Celebrating Diversity Within the Sickle Cell Community: Commitment, Innovation, Practice
Saturday, October 13 • 8:45am - 9:00am
Psychosocial Impact, Health Beliefs And Stigma Of Leg Ulcers In Adults With Sickle Cell Disease In A National Sickle Cell Center

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Dr. Edeghonghon Olayemi- GHANA INSTITUTE OF CLINICAL GENETICS/UNIVERSITY OF GHANA, LEGON, Dr. Adote Anum- University of Ghana, Legon, Dr. Yvonne Dei- GHANA INSTITUTE OF CLINICAL GENETICS/UNIVERSITY OF GHANA, LEGON, Mr. David Nana Adjei- University of Ghana, Legon, Prof. Solomon Ofori-acquah- University of Ghana, Legon

Background: Sickle Cell Disease (SCD) is recognized as the most predominant hereditary hemoglobinopathy in Africa with a significant public health impact. Currently, owing to the early detection through newborn screening, advancement in medicine, nutrition and patient education, people with SCD are now living longer into adulthood. However, clinical and psychosocial concerns remain on many persistent chronic manifestations such as leg ulcers. Hitherto, the psychosocial, health beliefs, and stigma-related problems that are experienced by SCD patients with chronic leg ulcers remain poorly defined.
Objective: This study examined the psychopathology, psychosocial impact, stigma and health beliefs experienced by adult SCD patients with and without leg ulcers attending a National Sickle Cell Centre in Ghana.
Methods: A total of 84 adults with SCD participated in the cross-sectional study: 36 had chronic leg ulcers and 48 without leg ulcers. Participants were administered Symptom Checklist-90-R, Sickle Cell Illness Impact Measurement, Health Belief Model Questionnaire and an adapted version of the Stigma of Mental Illness Scale. Factorial Multivariate Analyses of Covariance (MANCOVA) were conducted to determine the influence of leg ulcer, gender, and age of diagnosis of SCD on psychopathology, psychosocial, stigma and health beliefs of SCD patients. Age and education measured in years were covariates in the analyses.
Results: Leg ulcer had no impact on psychopathology of SCD patients. There was a significant effect of age of diagnosis of SCD on social functioning in patients [(3, 55) = 3.09, p < .035, Wilks' Λ = .86, partial η2 = .14]. Adult patients diagnosed with SCD after early childhood (aged 11years and above) experienced poor social functioning compared to patients diagnosed during early childhood (aged below11 years) [Social functioning (mean difference) 5.95; 95% confidence interval (CI), .1.04-10.85; p < .02)]. Leg ulcer and age of diagnosis influenced patients’ perception of stigma (discrimination, disclosure and positive aspects sub-scales) [(3, 50) = 4.75, p < .005, Wilks' Λ = .78, partial η2 = .22; (3, 50) = 3.23, p < .03, Wilks' Λ = .84, partial η2 = .16]. Adult patients with leg ulcer reported more frequency of discrimination associated with SCD compared to patients without leg ulcer [discrimination (mean difference 6.52; 95% CI, 2.03-11.02]; p < .005]. In addition, adult patients diagnosed with SCD after early childhood also reported more discrimination than adult patients diagnosed with SCD during early childhood [discrimination (mean difference 5.80; 95% CI, 1.15-10.44]; p < .015]. In addition, leg ulcer influenced SCD health beliefs (perceived severity, vulnerability, benefits and barriers sub-scales) [(4, 48) = 4.37, p < .004, Wilks' Λ = .73, partial η2 = .27]. Adult patients with leg ulcer reported more perceived severity, perceived barriers and negative health beliefs relating to SCD compared to those without leg ulcers [perceived severity (mean difference 2.15; 95% CI, 0.4-3.9]; p < .02), p < .003), perceived barriers (mean difference 3.52; 95% CI, 1.38 -5.67] ; p < .002; negative health beliefs (mean difference 7.88; 95% CI, 3.38-12.8].
Conclusion: Overall, our findings show that early identification and assessment of leg ulcers and their related SCD health beliefs and stigma may provide avenues for enhancing the quality of life of adults with SCD and living with chronic leg ulcers in Ghana.

avatar for Mary Akua Ampomah

Mary Akua Ampomah

Senior Clinical psychologist, Ghana Institute of Clinical Genetics
I am a Clinical Psychologist at the Ghana Institute of Clinical Genetics where the adolescent and adult sickle cell clinic is located. I have also served as a part-time lecturer at the Department of Psychology of the University of Ghana, Legon and currently teaching at the Regent... Read More →

Saturday October 13, 2018 8:45am - 9:00am
Baltimore/ Annapolis

Attendees (11)