title: Attitudes toward patients with sickle cell disease in a multicenter sample of emergency department providers.
abstract: Patients with sickle cell disease (SCD) often seek care in the emergency department (ED) for pain associated with vaso-occlusive crises. Research has shown that negative provider attitudes serve as a barrier to care in this patient population. Our aim was to validate a survey that measures attitudes toward SCD patients among ED providers (nurses and physicians) and to compare differences in attitude scores between provider types. We administered the general perceptions about Sickle Cell Disease Patients Scale, previously validated among internal medicine providers, and the Medical Condition Regard Scale (MCRS) to ED nurses and physicians from two EDs. A total of 215 surveys were returned (63% response rate, 200 with attitude items completed). Three subscales were identified: Negative Attitudes, Uneasiness With Care, and Positive Attitudes. Cronbach's αs exceeded 0.81 for each subscale. Mean (SD) scores for the Negative, Uneasiness, and Positive subscales and MCRS were 61.5 (20.3), 66.1 (17.1), 41.2 (17.8), and 42.2 (8.9), respectively. Compared with physicians, nurses had significantly higher mean Negative Attitude scores and lower Uneasiness scores. A slightly modified version of the general perceptions about Sickle Cell Disease Patients Scale appears to be a valid measure of ED provider attitudes toward SCD patients. Among ED providers, this scale identified a dimension not observed in research with the original instrument among internal medicine providers. Provider attitudes influence patient-provider interactions and quality of care. The scale we present here has major clinical implications, particularly for advanced practice nurses, who can use the scale not only to assess providers' attitudes toward SCD patients but also to determine the effectiveness of tailored interventions to improve those attitudes.
authors.affiliation: Division of Emergency Medicine, Department of Surgery (Drs Freiermuth, Thornton, and Tanabe), School of Nursing (Drs Silva, Sullivan, Thornton, and Tanabe and Ms Kayle), and Division of Hematology, Department of Medicine (Dr Tanabe), Duke University Medical Center, Durham, North Carolina; Division of Hematology, The Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Haywood); and Department of Emergency Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina (Dr Cline).
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Freiermuth
authors.forename: Carlton
authors.initials: C
authors.lastname: Haywood
authors.forename: Susan
authors.initials: S
authors.lastname: Silva
authors.forename: David M
authors.initials: DM
authors.lastname: Cline
authors.forename: Mariam
authors.initials: M
authors.lastname: Kayle
authors.forename: Dori
authors.initials: D
authors.lastname: Sullivan
authors.forename: Victoria
authors.initials: V
authors.lastname: Thornton
authors.forename: Paula
authors.initials: P
authors.lastname: Tanabe
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000523:psychology*; D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D011795:Surveys and Questionnaires