships may refine the biopsychosocial model and inform integrated medical and psychosocial approaches in SCD.
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Affiliation(s)
- Alyssa M Schlenz
- Department of Psychology, University of South Carolina, Department of Pediatrics, Medical University of South Carolina, and
| | | | - Carla W Roberts
- Department of Pediatrics, University of South Carolina School of Medicine
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Bediako SM, Lavender AR, Yasin Z. Racial Centrality and Health Care Use Among African American Adults With Sickle Cell Disease. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798407307044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study examined an exploratory model of the confluence of racial centrality, pain, psychological variables, and health care use in a sample of African American adults with sickle cell disease. Significant path coefficients were observed between pain severity, perceived stress, and psychological symptoms. The model yielded direct effects for paths to health care use from pain frequency and racial centrality—indicating that participants who reported more frequent pain episodes tended to use more health care services and those who endorsed a highly central African American identity utilized fewer health care services. Generally, these findings suggest a need for expanded thinking about determinants of health care use in this population beyond psychological and physiological variables. These findings support a rationale for further exploring the sociocultural context of sickle cell and highlight a specific need for better understanding the complex relationships among multidimensional aspects of racial identity and health care use.
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Jonassaint CR, Jones VL, Leong S, Frierson GM. A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease. Br J Haematol 2016; 174:136-47. [DOI: 10.1111/bjh.14023] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Victor L. Jones
- Department of Psychology; Howard University; Washington DC USA
| | - Sharlene Leong
- Department of Psychology; Howard University; Washington DC USA
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10
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Jonassaint CR, Beach MC, Haythornthwaite JA, Bediako SM, Diener-West M, Strouse JJ, Lanzkron S, Onojobi G, Carroll CP, Haywood C. The Association between Educational Attainment and Patterns of Emergency Department Utilization among Adults with Sickle Cell Disease. Int J Behav Med 2016; 23:300-309. [DOI: 10.1007/s12529-016-9538-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Bediako SM, Lanzkron S, Diener-West M, Onojobi G, Beach MC, Haywood C. The Measure of Sickle Cell Stigma: Initial findings from the Improving Patient Outcomes through Respect and Trust study. J Health Psychol 2014; 21:808-20. [PMID: 24997169 DOI: 10.1177/1359105314539530] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Research about the influence of stigma on health outcomes in sickle cell disease is limited. We administered the recently developed Measure of Sickle Cell Stigma to 262 patients in the United States. The Measure of Sickle Cell Stigma yielded very good internal consistency and four interpretable factors. Significant associations among stigma, pain-related healthcare utilization, and perceived disease severity were observed for three of the four stigma factors (F range = 2.78-5.44). The Measure of Sickle Cell Stigma appears to be a useful tool for measuring disease-specific stigma among adults living with sickle cell disease, and further assessment of its clinical utility is warranted.
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Affiliation(s)
| | | | | | | | - Mary C Beach
- The Johns Hopkins University School of Medicine, USA
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Taylor LEV, Stotts NA, Humphreys J, Treadwell MJ, Miaskowski C. A biopsychosocial-spiritual model of chronic pain in adults with sickle cell disease. Pain Manag Nurs 2013; 14:287-301. [PMID: 24315252 PMCID: PMC3857562 DOI: 10.1016/j.pmn.2011.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 06/04/2011] [Accepted: 06/06/2011] [Indexed: 01/30/2023]
Abstract
Chronic pain in adults with sickle cell disease (SCD) is a complex multidimensional experience that includes biologic, psychologic, sociologic, and spiritual factors. To date, three models of pain associated with SCD (i.e., biomedical model, biopsychosocial model for SCD pain, and Health Beliefs Model) have been published. The biopsychosocial multidimensional approach to chronic pain developed by Turk and Gatchel is a widely used model of chronic pain. However, this model has not been applied to chronic pain associated with SCD. In addition, a spiritual/religious dimension is not included in this model. Because spirituality/religion is central to persons affected by SCD, that dimension needs to be added to any model of chronic pain in adults with SCD. In fact, data from one study suggest that spirituality/religiosity is associated with decreased pain intensity in adults with chronic pain from SCD. A biopsychosocial-spiritual model is proposed for adults with chronic pain from SCD, because it embraces the whole person. This model includes the biologic, psychologic, sociologic, and spiritual factors relevant to adults with SCD based on past and current research. The purpose of this paper is to describe an adaptation of Turk and Gatchel's model of chronic pain for adults with SCD and to summarize research findings that support each component of the revised model (i.e., biologic, psychologic, sociologic, spiritual). The paper concludes with a discussion of implications for the use of this model in research.
