Sickle Cell Disease in Adults: Developing an Appropriate Care Plan

Abstract

Background Sickle cell disease (SCD) is primarily characterized by pain. This chronic pain with acute exacerbations is the most common reason for hospital visits, admissions, and readmissions, particularly in young adults (aged 18–39 years). People who present to the hospital for pain crises often report that nurses lack knowledge of SCD and, consequently, they do not provide appropriate, timely care. Objectives Because pain episodes often result in hospital admissions, this article highlights prominent issues that staff nurses need to know. Methods Using a review of the literature and case studies, the authors provide recommendations to improve care of adults with SCD. Findings No objective signs of a sickle cell pain crisis exist. Patients react to pain in different ways and use various coping mechanisms in response. Suspected opioid addiction should not affect the provision of nursing care. Pain must be treated appropriately to decrease the potential for prolonged admissions and/or readmissions. Patients are to be acknowledged as experts and collaborated with in developing an appropriate plan of care. Advocacy on behalf of the patient is important for better communication with providers. With this knowledge, nurses will be better equipped to provide the appropriate and timely care required to manage pain crises experienced by individuals living with SCD.

A Qualitative Study of Chronic Pain and Self-Management in Adults with Sickle Cell Disease

“…When providing care to individuals with SCD, clinicians should first consider the differences among tolerance, physical dependence, pseudo-addiction, and addiction. 47 They should also take into consideration that the appropriate use of opioids is applicable and should be individualized to the patient. 48 Challenges to managing chronic pain included being in pain, other responsibilities, and stress.…”

Prevalence and predictors of chronic pain intensity and disability among adults with sickle cell disease

“…Adults with SCD use self-management strategies to cope with pain (Jenerette et al, 2011a; Matthie et al, 2015, 2018; Matthie and Jenerette, 2015, 2017; Tanabe et al, 2010). Among these individuals, those who demonstrate higher self-efficacy have greater social support, a higher educational level, and tend to employ more self-management strategies to cope with acute pain (Matthie et al, 2015).…”

Factors Associated with Growth Retardation in Children Suffering from Sickle Cell Anemia: First Report from Central Africa

“…Great progress has been made in the care of children with SCA in recent decades [ 7 , 8 ]. Management of this haemoglobinopathy has been changing and is excellent as we have patients with advanced age in developed countries [ 8 , 9 ]. However, in developing countries such as the DRC, these cures are compromised by financial, human and laboratories resources deficiencies, inconsistent drug supplies, and delayed time of diagnosis [ 10 , 11 ].…”