Improving Emergency Providers’ Attitudes Toward Sickle Cell Patients in Pain

Abstract

Background Provider biases and negative attitudes are recognized barriers to optimal pain management in sickle cell disease, particularly in the emergency department (ED). Measures This prospective cohort measures pre- and post-intervention provider attitudes towards patients with sickle pain crises using a validated survey instrument. Intervention ED providers viewed an eight-minute online video that illustrated challenges in sickle cell pain management, perspectives of patients and providers as well as misconceptions and stereotypes of which to be wary. Outcomes Ninety-six ED providers were enrolled. Negative attitude scoring decreased, with a mean difference -11.5 from baseline, and positive attitudes improved, with a mean difference +10. Endorsement of red-flag behaviors similarly decreased (mean difference -12.8). Results were statistically significant and sustained on repeat testing three months post-intervention. Conclusions/Lessons Learned Brief video-based educational interventions can improve emergency provider attitudes towards patients with sickle pain crises, potentially curtailing pain crises early, improving health outcomes and patient satisfaction scores.

The psychosocial impact of leg ulcers in patients with sickle cell disease: I don’t want them to know my little secret

“…Sickle cell disease (SCD) is an inherited genetic disorder caused by a single point mutation in the beta-hemoglobin gene. The disease currently affects millions of people worldwide and over 100,000 individuals in the United States [ 1 , 2 ]. There is a range of clinical manifestations related to SCD, one of which is leg ulcers.…”

Utilization, financial outcomes and stakeholder perspectives of a re-organized adult sickle cell program

“…At the same time, we recognize that all of these estimates are much lower than estimates of the prevalence of opioid misuse among persons living with SCD by health professionals, which range up to~50% [26,29]. Indeed, these unfavorable attitudes have led to studies of interventions specifically designed to improve health professionals' attitudes towards persons living with SCD [42,43]. Thus, as stated in our principles, we believe that the management of pain, opioids, and opioid misuse in persons living with sickle cell disease is subjective, challenging, and imperfect.…”

Physicians’ and nurses’ perceptions and attitudes toward sickle cell disease patients in Jazan, Saudi Arabia

“…Nurses’ negative attitude can be explained by that nurses spending more time with sickle cell patients. 16 , 18 Other factors that may also contribute to nurses’ negative attitudes include: they are the first responders to the patients’ complaints, patients are blaming them for poor pain control, verbal abuse from the patients, and less participation in educational activities. 18 Moreover, nurses thought that sickle cell patients complain more than other patients and they do not use analgesics appropriately.…”

“… 15 Different educational interventions using videos and lectures have been implemented to improve the perceptions and attitudes of healthcare providers toward sickle cell patients and found to be effective with encouraging results in the increment of positive attitudes and decrement of negative attitudes. 7 , 16 In this setting, we aim to explore physicians’ and nurses’ perceptions of sickle cell patients, and to assess their attitudes toward sickle cell patients to provide a base for future interventions and plans to improve sickle cell patients’ status in Jazan, KSA.…”