Psychological Factors Influencing The Wellbeing Of Students Living With Sickle Cell Anaemia

Project And Seminar Material On Psychology Education

Psychological Factors Influencing The Wellbeing Of Students Living With Sickle Cell Anaemia


Abstract


In sickle cell anaemia, the red blood cells clump together causing the originally round-shaped red blood cells to appear as semicircular shaped red blood cells, sickle cell anaemia disease is categorized as a disease accompanied by frequent pain, low red cell blood count, and infection.

This study sought the psychological factors influencing the wellbeing of students living with sickle cell anaemia, a study of Babcock University, Illishan Remo, Ogun State.

The study adopted a descriptive survey design in conjunction with the enumeration sampling method was used in the study to select 100 students from all departments in the study area. Data collection was done through the use and administration of a questionnaire. The data generated were analyzed using simple percentage and frequency count with the aid of the software SPSS version 20 and the linear regression analysis was used to test the hypotheses at .05 significance level. The results indicated that psychological factors has significant influence on the well-being of students living with sickle cell anaemia.

The study concluded that there is strong relationship between psychological factors and the well-being of students living with sickle cell anaemia.

In this light, the study recommended that Lecturers, HOD’s, student unions, class reps should monitor their students living with sickle cell anaemia effectively and should not allow environmental sickness to influence them as this can increase there illness, Students living with sickle cell anaemia should ensure that their friends and roommates are aware of there health status as that will positively help if any sign of illness is shown, students living with sickle cell anaemia should be assessed by psychological counselor and doctor regularly so they can might do better.


Chapter One


Introduction

1.1 Background of the Study

People with sickle cell disease can live a normal life and achieve their dreams and aspirations if the condition is well managed especially from the psychological perspectives. Sickle cell anaemia is a genetic disorder that can be acquired if both parents carry the disease trait (World Health Organization WHO, 2010). In sickle cell anaemia, the red blood cells clump together causing the originally round-shaped red blood cells to appear as semicircular shaped red blood cells (National Institute of Health NIH, 2013). Sickle cell anaemia disease is categorized as a disease accompanied by frequent pain, low red cell blood count, and infection (NIH, 2013). Psychological factors for sickle cell anaemia are well known risk factors for many adverse health outcomes. These psychological factors can indirectly or indirectly influence the wellbeing of students living with sickle cell anaemia. Wellbeing is now commonly proposed as a theme for outcome measures as it reflects the expanded goals of care, from medical treatment of sickle cell anaemia toward broader wellness. Several reliable ways of measuring well-being are available, including measures that focus on the presence of positive emotions and the absence of negative emotions, life satisfaction, social engagement, and physical wellness. Such measures of subjective well-being emphasize the importance of the hedonic aspects of experience, such as pleasure, satisfaction, and happiness

Sickle cell anaemia affects red blood cell protein called hemoglobin. This hemoglobin carries oxygen to the entire body; however, with sickle cell anaemia the red blood cells are crescent shaped and unable to pass through the blood vessels appropriately (Sickle Cell Disease Association of America SCDAA, 2015). The inability of the crescent-shaped red blood cells to pass through the blood vessels decreases the level of oxygen carried from the lungs to rest of the body. The sickle shape causes red blood cells to deteriorate early, which leads to anemia (NIH, 2013). The long-term effect of sickle cell anaemia over time leads to a progressive and systemic weakening of multiple organs. The resulting symptoms include repeated occurrences of severe pain, anemia, organ damage, and infection (NIH, 2013). An individual with SS genotype which is the sickle cell disorder is likely to suffer pains throughout his or her entire life. This can lead to depression and even suicidal thoughts.

Sickle cell anaemia is a life-threatening disease that can damage how red blood cells break down (Steinberg, 1999). Sickle cell anaemia causes damage to the spleen as blood accumulates in it or when the bone marrow stops manufacturing red blood cells due to the presence of infection (Steinberg, 1999). Sickle cell anaemia patients who experience frequent crisis develop multisystem organ damage including but not limited to renal failure, pulmonary disease, cerebral vascular accidents, weakening of the bone, destruction to the eye, and damage to the central nervous system (Steinberg, 1999). Further complications include priapism (unwanted, painful penile erection) and respiratory problems (Steinberg, 1999).

