Johnson, Ryan (2015-08). Identifying and Assessing the Cognitive Influences and Medical Practices among Health Care Providers of Adult Sickle Cell Anemia Patients where Coordinate Comprehensive Care is Limited or Non-Existent. Master's Thesis. Thesis uri icon

abstract

  • Sickle cell anemia patients face disproportionate disparities in health care. Treatment for adult sickle cell disease (SCD) patients is mainly palliative (alleviating pain symptoms) without addressing underlying causes. Cognitive influences (e.g., knowledge, belief, attitude, and intentions) and systematic barriers often determine healthcare practices and quality of care. Gaining the healthcare providers' perspective on the social and systematic influences on the implementation of comprehensive coordinated care, a highly regarded disease management model, might be key to understanding stagnant health outcomes among adult sicklers. Caribbean Island nation's providers' treatment of SCD patients results in optimal health outcomes. Hence, Caribbean treatment providers can provide insight into improving the delivery of healthcare in the USA. The purpose of this study is to describe Trinidadian SCD healthcare providers' cognitive influences and systematic barriers to implementing coordinated comprehensive care. A purposive sample of 5 male and female SCD practitioners in Trinidad were interviewed by UWI - St. Augustine researchers. Data saturation was achieved by the end of the third interview. Utilizing Colaizzi's method of phenomenology to perform a secondary data analyses of informative research, rigor was established through the application of authentication, justification, and validity. Eight themes arose from 91 significant statements. Cognitive influences included: knowledge and promotion of preventative care; emphasis on beliefs of effective patient-provider communication; and positive attitudes regarding patient autonomy, self-care management, and comprehensive care. Barriers included: lack of resources and support; lack of consensus on standards of care, including proper pain management; social stigma; and accessibility to quality care. Understanding these social and structural influences and barriers to the implementation of coordinated comprehensive care from the perspective of the healthcare provider might help stakeholders identify viable solutions to improve adult sickle cell patients' quality of life and provide efficient, yet effective, treatment.
  • Sickle cell anemia patients face disproportionate disparities in health care. Treatment for adult sickle cell disease (SCD) patients is mainly palliative (alleviating pain symptoms) without addressing underlying causes. Cognitive influences (e.g., knowledge, belief, attitude, and intentions) and systematic barriers often determine healthcare practices and quality of care. Gaining the healthcare providers' perspective on the social and systematic influences on the implementation of comprehensive coordinated care, a highly regarded disease management model, might be key to understanding stagnant health outcomes among adult sicklers. Caribbean Island nation's providers' treatment of SCD patients results in optimal health outcomes. Hence, Caribbean treatment providers can provide insight into improving the delivery of healthcare in the USA.

    The purpose of this study is to describe Trinidadian SCD healthcare providers' cognitive influences and systematic barriers to implementing coordinated comprehensive care. A purposive sample of 5 male and female SCD practitioners in Trinidad were interviewed by UWI - St. Augustine researchers. Data saturation was achieved by the end of the third interview. Utilizing Colaizzi's method of phenomenology to perform a secondary data analyses of informative research, rigor was established through the application of authentication, justification, and validity.

    Eight themes arose from 91 significant statements. Cognitive influences included: knowledge and promotion of preventative care; emphasis on beliefs of effective patient-provider communication; and positive attitudes regarding patient autonomy, self-care management, and comprehensive care. Barriers included: lack of resources and support; lack of consensus on standards of care, including proper pain management; social stigma; and accessibility to quality care.

    Understanding these social and structural influences and barriers to the implementation of coordinated comprehensive care from the perspective of the healthcare provider might help stakeholders identify viable solutions to improve adult sickle cell patients' quality of life and provide efficient, yet effective, treatment.

publication date

  • August 2015