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Affiliation(s)
- Lou Ella V Taylor
- Department of Physiological Nursing University of California, San Francisco.
| | - Nancy A Stotts
- Department of Physiological Nursing University of California, San Francisco
| | - Janice Humphreys
- Department of Family Health Care Nursing University of California, San Francisco
| | - Marsha J Treadwell
- Sickle Cell Center, Children's Hospital and Research Center, Oakland, California
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Raphael JL, Butler AM, Rattler TL, Kowalkowski MA, Mueller BU, Giordano TP. Parental information, motivation, and adherence behaviors among children with sickle cell disease. Pediatr Blood Cancer 2013; 60:1204-10. [PMID: 23303618 PMCID: PMC3717582 DOI: 10.1002/pbc.24466] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 12/11/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Identification of psychosocial correlates of health care utilization has become an important strategy in improving clinical care. The objective of the study was to examine the fit of the Information-Motivation-Behavioral Skills (IMB) model, applied to health care utilization among children with sickle cell disease (SCD). PROCEDURE Participants were parents of 150 children, ages 1-17 years, receiving care in a sickle cell center. Parents completed questionnaires assessing information, motivation, adherence behaviors, and other factors with respect to SCD management. Data regarding health care utilization in the previous 12 months were obtained from parent report and electronic medical records. Stepwise multiple regression analysis was conducted to determine associations between IMB factors and health care use. RESULTS Parents rated highly in the domains of information, motivation, and adherence behaviors for managing their child's SCD. Children of parents reporting higher satisfaction with social supports had higher odds (OR 1.49, 95% CI 1.03-2.15) of two or more routine hematology visits in the previous 12 months. Neither information nor adherence behavior was associated with urgent or routine care use. Among other variables measured, high parental illness-related stress and child health status reported as fair/poor were the strongest predictors of urgent care use while private insurance type was the strongest predictor of routine care use. CONCLUSIONS Among IMB factors, social support was associated with routine health care utilization. Social support and parental illness-related stress may serve as important, modifiable targets in interventions to allocate needed resources to families and reduce unnecessary medical care.
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Affiliation(s)
- Jean L. Raphael
- Department of Pediatrics, Baylor College of Medicine, Hematology/Oncology, Houston, TX
| | - Ashley M. Butler
- Department of Pediatrics, Baylor College of Medicine, Psychology, Houston, TX
| | - Tiffany L. Rattler
- Department of Pediatrics, Baylor College of Medicine, Hematology/Oncology, Houston, TX
| | | | - Brigitta U. Mueller
- Department of Pediatrics, Baylor College of Medicine, Hematology/Oncology, Houston, TX
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Sanders KA, Labott SM, Molokie R, Shelby SR, Desimone J. Pain, coping and health care utilization in younger and older adults with sickle cell disease. J Health Psychol 2010; 15:131-7. [PMID: 20064892 DOI: 10.1177/1359105309345554] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sickle cell disease is characterized by acute pain crises. Pain, chronic medical problems, utilization and coping were compared in younger vs older patients using questionnaires and medical record review. Groups reported similar pain intensity and medical conditions. The pattern of utilization differed such that older patients attended outpatient clinic, and younger patients went to the Emergency Department. Younger patients were more likely to cope by ignoring pain, or by using heat, cold or massage. Older patients were more likely to pray and hope. We conclude that age plays an important role in the utilization and coping of sickle cell patients.
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Affiliation(s)
- Kathryn A Sanders
- VA Connecticut Healthcare System & Yale University School of Medicine, West Haven, CT 06516, USA.