The wellbeing of students living with sickle cell anaemia is greatly influenced psychologically. A student is a learner or someone who attends an educational institution with the expectation of passing out with a particular level of grade before he/she can be considered successful. During the course of study, students are involved in a lot of mental, physical and social activities which can only be done when in a state of good health. The inability of students living with sickle cell anaemia to participate adequately in all the school activities due to the condition has being a major concern to many scholars because of poor academic outcome that comes with their in-and-out-of-hospital trend the disease normally takes.

The diverse paths and severity of sickle cell anaemia are the result of intrinsic and extrinsic factors ranging from genetic markers, environment, ethnicity, socioeconomic status, religion, and cultural beliefs (Anie et. al., 2010; Cajado et al., 2011). These factors affect the wellbeing and quality of life of students who live with sickle cell anaemia. The wellbeing describes the positive and negative aspects of life that can affect the mental and physical state of the students. This is determined by health status, level of comfort, and state of happiness (Centers for Disease Control and Prevention CDC, 2011). The students wellbeing displays the balance between biophysical, psychosocial, sociocultural and spiritual aspect of life (Adegbola, 2011). Wellbeing can be determined by understanding the contributing factors and how individuals cope (Adegbola, 2011). Students living with sickle cell anaemia can be reported to have difficulty coping with pain associated with the condition, which may obstruct with the ability to complete daily academic task, therefore impacting psychologically on his/her wellbeing (Adegbola, 2011). Students living with sickle cell anaemia are mostly perceived as people who do not have a better social life as those without the disease (Adegbola, 2011). This study will however identify the psychological factors influencing the wellbeing of students living with sickle cell anaemia.


1.2 Statement of the Problem

It is widely known facts that the wellbeing of students living with sickle cell anaemia is greatly affected due to their inability to actively participate in most educational activities which oftentimes lead to poor performance and other unfortunate educational outcomes. And researchers have previously shown that differences in psychosocial functioning experienced by people with sickle cell anaemia in Nigeria might be the result of divergent levels of health (Anie et al., 2010). Anie et al., (2010) suggested the initiation of basic psychosocial interventions by non-specialized health workers in primary health care team to decrease harmful feelings towards sickle cell anaemia, and to foster the development of sickle cell anaemia management techniques. Researchers have not fully explained the psychological factors influencing the wellbeing of people living with sickle cell anaemia in Nigeria. In this study, the psychological factors influencing the well being of students living with sickle cell anemia will be identified. The study will also determine the socioeconomic and cultural practices of Nigerians that may influence the wellbeing and quality of life of individuals living with sickle cell anaemia with particular focus on students. This study will further explore the psychological impact of the disease based on accessibility to comprehensive management of and may inform the development of future health educational interventions to encourage behavioral change and reduce the disease burden on wellbeing.


1.3 Objectives of the Study

The following are the objectives of this study:

  1. To determine the psychological factors influencing the wellbeing of students living with sickle cell anaemia in Babcock University.
  2. To examine the socioeconomic and cultural practices of Nigerians that may influence the wellbeing of students living with sickle cell anaemia in Babcock University?
  3. To analyze the level of accessibility of Babcocock students living with sickle cell anaemia to comprehensive management to encourage behavioral change.

1.4 Research Questions

  1. What are the psychological factors influencing the wellbeing of students living with sickle cell anaemia in Babcock University?
  2. What are the socioeconomic and cultural practices of Nigerians that may influence the wellbeing of students living with sickle cell anaemia in Babcock University?
  3. What is the level of accessibility of Babcocock students living with sickle cell anaemia to comprehensive management to encourage behavioral change?

1.5 Research Hypothesis

  • HO: There are no psychological factors influencing the wellbeing of Babcock’s students living with sickle cell anaemia.
  • HA: There are psychological factors influencing the wellbeing of Babcock’s students living with sickle cell anaemia.

1.6 Significance of Study

This research is significant because it focuses on the psychological factors influencing the wellbeing of students living with sickle cell anaemia. Globally, the course and severity of sickle cell anaemia varies as a result of several factors like genetic markers, environmental factors, ethnicity, social and economic variables, religion, and cultural beliefs. The number of sickle cell anaemia patients particularly the students category continues to increase exponentially in Nigeria with no strategic programmatic efforts geared towards improving the wellbeing of the affected persons. This may be due to rampant misconceptions about sickle cell anaemia and the misdiagnosis of hemoglobin phenotypes. After determining the psychological factors influencing the wellbeing of students living with sickle cell anaemia, researchers and providers can explore public health interventions that encourage changes in health behavior and beliefs of patients towards the condition. This research will be a contribution to the body of literature in the area of the psychological factors influencing the wellbeing of students living with sickle cell anaemia, thereby constituting the empirical literature for future research in the subject area.


