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Identifying social-behavioral health needs of adults with sickle cell disease in the Emergency Department


J Emerg Nurs

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.

Smith SK, Johnston J, Rutherford C, Hollowell R, Tanabe P. Identifying social-behavioral health needs of adults with sickle cell disease in the emergency department. J Emerg Nurs. 2017;43(5):444-450.PMID: 28527641. DOI: 10.1016/j.jen.2017.04.009.

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Publication year
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Peer Reviewed Research
Outcomes
Process
Social Determinant of Health
Not Specified
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Other Study Design
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