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15
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Pells J, Edwards CL, McDougald CS, Wood M, Barksdale C, Jonassaint J, Leach-Beale B, Byrd G, Mathis M, Harrison MO, Feliu M, Edwards LY, Whitfield KE, Rogers L. Fear of Movement (Kinesiophobia), Pain, and Psychopathology in Patients With Sickle Cell Disease. Clin J Pain 2007; 23:707-13. [PMID: 17885350 DOI: 10.1097/ajp.0b013e31814da3eb] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Fear of movement (ie, kinesiophobia) has emerged as a significant predictor of pain-related outcomes including disability and psychologic distress across various types of pain (eg, back pain, headache, fibromyalgia, complex regional pain syndrome). However, no research has examined the prevalence of kinesiophobia in adults with sickle cell disease (SCD). The purpose of this study was to assess the degree of kinesiophobia reported by African American men and women with SCD and to determine whether kinesiophobia is related to pain and psychologic distress in this population. METHODS Sixty-seven men and women with SCD recruited from a comprehensive sickle cell treatment program in a large academic medical center completed questionnaires that assess fear of movement, pain and pain interference, and psychologic distress. RESULTS Participants reported levels of kinesiophobia (M=30.48, SD=7.55) that were comparable to those obtained for patients with low back pain and fibromyalgia. Although pain levels did not differ by sex, men reported greater kinesiophobia than women (P=0.02). As hypothesized, higher levels of kinesiophobia were associated with greater psychologic distress, particularly Phobic Anxiety (r=0.35), Psychoticism (r=0.29), Somatization (r=0.45), Anxiety (r=0.35), Obsessive-compulsive (r=0.34), Interpersonal Sensitivity (r=0.25), Depression (r=0.29), and all 3 summary indices of the SCL-90-R (all Ps<0.05). DISCUSSION Although and historically, pain associated with SCD has not been considered in the context of fear of movement, findings suggest that both kinesiophobia and sex are relevant constructs for consideration in understanding pain-related outcomes in SCD. Though our results require replication, this study suggests that greater kinesiophobia is associated with greater pain and psychologic distress.
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Affiliation(s)
- Jennifer Pells
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
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Gustafson SL, Gettig EA, Watt-Morse M, Krishnamurti L. Health beliefs among African American women regarding genetic testing and counseling for sickle cell disease. Genet Med 2007; 9:303-10. [PMID: 17505208 DOI: 10.1097/gim.0b013e3180534282] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The Health Belief Model can help in understanding low acceptance of disease prevention and screening. We studied health beliefs of African American women to determine causes of low acceptance of genetic testing and counseling despite high prevalence of sickle cell disease and heterozygotes in this population. METHODS An anonymous questionnaire using a 12-question measure with a 5-point Likert scale response was administered to 101 African American women attending an obstetrics and gynecology clinic to determine knowledge of sickle cell disease, perception of risk, severity, likelihood of benefit and barriers to counseling. RESULTS The cumulative mean perceived scores on the 5-point Likert scale were 4.22 +/- 0.88 for severity of sickle cell disease, 4.10 +/- 1.03 for benefit of genetic testing, 2.28 +/- 1.00 for barriers to testing, and 2.62 +/- 1.06 for risk of having a child with sickle cell disease. High average level knowledge was associated with high perception of severity and benefit to screening (P < 0.05). CONCLUSION African American women have a relatively high belief of the severity of sickle cell disease and benefits of genetic counseling but frequently do not appear to believe that they are at risk of having a child with the disease. This should be taken into account in the design of educational and counseling strategies.
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Affiliation(s)
- Shanna L Gustafson
- Genetic Counseling Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Abstract
This review examines the evidence for some of the common psychological complications found across the life span of patients with sickle cell disease (SCD), which are likely to be encountered by haematologists responsible for their medical management. Electronic searches of medical and psychological databases were conducted with a focus on three main areas: psychological coping, quality of life and neuropsychology. Psychological complications were identified in both children and adults with SCD, and included inappropriate pain coping strategies; reduced quality of life owing to restrictions in daily functioning, anxiety and depression; and neurocognitive impairment. There were wide variations in design and consistency of the studies, therefore, some caution needs to be observed in the findings. Moreover, interventional studies were lacking in some areas such as neuropsychology. Utilization of psychological interventions including patient education, cognitive behavioural therapy, and special educational support to help improve the quality of life of patients are recommended.
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Affiliation(s)
- Kofi A Anie
- Department of Haematology, Brent Sickle Cell and Thalassaemia Centre, Imperial College London, Central Middlesex Hospital, London, UK.
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Cote MP, Mullins LL, Hartman V, Hoff A, Balderson BHK, Chaney J, Domek D. Psychosocial Correlates of Health Care Utilization for Children and Adolescents With Type 1 Diabetes Mellitus. CHILDRENS HEALTH CARE 2003. [DOI: 10.1207/s15326888chc3201_1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
This article summarizes the psychometric evaluation of the Chronic Illness Assessment Interview for Sickle Cell Disease (CIAI-SCD), an instrument based on a model of self-care for adult patients with chronic medical conditions. The CIAI-SCD was administered to 104 adults with sickle cell disease. A factor analysis identified three factors that reflected the psychological constructs of Personal Satisfaction and Perceived Control (Factor 1), Feeling Concerned and Worried (Factor 2), and Feeling Supported (Factor 3). Preliminary evidence for the internal consistency, test-retest reliability content validity, and construct validity of the CIAI-SCD was obtained. After further refinement and validation, the CIAI-SCD may be a useful tool for assessing factors related to self-care skills among adults with sickle cell disease.
