"Pain is Subjective": A Mixed-Methods Study of Provider Attitudes and Practices Regarding Pain Management in Sickle Cell Disease Across Three Countries.

Abstract:

CONTEXT:Sickle cell disease (SCD), an autosomal recessive blood disorder, affects millions of people worldwide. Approximately 80% of all cases are located in Africa. OBJECTIVES:This cross-national, interdisciplinary, collaborative study investigated provider attitudes about, and practices for, managing (assessing and treating) SCD pain. METHODS:We conducted 111 quantitative surveys and 52 semistructured interviews with health-care providers caring for adults and/or children with SCD in Cameroon, Jamaica, and the U.S. RESULTS:Applying Haywood's scale for assessing SCD provider attitudes, the Jamaica site scored lower on "Negative Attitudes" than the Cameroonian and U.S. sites (P = 0.03 and <0.001, respectively). Providers at the U.S. site scored lower on "Positive Attitudes" than other sites (P < 0.001). "Red Flag" scores at the Cameroon sites were lower than at other sites (P < 0.001). Qualitative results across all three sites describe the current practices for SCD pain management, as well as the challenges surrounding management for health providers, including pain subjectivity, patient-provider and parent-provider relationships, resource availability, perceptions of drug-seeking behavior, and adherence. Providers also spontaneously offered solutions to reported challenges. CONCLUSION:Overall, findings reveal that SCD provider attitudes toward their patients differed across sites, yet at all three sites, treating SCD pain is multidimensional.

journal_name

J Pain Symptom Manage

authors

Stewart KA,Parshad-Asnani M,Wonkam A,Bollinger J,Ngo Bitoungui V,Wonkam-Tingang E,Powell J,Desronvil K,Benson KRK,Clark A,Katz M,Martin B,Peterseim C,Williams C,Young N,Shah N,Tanabe P,Babyak M,Royal CDM

doi

10.1016/j.jpainsymman.2020.08.029

subject

Has Abstract

pub_date

2020-09-01 00:00:00

eissn

0885-3924

issn

1873-6513

pii

S0885-3924(20)30715-6

pub_type

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