The illness of women and men with sickle cell disease: a Grounded Theory study

Repercussions of sickle cell disease and sickle cell ulcers for men inserted in the world of work

OBJECTIVE

To analyze the repercussions of sickle cell disease and sickle cell ulcer for men in the world of work and discuss the challenges faced to remain in the work environment.

METHOD

A qualitative study, developed at the dressing clinic and at a stomatherapy clinic. Twenty men with sickle cell disease and sickle cell ulcer participated, applying a semi-structured interview script. The software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires was used for treatment and lexical data analysis.

RESULTS

The Descending Hierarchical Classification enabled the creation of classes: Man with sickle cell disease and sickle cell ulcer: experiences and repercussions; and Coping measures adopted by men with sickle cell disease and sickle cell ulcer to stay at work.

CONCLUSION

Disease and injury repercussions involve biopsychosocial dimensions, highlighting the need for professional training to assist with competence and humanity. Strategies adopted to maintain work are breaks in the working day, use of analgesics to relieve pain, allocating time during work to apply dressings.

Contraception and reproductive planning from the perspective of women with sickle cell disease

OBJECTIVE

To understand the perceptions of women with sickle cell disease (SCD) about reproductive planning in a public health service.

METHOD

This is a qualitative study conducted with 15 women with SCD attended at a public hospital in Recife, between August 2018 and May 2019. Bardin's content analysis technique was used.

RESULTS

The women were between 25 and 38 years old, married, and had low education. After the analysis, four thematic categories emerged: information about contraception, use of contraceptive methods, feelings about pregnancy, and gynecological consultation. It was found that women with SCD are influenced by factors such as fear of complications during pregnancy, lack of information on reproductive planning, partners and health professional opinion, and difficulties in health service access.

FINAL CONSIDERATIONS

The reports demonstrate that health workers need to improve the way through which information reaches the patient, to offer a more satisfactory professional practice.

Why does your pain never get better? Stigma and coping mechanism in people with sickle cell disease

OBJECTIVES

to analyze the characteristics of stigma in the interactions of people with pain and sickle cell disease and the coping strategies adopted.

METHODS

qualitative study, conducted in Bahia's reference units between January and July 2018. In-depth interviews were applied to 25 adults, followed by content analysis and interpretation in light of the Sociological Theory of Stigma.

RESULTS

four categories emerged from the data: Stigma in interactions with family members; Stigma in interactions with people in the general public; Stigma in interactions with health workers; and Strategies for coping with stigma.

FINAL CONSIDERATIONS

in the participants' interactions, stigma produced discrediting pain reports, labeling and stereotyping, blaming patients for not improving their health, discrimination, racism, inadequate pain assessment, and delay in care. Coping included silencing, covering up, aggressive behavior, exposure to risk, reading religious texts and praises, and church attendance.

PROFILE OF WOMEN WITH LEG ULCERS DUE TO SICKLE CELL DISEASE

Objective: to characterize the profile of women with leg ulcers resulting from sickle cell disease treated at a public health institution in Brazil. Method: historical cohort study conducted in the outpatient sector with a sample of women with sickle cell disease and leg ulcer, followed from 1998 to 2014. The data were extracted from the medical record and included sociodemographic, clinical and ulcer-related variables, and underwent descriptive statistical analysis. Results: of the 17 women, 64.7% were cured, 58.8% were aged between 30 and 39 years, 64.7% declared themselves brown, 70.6% were without partners, 41.2% had incomplete elementary education, 52, 9% had an income of 2 to 3 minimum wages, 70.6% were eutrophic and 82.4% used vitamin supplements. Women had a total of 29 ulcers, 52.9% had a single ulcer, 41.4% were located in the malleolar region, 55.17% were between 2 and 36 months, all classified as stage 3. The treatment was with coverings and Unna’s boot. Conclusion: the women received care from specialist nurses and most were cured with up to eight months of follow-up, which required a nursing consultation, including clinical evaluation, topical treatment and application of compression therapy.

PERFIL DE MULHERES COM ÚLCERAS DA PERNA DECORRENTES DE DOENÇA FALCIFORME

Objetivo:caracterizar o perfil de mulheres com úlceras da perna decorrentes da doença falciforme atendidas em uma instituição pública de saúde do Brasil. Método: estudo de coorte histórica realizado no setor ambulatorial com amostra de mulheres com doença falciforme e úlcera da perna, acompanhadas de 1998 a 2014. Os dados foram extraídos do prontuário e contemplaram variáveis sociodemográficas, clínicas e relacionadas à úlcera, e passaram por análise estatística descritiva. Resultados: das 17 mulheres, 64,7% obtiveram cura, 58,8% tinham idade entre 30 e 39 anos, 64,7% se autodeclaram pardas, 70,6% estavam sem parceiros, 41,2% possuíam ensino fundamental incompleto, 52,9% tinham renda de 2 a 3 salários mínimos, 70,6% eram eutróficas e 82,4% faziam uso de suplementos vitamínicos. As mulheres apresentaram o total de 29 úlceras, 52,9% tinham úlcera única, 41,4% localizadas na região maleolar, 55,17% com existência entre 2 e 36 meses, todas classificadas em estágio 3. O tratamento foi com coberturas e bota de Unna. Conclusão: as mulheres receberam cuidados de enfermeiros especialistas e a maioria obteve a cura com até oito meses de acompanhamento que demandou a consulta de enfermagem, contemplando a avaliação clínica, o tratamento tópico e aplicação da terapia de compressão.

Self-care of men with priapism and sickle cell disease

ABSTRACT Objective: To identify self-care demands of men with sickle cell disease and priapism and describe self-care measures in light of Orem's Self-Care Theory. Method: This is a descriptive exploratory study with qualitative approach conducted with nine men with a history of sickle cell disease and priapism. Data were analyzed using Orem's Self-Care Theory. Results: Some demands were identified: from universal self-care - difficulty in social interaction and solitude, changes in self-image, self-esteem and sexual activity; from development - the experience with priapism and little knowledge about the pathophysiology of the disease; regarding health deviations - pain crises. Conclusion: Orem's theory allowed to identify self-care demands, which are essential for the nursing care provided for men with priapism. Nursing has an essential role in the measures for the different demands presented.