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Edwards R, Telfair J, Cecil H, Lenoci J. Self-efficacy as a predictor of adult adjustment to sickle cell disease: one-year outcomes. Psychosom Med 2001; 63:850-8. [PMID: 11573035 DOI: 10.1097/00006842-200109000-00020] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study prospectively investigated the role of self-efficacy in predicting disease symptomatology and health services utilization for adult patients with sickle cell disease. METHODS These data are derived from a 12-month prospective cohort study of African American adults with sickle cell disease. Disease-specific perceptions of coping self-efficacy and indices of disease severity, health care utilization, and psychosocial adjustment were assessed by use of standardized questionnaires administered by trained clinicians. RESULTS Perceptions of self-efficacy for coping with sickle cell disease were moderately stable across the 12-month study period. At baseline (N = 147), significant inverse relationships, measured with Pearson correlations, were noted between self-efficacy and the following variables: physical symptoms, psychological symptoms, pain severity, and number of physician visits over the preceding 12 months (p <.01). Similar relationships with self-efficacy were noted at the 1-year follow-up (N = 104) period for measures of physical symptoms, psychological symptoms, and pain severity (p <.01). In multiple-regression models, baseline self-efficacy scores predicted changes over the 1-year study period in physical and psychological sickle cell disease symptomatology. Moreover, changes in self-efficacy from baseline to 1-year follow-up were significantly and independently related to changes in physical symptoms, psychological symptoms, and pain ratings from baseline to 1-year follow-up. CONCLUSIONS Self-efficacy beliefs among African American adults with sickle cell disease are inversely related to reported disease symptomatology, and these relationships persist across time. Future investigations should examine the mechanisms through which relationships between self-efficacy and adjustment to sickle cell disease are effected, as well as the feasibility and effectiveness of enhancing self-efficacy beliefs as a means of improving adjustment to sickle cell disease.
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Affiliation(s)
- R Edwards
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0022, USA
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Soliday E, Hoeksel R. Health beliefs and pediatric emergency department after-care adherence. Ann Behav Med 2001; 22:299-306. [PMID: 11253441 DOI: 10.1007/bf02895666] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study's purpose was to apply a multivariate adaptation of the Health Belief Model (HBM) to examine parental adherence to pediatric emergency department (ED) after-care instructions. Parents/legal guardians (n = 162) of children ages 0-17 years with minor (noncritical) conditions (e.g. abrasion/contusion, laceration) completed health beliefs and demographics questionnaires while waiting for their child to be seen. Postdischarge, children's medical records were reviewed for after-care instructions and insurance status, and parents were phoned to assess adherence to specific after-care instructions. In logistic regressions, health beliefs (barriers, severity, susceptibility) and child age significantly predicted several postdischarge adherence behaviors, including home care procedures and prescription medication purchase. Results are discussed as they relate to the effects of specific health belief variables and the need for further refinement of the HBM in accordance with the changing health care system; clinical applications are proposed.
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Affiliation(s)
- E Soliday
- Washington State University, 14204 Salmon Creek Avenue, Vancouver, WA 98686, USA
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Edwards R, Telfair J, Cecil H, Lenoci J. Reliability and validity of a self-efficacy instrument specific to sickle cell disease. Behav Res Ther 2000; 38:951-63. [PMID: 10957829 DOI: 10.1016/s0005-7967(99)00140-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The psychometric properties of a new, 9-item scale measuring disease-specific perceptions of self-efficacy were investigated in a community-based sample of adults (N = 83) with sickle cell disease (SCD). The Sickle Cell Self-Efficacy Scale (SCSES) was comprised of nine questions relating to participants' perceptions of their ability to function on a day-to-day basis and to manage SCD symptomatology (e.g. episodes of pain). The SCSES demonstrated good internal consistency, discriminant validity, and convergent and predictive validity, both with previously validated measures of related constructs as well as with reported SCD symptomatology. Overall, the instrument appears to be reliable and valid for assessing clients' self-efficacy for engaging successfully in day-to-day activities despite having SCD. Future investigators may wish to examine temporal and causal links between alterations in self-efficacy and changes in adjustment to sickle cell disease; the SCSES provides a psychometrically sound tool with which to investigate these phenomena.
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Affiliation(s)
- R Edwards
- University of Alabama at Birmingham, Department of Psychology, USA
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