title: Psychosocial stressors of sickle cell disease on adult patients in Cameroon.
abstract: Sickle Cell Disease (SCD) is a debilitating illness that affects quality of life. Studies of the psychosocial burden of SCD on patients have been rarely reported in Africa. We used a quantitative method, with face-to-face administered questionnaires, to study indices of psychosocial stressors on adult SCD patients in Cameroon. The questionnaire included a 36-item stress factors scale evaluating general perceptions of stress and five main stressors' domain: disease factors, hospital factors, financial factors, family factors and quality of personal-life factors. Items pertaining to psychosocial stressors involved four response options with increasing severity: 0, 1, 2 or 3. Non-parametric tests were used for analysis. The majority of the 83 participants were urban dwellers, female, 20-30 years old, single, unemployed, with at least a secondary or tertiary education. Median age at diagnosis was 100 months; 47.8% had >3 painful vaso-oclusive crises annually. Only 4.8% had been treated with hydroxyurea. The majority reported moderate to severe difficulty coping with SCD. The "degree of clinical severity" category displayed the highest median score (2.0), while familial stressors showed the lowest (0.8). Being female, married, with low education level, an additional affected sibling and low direct income were significantly associated with specific stressors' categories. In Cameroon, there is an urgent need to implement policies that ensure affordable access to health-care and practices to reduce SCD morbidity and improve patients' quality of life.
authors.affiliation: Division of Human Genetics, Faculty of Health Sciences, University of Cape Town (UCT), Anzio road-7925, Observatory, Cape Town, South Africa, ambroise.wonkam@uct.ac.za.
authors.forename: Ambroise
authors.initials: A
authors.lastname: Wonkam
authors.forename: Caryl Zameyo
authors.initials: CZ
authors.lastname: Mba
authors.forename: Dora
authors.initials: D
authors.lastname: Mbanya
authors.forename: Jeanne
authors.initials: J
authors.lastname: Ngogang
authors.forename: Raj
authors.initials: R
authors.lastname: Ramesar
authors.forename: Fru F
authors.initials: FF
authors.lastname: Angwafo
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000755:Anemia, Sickle Cell / Q000175:diagnosis* / Q000523:psychology*; D002163:Cameroon; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing / Q000379:methods; D015438:Health Behavior; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult