PSYCHOSOCIAL ISSUES IN THE TREATMENT OF CHILDREN WITH SICKLE CELL DISEASE

Abstract

The impact of chronic illness on psychological development is a topic of much interest in current pediatric behavioral studies. This paper reports on the ongoing study in the Department of Pediatrics and the Comprehensive Sickle Cell Center of the University of Illinois Health Sciences Center to determine the psychosocial impact of sickle cell disease on a population of 150 children and adolescents, ages 8 to 16. The results of this study completed on ten patients, investigating the relationship between illness variables and personality, cognitive adjustment, family and school variables, reveal that a number of illness variables correlate significantly with personality and adjustment. Those illness variables include hemoglobin type, number and frequency of hospitalizations and ER visits, frequency and intensity of pain crises, type of disease involvement and presence or absence of transfusion. Adjustment and behavior showed a positive correlation with improved health status. However, beginning at age 12 an increase in hospitalizations and ER visits was accompanied by a significant reduction in self-esteem and social adjustment, family cohesion and sense of internal control. Our transfused population, in particular, showed poorer functioning on cognitive, personality and adjustment measures. These preliminary findings suggest that family, personality and school issues are effected by the disease process, and emphasize the need for early intervention with the family, school and medical establishment.