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J Emerg Nurs. 2017 Sep;43(5):444-450. doi: 10.1016/j.jen.2017.04.009. Epub 2017 May 17.

Identifying Social-Behavioral Health Needs of Adults with Sickle Cell Disease in the Emergency Department.

Author information

1
Durham, NC.
2
Durham, NC. Electronic address: paula.tanabe@duke.edu.

Abstract

INTRODUCTION:

Sickle cell disease (SCD) is a complex illness with many social-behavioral co-morbidities. The aim of this project was to describe unmet social-behavioral health needs for adults with SCD who presented to the emergency department for treatment of vaso-occlusive episodes (VOEs).

METHODS:

A descriptive study using 1:1 interviews during an ED visit for a VOE was conducted; a brief social behavioral health screening interview guide was used. A convenience sample of adults with SCD treated in the emergency department for a VOE were eligible for inclusion.

RESULTS:

We conducted 147 interviews over 14 months. Patients reported transportation and/or scheduling difficulties with clinic appointments in one third of the interviews. Four major themes emerged: clinic appointment barriers, medication barriers, other care barriers, and social-behavioral issues. A majority of patients (53%) reported being brought to the emergency department by a family member at their current visit. Patients cited having insurance coverage issues in more than one quarter (27%) of the interviews. Difficulties in obtaining prescriptions were cited as a result of a financial copay (17%), transportation (11%), and pharmacy (9%) issues. Almost one third of patients (29%) reported feeling depressed, and 20% reported feeling anxious.

DISCUSSION:

Many patients with SCD who are treated in the emergency department have social or behavioral health risk factors. Emergency departments have an opportunity to screen and refer patients for follow-up. Future research should investigate referral outcomes and their effect on ED and hospital use.

KEYWORDS:

Emergency department; Sickle cell disease; Social behavioral health

PMID:
28527641
DOI:
10.1016/j.jen.2017.04.009
[Indexed for MEDLINE]

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