RESUMO
Sickle cell disease (SCD), a life-threatening chronic disease, necessitates a paediatric treatment plan that considers the influence of psychological, family and intercultural factors. At the Louis-Mourier Hospital (APHP) in Colombes, France, we introduced an original paediatric-psychological partnership where a clinical psychologist accompanies the paediatrician at programmed consultations. We evaluated children and their parents treated in Colombes and in two other paediatric units using standardized culture-free tools and clinical interviews to evaluate the psychological repercussions of SCD. We first present a global view of the different ways that SCD affects both children and their families. We then discuss findings from a study evaluating the overall efficacy of an integrated psycho-medical treatment model as compared to the usual medical care model. Children in the integrated care model improved their cognitive functioning assessed using the Rey-Osterrieth complex figure test compared to treatment as usual. CONCLUSION: Findings suggest that the concept of a "partnership practice" can improve children's ability to grapple with SCD and is a promising approach for long-term care of SCD. What is Known: ⢠Painful crises of sickle cell disease are unpredictable and appear in early childhood ⢠Stress as well as the complex psychological and intercultural issues associated with SCD may aggravate the children's symptoms ⢠Standard pediatric care and research deal primarily with medical issues What is New: ⢠Evidence-based research examining the psychological repercussions of SCD in pediatric treatment as well as the parental distress ⢠First study using standardized culture-free tools ⢠Cognitive functioning improves under an innovative "partnership" model.
