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Marks LR, Stenersen M, Coleman M, Sanders S, Wilkins-Yel K. Health psychology in Jamaica: A qualitative analysis. COUNSELLING PSYCHOLOGY QUARTERLY 2021. [DOI: 10.1080/09515070.2021.1927670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Laura Reid Marks
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Madeline Stenersen
- Division of Prevention and Community Research, Yale University School of Medicine, New Haven, CT, USA
| | - Monica Coleman
- Department of Counseling Educational Psychology and Research, University of Memphis, Memphis, TN, USA
| | - Shondolyn Sanders
- Department of Counseling Educational Psychology and Research, University of Memphis, Memphis, TN, USA
| | - Kerrie Wilkins-Yel
- Department of Counseling & School Psychology, University of Massachusetts-Boston, Boston, MA, USA
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Anim MT, Osafo J, Yirdong F. Prevalence of psychological symptoms among adults with sickle cell disease in Korle-Bu Teaching Hospital, Ghana. BMC Psychol 2016; 4:53. [PMID: 27832817 PMCID: PMC5103464 DOI: 10.1186/s40359-016-0162-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research revealed high prevalence of psychological symptoms among sickle cell disease (SCD) patients in the West and Europe. In some Black SCD populations such as Nigeria and Jamaica, anxiety and depression had low prevalence rates compared to Europe. With difficulty locating research data on the prevalence of psychological symptoms in Ghana, this study aimed at exploring psychological symptoms among adults with SCD in a Teaching Hospital in Accra, Ghana. METHODS Two hundred and one participants (males 102 and females 99) who were HbSS (n = 131) and HbSC (n = 70), aged 18 years and above were purposively recruited. Using the Brief Symptom Inventory (BSI) in a cross-sectional survey, the research answered questions about the prevalence of psychological symptoms. It also examined gender and genotype differences in psychological symptoms scores. RESULTS Results indicated that adults with SCD had non-distress psychological symptoms scores. Although paranoid ideation as a psychological symptom indicated "a little bit" score, its prevalence was only 1 %. The prevalence of psychological symptoms as indexed by the Positive Symptom Total (PST) was 10 %. Anxiety, hostility, and depression were psychological symptoms with low scores. Furthermore, except psychoticism scores, males did not differ significantly from females in other psychological symptoms. On the contrary, HbSS participants differed significantly, reporting more psychological symptoms than their HbSC counterparts. CONCLUSIONS The study concluded that there was low prevalence of psychological symptoms among adults with SCD in this Ghanaian study. Although psychological symptoms distress scores were not observed among study participants at this time, females differed significantly by experiencing more psychoticism symptoms than males. HbSS participants also differed significantly by experiencing more depression, phobic anxiety, paranoid ideation, psychoticism, and additional symptoms such as poor appetite, trouble falling asleep, thoughts of dying, and feeling guilty, than their HbSC counterparts. Implications for further study and clinical practice were discussed.
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Affiliation(s)
- Michael Tetteh Anim
- Department of Psychological Medicine and Mental Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Psychological Medicine and Mental Health, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Legon, Ghana
| | - Felix Yirdong
- Department of Psychological Medicine and Mental Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Bediako SM, Lavender AR, Yasin Z. Racial Centrality and Health Care Use Among African American Adults With Sickle Cell Disease. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798407307044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study examined an exploratory model of the confluence of racial centrality, pain, psychological variables, and health care use in a sample of African American adults with sickle cell disease. Significant path coefficients were observed between pain severity, perceived stress, and psychological symptoms. The model yielded direct effects for paths to health care use from pain frequency and racial centrality—indicating that participants who reported more frequent pain episodes tended to use more health care services and those who endorsed a highly central African American identity utilized fewer health care services. Generally, these findings suggest a need for expanded thinking about determinants of health care use in this population beyond psychological and physiological variables. These findings support a rationale for further exploring the sociocultural context of sickle cell and highlight a specific need for better understanding the complex relationships among multidimensional aspects of racial identity and health care use.
