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

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

Sickle cell disease (SCD), an autosomal recessive blood disorder, affects millions of people worldwide. Approximately 80% of all cases are located in Africa. This cross-national, interdisciplinary, collaborative study investigated provider attitudes about, and practices for, managing (assessing and...

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Bibliographic Details
Published in:Journal of pain and symptom management Vol. 61; no. 3; pp. 474 - 487
Main Authors: Stewart, Kearsley A., Parshad-Asnani, Monika, Wonkam, Ambroise, Bollinger, John, Ngo Bitoungui, Valentina, Wonkam-Tingang, Edmond, Powell, Jill, Desronvil, Kathia, Benson, Kathryn R.K., Clark, Abby, Katz, Madelaine, Martin, Bianca, Peterseim, Carolyn, Williams, Christina, Young, Nana, Shah, Nirmish, Tanabe, Paula, Babyak, Michael, Royal, Charmaine D.M.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-03-2021
Elsevier Limited
Subjects:
Adult
Africa
Anemia, Sickle Cell - therapy
Attitude of Health Personnel
Attitudes
Blood diseases
Cameroon and US
Child
Global Health
Health care
Humans
Interdisciplinary aspects
Jamaica
Medical personnel
Mixed methods research
Pain
Pain Management
Provider Attitudes
Sickle Cell Disease
Subjectivity
Africa
Jamaica
United States > US
Cameroon
Sickle Cell Disease
Cameroon and US
Provider Attitudes
Global Health
Jamaica
Pain Management
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Summary:Sickle cell disease (SCD), an autosomal recessive blood disorder, affects millions of people worldwide. Approximately 80% of all cases are located in Africa. This cross-national, interdisciplinary, collaborative study investigated provider attitudes about, and practices for, managing (assessing and treating) SCD pain. 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. 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. Overall, findings reveal that SCD provider attitudes toward their patients differed across sites, yet at all three sites, treating SCD pain is multidimensional.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2020.08.029