How young adults with sickle cell disease define “being a good patient” in the adult healthcare system

Author:

Nwora Christle1,Prince Elizabeth J.2,Pugh Laura3,Weaver Meaghann S.4,Pecker Lydia H.56

Affiliation:

1. Department of Medicine and Pediatrics Johns Hopkins University School of Medicine Baltimore Maryland USA

2. Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA

3. Internal Medicine Resident University of California San Francisco San Francisco California USA

4. National Center for Ethics in Healthcare Veteran Affairs Washington District of Columbia USA

5. Division of Hematology Johns Hopkins University School of Medicine Baltimore Maryland USA

6. Department of Gynecology and Obstetrics Johns Hopkins University School of Medicine Baltimore Maryland USA

Abstract

AbstractBackgroundYoung adulthood brings new challenges for managing sickle cell disease. There are fewer adult specialists, sickle cell disease morbidities accumulate, and mortality increases. Developmental changes in roles and responsibilities also affect management. This study explores how young adults with sickle cell disease experience their role as a patient.MethodsIn this mixed‐methods study at a sickle cell center, young adult participants completed the Sickle Cell Self Efficacy Survey, the Measures of Sickle Cell Stigma, and the Adult Sickle Cell Quality of Life Measurement Short‐Forms. Semi‐structured interviews on the patient role were conducted, transcribed, and then analyzed using thematic analysis.ResultsTwenty‐four participants aged 19–25 years defined expectations of being a “good patient.” Five definitional themes emerged: health maintenance, emotion regulation, self‐advocacy, honest communication, and empathy for clinicians. Participants identified support from families and clinicians are important facilitators of role fulfillment.DiscussionHow young adult patients with sickle cell disease define being a “good patient” has implications for the transition of care for both pediatric and adult medicine practices. This understanding can inform healthcare system designs and programs aimed at supporting patients and families.

Funder

Doris Duke Charitable Foundation

National Heart, Lung, and Blood Institute

American Society of Hematology

Publisher

Wiley

Subject

Oncology,Hematology,Pediatrics, Perinatology and Child Health

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