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Adult sickle cell quality-of-life measurement information system (ASCQ-Me): conceptual model based on review of the literature and formative research. Clin J Pain 2015; 30:902-14. [PMID: 24300219 DOI: 10.1097/ajp.0000000000000054] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Research-derived evidence about the impact of sickle cell disease (SCD) on the lives of affected adults is lacking. We conducted formative research to provide the basis for a comprehensive description of how SCD affects the lives of adults, with the goal of developing a SCD-specific quality-of-life measurement system. METHODS We conducted a comprehensive literature review of patient-reported outcomes, followed by a series of focus groups and structured individual interviews with adults with SCD (n=122) and their health care providers (n=15). RESULTS We reviewed 473 abstracts and included 86 articles in the final review. The literature revealed broad categories of the impact of SCD and its treatment on the lives of adults-pain; emotional distress; social-role functioning; overall quality-of-life; and quality of care. We classified 1213 incidents from the focus groups and interviews into a taxonomy (16 domains) that met the criterion for saturation and was demonstrated to be reliable for the classification of incidents. The final conceptual model was built upon the taxonomy. DISCUSSION Our conceptual model was similar to previous models with the effects of pain predominating, interwoven with emotional distress, quality of care, and stigmatization. We found a broad range of emotions reflected, including positive effects of SCD. Items for the quality-of-life measure were derived from the taxonomy and the conceptual model may be of use in generating hypotheses for clinical research and improving understanding for clinicians of the lived experience of adults with SCD.
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Anderson M, Asnani M. "You just have to live with it": coping with sickle cell disease in Jamaica. QUALITATIVE HEALTH RESEARCH 2013; 23:655-64. [PMID: 23459927 DOI: 10.1177/1049732313480048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Research has shown that living with sickle cell disease (SCD) can be a considerable challenge. Unfortunately, although it is Jamaica's most common genetic disorder, to date, no qualitative research has been conducted on Jamaicans' experiences of SCD. We conducted thematic analysis on transcripts of in-depth semistructured interviews with 30 patients and found two interlinked themes bound up in life with SCD: loss and control. Faced with important losses, respondents used cognitive and behavioral coping strategies to reestablish control over their response to SCD, others' responses to SCD, and SCD's physical manifestations. Although the adaptive nature of some of these strategies is debatable, many facilitate management of the illness. Health care practitioners should encourage positive coping strategies and have nonjudgmental discussions with patients about (potentially) negative ones. They should also share information with nonspecialist doctors and nurses to reduce stigmatization around the illness. More exploration of this underresearched topic is needed.
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Affiliation(s)
- Moji Anderson
- Department of Sociology, Psychology and Social Work, University of the West Indies, Kingston, Jamaica.
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Burnette AD, Nimjee SM, Batchvarova M, Zennadi R, Telen MJ, Nishimura JI, Sullenger BA. RNA aptamer therapy for vaso-occlusion in sickle cell disease. Nucleic Acid Ther 2011; 21:275-83. [PMID: 21793788 DOI: 10.1089/nat.2010.0270] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Patients with sickle cell disease (SCD) often suffer painful vaso-occlusive episodes caused in part by the adhesion of sickle erythrocytes (SS-RBC) to the vascular endothelium. To investigate inhibition of SS-RBC adhesion as a possible treatment for vaso-occlusion, 2 adhesion molecules, α(v)β(3) and P-selectin, were targeted by high-affinity RNA aptamers. An in vitro flow chamber assay was used to test the antiadhesion activity of α(v)β(3) aptamer clone 17.16. Human SS-RBC were passed across a confluent monolayer of thrombin-stimulated human umbilical vein endothelial cells (HUVEC) at a constant rate. α(v)β(3) aptamer reduced SS-RBC adhesion to activated endothelial cells to the level seen with untreated HUVEC. An aptamer reactive with complement component 8 was used as a negative control and exerted no inhibition, confirming the specificity of α(v)β(3) aptamer (P=0.04). At 2 dyn/cm(2) shear stress, 30 nM α(v)β(3) aptamer showed maximal effect in decreasing SS-RBC adhesion to HUVEC. The antiadhesive activity of the P-selectin aptamer clone PF377 was also tested using HUVEC pretreated with IL-13 to upregulate expression of P-selectin as seen in activated endothelial cells. At 1 dyn/cm(2) shear stress, 60 nM of P-selectin aptamer had antiadhesion activity similar to heparin, a known inhibitor of SS-RBC adhesion to P-selectin. A negative control did not prevent adhesion (P=0.05). These data show the potential utility of aptamers to block endothelial adhesion molecules to prevent or treat vaso-occlusion in SCD.