1.7 Scope of the Study

This research work will examine the Psychological Factors Influencing The Wellbeing Of Students Living With Sickle Cell Anaemia.


1.8 Limitation of Study

Financial constraint

Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint

The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.


1.9 Operational Definition of Terms

Psychological factors:

Are the factors that talk about the mindset of an individual that drive his actions to seek satisfaction

Wellbeing:

The state of being comfortable, healthy, or happy

Anaemia:

A condition in which there is a deficiency of red cells or of haemoglobin in the blood, resulting in pallor and weariness.

Sickle cell anaemia:

A severe hereditary form of anaemia in which a mutated form of haemoglobin distorts the red blood cells into a crescent shape at low oxygen levels. It is commonest among those of African descent

Red blood cell:

Is typically a biconcave disc without a nucleus which imparts the red colour to blood, and transport oxygen and carbon dioxide to and from the tissues.

Haemoglobin:

A red protein responsible for transporting oxygen in the blood of vertebrates. Its molecule comprises four subunits, each containing an iron atom bound to a haem group.


Chapter Five


Summary Conclusion and Recommendation

5.1 Summary

More research on the public’s general knowledge about this disease will help determine the areas where more education is needed on SCD. The reviewed literature has focused on the biological genetics of this disease, but not much research has specifically addressed the awareness of this disease in all populations. Further studies are needed to address the effectiveness of intervening media campaigns to increase sickle cell awareness. It is important to evaluate which media source is most effective in increasing the public’s awareness on this disease. We live in a technological age where Facebook, Twitter, MySpace, television/public radio commercials, web advertisement, and celebrity spokesmen are all currently a part of the marketing strategies used to inform the general public about a health disease or product. If this same approach was used to increase public awareness, more people would be informed about SCD, as well as their status as a carrier.

Another factor that can help address this issue is placing a public figure in the forefront for sickle cell disease. Ideally, he or she could help start a movement on SCD awareness. The public figure would more than likely generate additional funds for research, treatment, and even cures for SCD. Public interest would increase more medical training on this particular disease and help eliminate attitudes and preconceived notions of this disease. With more education and training, patients will be able to receive optimum care, and more centers can be built to specifically treat this disease in high-risk communities.

More research on health care professionals’ perceptions and practices on painrelated SCD would also help increase sickle cell disease awareness in the medical world. The reviewed literature shows that some pain specialists who operate on sickle cell patients have inadequate knowledge on the disease’s related pain. Therefore, physicians must continue to build strong relationships with patients who have SCD. Establishing centers that focus on this disease will allow more people to receive appropriate treatment and care.

In addition, studies have not addressed sickle cell disease and interracial marriages. In the United States, we see a steady growth of immigrants from all over the world. Our world has become more diverse, and more couples are pushing the racial boundaries and marrying outside their race (see Figure 2-7). Researchers from the Pew Research Center for the People and the Press, an independent research organization, reported that one out of seven new marriages are multi-racial or multi-ethnic (Chen, 2010).

Figure 5-1: Interracial marriages 2005 (Microsoft News, 2007).

An increase in interracial marriages among the millennial generation 18 to 29 year olds has occurred. Research shows that 85% of the millennial generation accepts interracial marriages, and more people from this age group are producing a new generation of multi-racial children (Chen, 2010). Since interracial marriages are a growing trend, a need arises for more research on interracial marriages and how they correlate with sickle cell disease. Sickle cell disease will soon have an impact on all ethnicities and the gene will no longer be found primarily among African-Americans. Since this disorder will soon be a problem for all races, it is important that all ethnicities are knowledgeable about this disease and the effects that SCD has on the human body.

In contrast to Chen (2010), Bloom (1995) argued that, due to natural selection, the Hb S gene has become less common among African-Americans in comparison to their African ancestors. Bloom (1995) suggested that fewer African-Americans will have this particular trait. He believed that interracial mating and the decrease of needing a survival mechanism against malaria are causing the gene to be diluted over time. Bloom (1995) believed that these two factors explain why a reduction in the frequency of SCD in black Americans will occur.

