Effect of Upgrading Maternal Concepts and Skills on Reducing Pain Severity of their Children Suffering From Sickle Cell Disease

Abstract

Background; sickle cell means an abnormal crescent shaped red blood cell. The present study aimed to evaluate an educational program for the mothers and their children including the knowledge and practices needed in dealing with the sickle cell disease and assessment of pain severity before and after the educational program. This study followed a quasi- experimental design. The sample was consist of 50 children suffering from sickle cell disease and their mothers who were attending at Pediatric Hematology and Oncology unit of Tanta University Hospital and Inpatient Pediatric Department of Elhoboor Hospital in Khafer Al-Sheik. Three tools were used for data collection: a structured interview sheet , pain assessment tool, and mothers and their children knowledge Questionnaire. The result revealed that 60% of children with sickle cell disease had a mean age of 12.1±4.02 years. Before program application the total scores of knowledge for mothers are fair and poor with percentage 14% and 43% respectively, whereas immediately and after three months of the program application the total score of knowledge for all mothers is good. There was significant positive impact on total score of the knowledge about sickle cell disease. There was a highly significant positive impact of Quran program on total score of pain severity. Conclusion: the study was found that the three programs of non pharmacological methods (Quran, progressive relaxation and yoga) reduce severity of pain respectively. There was highly improvement of mothers' knowledge immediately, and after three month the application of program. This study recommended: informing parents about non-pharmacological therapies for pain, such as, progressive relaxation and massage. to recurrent painful episodes called sickle cell crises. (1) The prevalence of sickle cell anemia, are globally widespread. About 5% of the world ' s population carries genes responsible for haemoglobinopathies. (2) The first case of sickle cell anemia in Egypt was reported in 1951 by Abbasy (3) sickle cell disease was recorded in Pediatric Hematology and Oncology unit of University Hospital in Tanta that 1(2%) as homozygous sickle cell (HBSS), 3(6%) as compound heterozygous state of sickle cell (SS), 2(4%) as sickle cell B. Thalassemia , 1(2%) as sickle cell hemoglobin C disease (HbSC). ( 4) Sickle cell anemia is caused by a mutation in the gene that tells the body to make hemoglobin. The red cells, iron rich compound that gives blood its red color. Hemoglobin allows red blood cells to carry oxygen from the lung to all parts of the body. In sickle cell anemia the abnormal hemoglobin causes red blood cells to become rigid, sticky and misshaped, also the sickle cell gene is passed from generation to generation in pattern of inheritance called autosomal receive inheritance. This means that both the mother and father must pass the defective from of the gene to the child to be affected. (5) Sickle cell anemia covers a wide spectrum of illness. Most affected children have chronic anemia with a hemoglobin concentration of around 8 g/dl. The main problems arise from the tendency of the red blood cells to become sickle shaped and block capillaries at low oxygen tension. In children, sickle shaped red blood cells often become trapped in the spleen, leading to a serious risk of death before the age of seven years from a sudden profound anemia associated with rapid splenic enlargement or because lack of splenic function that permits an overwhelming infection. Between 6 and 18 months of age the affect children most often present with painful swelling of the hands or feet (hand -feet syndrome). Children may also suffer recurrent and