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Affiliation(s)
- Angela D Burnette
- Department of Surgery, Duke University Medical Center , Durham, NC 27710, USA
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Caird H, Camic PM, Thomas V. The lives of adults over 30 living with sickle cell disorder. Br J Health Psychol 2011; 16:542-58. [PMID: 21722275 DOI: 10.1348/135910710x529278] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The study investigated the lived experiences of adults over 30 years old living with sickle cell disorder (SCD) and sought to develop a model understanding participants' ability to function. DESIGN Over a period of 10 months, in-depth individual interviews were held with nine participants and three focus groups were held with six further participants. METHODS Grounded theory, a qualitative methodology, was chosen to explore functioning across domains of experience in order to build an explanatory model. RESULTS Physical, psychological, and social functioning were adversely effected by SCD. Access to and quality of resources including friends, family, and finances formed the context in which participants attempted to manage the disorder. Management of SCD improved over time as participants moved to acceptance of the condition. This allowed participants to strengthen their resilience by creating meaning, developing their identity, and actively coping with the effects of SCD, thus improving their ability to function and to appreciate life. CONCLUSIONS The study demonstrates the considerable resilience of people over 30 with SCD, providing a positive and hopeful model which can be utilized clinically to support the functioning of people with SCD.
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Affiliation(s)
- Helen Caird
- Department of Applied Psychology, Canterbury Christ Church University, Salomons Campus at Tunbridge Wells, UK.
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Depression, anxiety, and stress comorbidities in sickle cell anemia patients with vaso-occlusive crisis. J Pediatr Hematol Oncol 2010; 32:345-9. [PMID: 20485202 DOI: 10.1097/mph.0b013e3181d869d5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We investigated the association of sickle cell anemia (SCA) vaso-occlusive crisis (VOC) with depression, anxiety, and stress disorders among Bahraini patients and controls. This was a cross-sectional study that involved administering Depression Anxiety Stress Scales (DASS-21) consisting of structured depression, anxiety, and stress scales to SCA patients with (n=138) and without (n=105) VOC. Multinomial regression and correlation analysis were used in assessing the association of VOC with depression and/or anxiety and/or stress, after adjusting for other covariates. Significantly higher proportion of VOC patients was found among the severe-extremely severe anxiety (P<0.002) and stress (P=0.001) groups; the frequency of depressed patients was comparable between the 2 groups. Adjusting for age, sex, income, number of affected individuals per family, and HbS levels, mild-moderate (P=0.042; odds ratio=2.00; 95% confidence interval=1.03-3.91) and severe-extremely severe (P=0.004; odds ratio=4.43; 95% confidence interval=1.59-12.34) anxiety were independently associated with VOC. Both depression and stress were not associated with VOC after adjusting for these covariates. These results suggest a positive contribution of VOC to the increased rates of anxiety disorders among SCA patients, thereby recommending counseling SCA patients with repeated VOC for these psychologic comorbidities, in particular anxiety.
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Utility of WHOQOL-BREF in measuring quality of life in sickle cell disease. Health Qual Life Outcomes 2009; 7:75. [PMID: 19664266 PMCID: PMC2736920 DOI: 10.1186/1477-7525-7-75] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 08/10/2009] [Indexed: 11/26/2022] Open
Abstract
Background Sickle cell disease is the commonest genetic disorder in Jamaica and most likely exerts numerous effects on quality of life (QOL) of those afflicted with it. The WHOQOL-Bref, which is a commonly utilized generic measure of quality of life, has never previously been utilized in this population. We have sought to study its utility in this disease population. Methods 491 patients with sickle cell disease were administered the questionnaire including demographics, WHOQOL-Bref, Short Form-36 (SF-36), Flanagan's quality of life scale (QOLS) and measures of disease severity at their routine health maintenance visits to the sickle cell unit. Internal consistency reliabilities, construct validity and "known groups" validity of the WHOQOL-Bref, and its domains, were examined; and then compared to those of the other instruments. Results All three instruments had good internal consistency, ranging from 0.70 to 0.93 for the WHOQOL-Bref (except the 'social relationships' domain), 0.86–0.93 for the SF-36 and 0.88 for the QOLS. None of the instruments showed any marked floor or ceiling effects except the SF-36 'physical health' and 'role limitations' domains. The WHOQOL-Bref scale also had moderate concurrent validity and showed strong "known groups" validity. Conclusion This study has shown good psychometric properties of the WHOQOL-Bref instrument in determining QOL of those with sickle cell disease. Its utility in this regard is comparable to that of the SF-36 and QOLS.
