title: Perceived injustice predicts stress and pain in adults with sickle cell disease.
abstract: Research evidence shows that perceived injustice is a context-based unfair treatment that has negative influence on health outcomes. We examined the contribution of patients' perceived injustice regarding interactions with health care providers to stress and pain in adults with sickle cell disease (SCD). This study was a cross-sectional correlational pilot study. Included in the study were adults with SCD who received their care from a university-affiliated comprehensive sickle cell clinic. Participants were 52 adults whose mean age was 34 ± 11 years (minimum [min] 20 years, maximum [max] 70 years). Most of the patients were African American (n = 48, 92%) and female (n = 41, 79%). Forty-eight patients (92%) reported having a high school diploma or higher. Participants completed the perceived injustice questionnaire, perceived stress questionnaire, and the PAINReportIt, which includes questions to measure pain and demographics. We analyzed the data using the linear regression analyses. Perceived injustice from doctors was a significant predictor of perceived stress (p < .001) and pain (p = .002). Perceived injustice from nurses also was a significant predictor of perceived stress (p < .001) and pain (p = .02). The procedural, distributive, and informational domains of perceived injustice attributed to both doctors and nurses consistently predicted patients' perceived stress, but only the procedural and distributive domains of perceived injustice consistently predicted patients' pain. Findings suggest that perceived injustice was negatively associated with stress and pain in adults with SCD and warrant further investigation in a larger sample.
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing and Comprehensive Sickle Cell Center, Chicago, Illinois. Electronic address: moezenwa@uic.edu.
authors.forename: Miriam O
authors.initials: MO
authors.lastname: Ezenwa
authors.affiliation: University of Illinois at Chicago, College of Medicine Department of Medicine, Division of Hematology/Oncology College of Pharmacy Department of Biopharmaceutical Sciences, and Comprehensive Sickle Cell Center, Chicago, Illinois.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Molokie
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing and Comprehensive Sickle Cell Center, Chicago, Illinois.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Wilkie
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing and Comprehensive Sickle Cell Center, Chicago, Illinois.
authors.forename: Marie L
authors.initials: ML
authors.lastname: Suarez
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing and Comprehensive Sickle Cell Center, Chicago, Illinois.
authors.forename: Yingwei
authors.initials: Y
authors.lastname: Yao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000523:psychology*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D017060:Patient Satisfaction; D010465:Perception; D010865:Pilot Projects; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult