Improving Clinician Attitudes of Respect and Trust for Persons With Sickle Cell Disease

Abstract

A B S T R A C T OBJECTIVE:To test the effect of 1 high-intensity, and 1 reduced-intensity, educational intervention designed to improve health care provider attitudes toward youth with sickle cell disease (SCD). METHODS:We exposed a regional sample of pediatric health care providers to a 2.5-day highintensity educational and experiential intervention using videos about the SCD patient experience. Additionally, we traveled to a different set of regional health care institutions and offered pediatric providers a reduced-intensity intervention, consisting of a 90-minute lunchtime in-service centered on our same set of videos about the patient's experience. We assessed the impact of both interventions by taking pre/post measurements of the negative and positive attitudes expressed by participating providers toward patients with SCD. RESULTS:Both interventions tested elicited improvements in the SCD attitudes expressed by the pediatric providers as suggested through a reduction in measured negative attitude scores (20.0 vs 12.1, P , .001), and an improvement in positive attitude scores (67.1 vs 72.2, P , .001). Further testing suggested that the high-intensity intervention elicited a stronger effect than the reducedintensity intervention across multiple attitudinal domains. CONCLUSIONS:Video-based interventions can be used to improve the attitudes of pediatric providers toward patients with SCD. The availability of interventions of varying intensities provides greater flexibility in designing efforts to advance the quality of SCD care through the improvement of provider attitudes.

Pediatric residents’ perceived barriers to opioid use in sickle cell disease pain management

“…Qualitative analyses provided insights into the complexity of barriers that patients with SCD often face, including their disease and its complications, psychosocial barriers, and distrust of the healthcare system, as a potential reason for negative provider attitudes. These findings are consistent with SCD literature that shows how negative provider attitudes can diminish trust in a patient–provider relationship, resulting in inadequate care . Previous studies have also shown that negative provider attitudes are associated with higher volumes of patients with SCD as well as decreased provider adherence to NHLBI guidelines in treatment of acute SCD pain, potentially increasing the morbidity and mortality of patients with SCD.…”

“…This highlights the need for targeted education early in residency training so that physicians develop the skills to safely and responsibly provide effective, evidence‐based treatments for patients in pain. A variety of curricular approaches, including traditional didactic sessions, experiential case‐based methods, patient panels, and digital toolkits, can be utilized by training programs to better equip residents to care for patients with pain and attend to those who develop substance‐use disorders …”

“…It is well documented that sickle cell pain is often undertreated . Negative provider attitudes toward patients with SCD have been shown to present significant barriers to patients receiving adequate pain management .…”

Does Attendance at a Sickle Cell Educational Conference Improve Clinician Knowledge and Attitude Toward Patients with Sickle Cell Disease?

“…Although other approaches have been used to identify and change healthcare providers’ attitudes towards individuals with SCD (Freiermuth et al, 2014; Glassberg et al, 2013; Haywood et al, 2011; Haywood, Williams-Reade, Rushton, Beach, & Geller, 2015; O'Connor et al, 2014; Ratanawongsa et al, 2009), we report data from an education conference intervention that facilitated interaction among healthcare providers, individuals living with sickle cell disease, and family members as a part of enhancing sickle cell knowledge and healthcare provider attitudes. Because the intervention is successful in both improving healthcare provider knowledge and decreasing negative attitudes even with a small sample, we consider this educational conference approach as a feasible first step in closing the SCD knowledge gap of healthcare providers while also influencing their attitude toward individuals living with SCD.…”

The Whys of Patient Centered Care

“…Patient-centered care is intended to improve the status of patients from the units of throughput to one of the pillars of decision making in patient-oriented treatment. [8][9][10] It is impossible to serve this purpose unless physicians find a new perception of what leadership in medical performance is and to shift from the old hakim concept of practitioner that is physician-oriented to a new concept of practitioner in the modern era. 11 Moreover, the advocacy and insurance systems should try to lower the complexity of the bureaucratic strategies and consider the role of health consumers important in decision making for their own treatment.…”