"Pain is Subjective": A Mixed-Methods Study of Provider Attitudes and Practices Regarding Pain Management in Sickle Cell Disease Across Three Countries.
J Pain Symptom Manage
; 61(3): 474-487, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-32889040
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Manejo da Dor
/
Anemia Falciforme
Tipo de estudo:
Qualitative_research
Limite:
Adult
/
Child
/
Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
J Pain Symptom Manage
Assunto da revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPEUTICA
Ano de publicação:
2021
Tipo de documento:
Article