On the other hand, with an increase of sickle cell disease in our society, health care will became a main issue. An individual with this disease suffers from chronic health problems throughout his/her life. It is therefore imperative for treatment to be accessible to the public regardless of race, religion, gender, and sexual orientation. With a possible influx of urgent treatment for people with sickle cell disease, more SCD medical centers will need to be established. With sickle cell disease awareness in our communities and federal funding for addition SCD research, plus our government intervention to put a plan into action to cover SCD medical expenses, will help the process of finding a cure to eliminate SCD around the world.


5.2 Conclusion

A case finding observational study that assessed children with SCA who attended two different hospitals (Academe
Charity Teaching Hospital and Jaafar ibn Oaf Pediatric Hospital) during the period of September 2014 to February 2015 were studied to assess the effect of SCA on academic performance. Ninety subjects were found and showed a wide range of ages (4 to 18yrs) with the the majority between the age group of (7 to 9 yrs.). Most of them were primary schoolers and were diagnosed before the age of 6months.More than third of them spent less than one week in the hospital, however, those with poor grades spent more time in the hospital. Furthermore, there was frequent absence among the children especially among the repeaters. The majority of children had more than 2 blood transfusions with third of them being among repeaters. More than half of the children and their parents strongly communicated and interacted with their school teachers regarding the child‟s illness, mostly among those who scored “very good” in end-of-year grades. Only three of them had a history of a stroke and were among those who scored poorly in their school. Furthermore, more than third of them had only one child with SCA in the family, however, half of the repeaters is one of three (or more) of affected children in the family. Most parents found it hard to cope with the disease, especially those who had children who were school repeaters. However, among those that coped well with the disease, a third of their children had scored excellent in school. In summary, there was a strong association between academic performance and time spent in the hospital; teacher-parent-child interaction and communication; stroke; and number of children in the family with SCA.


5.3 Recommendations

Due to our findings that most of the sample scored below the normal percent on measures of academic achievement, the majority of children with SCD may require major interventions from school personnel in order to optimize learning.

  1. Academic functioning is optimized when parents, school administrators and teachers, physicians, and mental health professionals work together and are educated on the cognitive outcomes of SCD.
  2. Modifications at home. by counseling the parents and Allow accommodations during extreme temperatures and conditions. Cold or hot weather can trigger pain crise and by that care the frequency of school absence will change and child will improve in performance
  3. In school teachers that are willing to send assignments home, explain missed assignments, and in some cases provide alternative assignments can promote optimal school functioning for children with SCD.
  4. Care of teachers and school-based mental health professionals can support students with chronic illnesses in their relationships with peers and manage minor pain episodes by working with the school nurse to allow children access to medications when needed.
  5. Set up a meeting to discuss SCD with the child‟s teacher. It may be important for parents and teachers to meet at the beginning of each school year. These school staff should be invited to an introductory meeting
  6. Early identification and treatment of children at risk for stroke as well as increased support for parents at home in obtaining special education services for their child may be instrumental in further supporting academic development in children with SCD Because of the risks to general cognitive development and in other hand Teachers should be aware that declines in academic achievement, inability to maintain attention, difficulties with organization, and mild delays in vocabulary development may be due to small brain injuries caused by strokes.,
  7. Children with SCD may require learning accommodations, such as early, small group instruction, close monitoring of progress, and/or accommodations in the classroom to promote optimal development.
  8. Our findings reveal that there are disease factors in addition to stroke that influence academic achievement (e.g., chronic transfusion) .
  9. Improve the psychosocial factors such as quality of life play an important role in determining those at risk. And easy parental coping ability with child and responsibilities of the situation.
  10. Make a constant protocol for those children having SCD by frequent screening for neurocognitive deficits a comprehensive screening program that identifies children with SCD who demonstrate additional environmental and psychosocial risk factors may aid in detecting a broader range of children at risk for poor academic achievement.
  11. Counseling the parents about the screening programs for haemoglobinopathies, in order to of reducing the birth rate of affected with SCD Especially in areas with high prevalence rates of SCA such as Darfur and Kordofan regions, to allow couples to take an informative decision when they are both carriers of the gene.

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