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Zennadi R, Moeller BJ, Whalen EJ, Batchvarova M, Xu K, Shan S, Delahunty M, Dewhirst MW, Telen MJ. Epinephrine-induced activation of LW-mediated sickle cell adhesion and vaso-occlusion in vivo. Blood 2007; 110:2708-17. [PMID: 17609430 PMCID: PMC1988948 DOI: 10.1182/blood-2006-11-056101] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Sickle red cell (SS RBC) adhesion is believed to contribute to the process of vaso-occlusion in sickle cell disease (SCD). We previously found that the LW RBC adhesion receptor can be activated by epinephrine to mediate SS RBC adhesion to endothelial alphavbeta3 integrin. To determine the contribution of LW activation to vaso-occlusive events in vivo, we investigated whether in vitro treatment of SS RBCs by epinephrine resulted in vaso-occlusion in intact microvasculature after RBC infusion into nude mice. Epinephrine enhanced human SS but not normal RBC adhesion to murine endothelial cells in vitro and to endothelium in vivo, promoting vaso-occlusion and RBC organ sequestration. Murine sickle RBCs also responded to epinephrine with increased adhesion to postcapillary endothelium in nude mice. Epinephrine-induced SS RBC adhesion, vaso-occlusion, and RBC organ trapping could be prevented by the beta-adrenergic receptor (beta-AR) antagonist, propranolol. Infusion of soluble recombinant LW also significantly reduced adhesion and vaso-occlusion. In addition, epinephrine-treated SS RBCs induced activation of murine leukocyte adhesion to endothelium as well. We conclude that LW activation by epinephrine via beta-AR stimulation can promote both SS RBC and leukocyte adhesion as well as vaso-occlusion, suggesting that both epinephrine and LW play potentially pathophysiological roles in SCD.
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Affiliation(s)
- Rahima Zennadi
- Division of Hematology and Duke Comprehensive Sickle Cell Center, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
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Abetz L, Baladi JF, Jones P, Rofail D. The impact of iron overload and its treatment on quality of life: results from a literature review. Health Qual Life Outcomes 2006; 4:73. [PMID: 17007645 PMCID: PMC1592476 DOI: 10.1186/1477-7525-4-73] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Accepted: 09/28/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess the literature for the impact of iron overload and infusion Iron Chelation Therapy (ICT) on patients' quality of life (QoL), and the availability of QoL instruments for patients undergoing infusion ICT. Also, to obtain patients' experiences of having iron overload and receiving infusion ICT, and experts' clinical opinions about the impact of treatment on patients' lives. METHODS A search of studies published between 1966 and 2004 was conducted using Medline and the Health Economic Evaluation Database (HEED). Qualitative results from patient and expert interviews were analysed. Hand searching of relevant conference abstracts completed the search. RESULTS Few studies measuring the impact of ICT with deferoxamine (DFO) on patients QoL were located (n = 15). QoL domains affected included: depression; fatigue; dyspnoea; physical functioning; psychological distress; decrease in QoL during hospitalization. One theme in all articles was that oral ICT should improve QoL. No iron overload or ICT-specific QoL instruments were located in the articles. Interviews revealed that the impact of ICT on patients with thalassemia, sickle cell disease, and myelodysplastic syndromes is high. CONCLUSION A limited number of studies assessed the impact of ICT or iron overload on QoL. All literature suggested a need for easily administered, efficacious and well tolerated oral iron overload treatments, given the impact of current ICT on adherence. Poor adherence to ICT was documented to negatively impact survival. Further research is warranted to continue the qualitative and quantitative study of QoL using validated instruments in patients receiving ICT to further understanding the issues and improve patients QoL.
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Affiliation(s)
- Linda Abetz
- Mapi Values Ltd, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - Jean-Francois Baladi
- Novartis Pharmaceuticals Corporation, Global Marketing Oncology, 180 Park Avenue, Bldg. 105, Florham Park, NJ 07932-0675, USA
| | - Paula Jones
- Novartis Pharmaceuticals Corporation, Global Marketing Oncology, 180 Park Avenue, Bldg. 105, Florham Park, NJ 07932-0675, USA
| | - Diana Rofail
- Mapi Values Ltd, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
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Carr ECJ, Nicky Thomas V, Wilson-Barnet J. Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective. Int J Nurs Stud 2004; 42:521-30. [PMID: 15921983 DOI: 10.1016/j.ijnurstu.2004.09.014] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2003] [Revised: 09/15/2004] [Accepted: 09/16/2004] [Indexed: 02/06/2023]
Abstract
This study sought to explore the impact of the psychological variables anxiety and depression, on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4-6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and one-third of the sample experienced levels of anxiety in psychiatric proportions whilst under one-third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care.
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Affiliation(s)
- Eloise C J Carr
- Institute of Health and Community Studies, Bournemouth University, Royal London House, Dorset, UK.
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