OUTCOME OF NURSING INTERVENTION ON SELF-CARE ABILITY AND QUALITY OF LIFE OF ADOLESCENTS LIVING WITH SICKLE CELL DISEASE IN OYO AND EKITI STATES

Abstract

Sickle Cell Disease (SCD) is a lifelong disorder which influences Quality of Life (QoL) of affected individuals. Studies have shown that nursing intervention in form of self-care education has positively influenced self-care ability and subsequently enhanced QoL of individuals in other chronic diseases. Anecdotal evidence indicates that parents do not have confidence in the self- care ability of adolescents with SCD; which aggravates the effect of the disease on their psychological and social well-being. However, there is a dearth of nursing intervention studies on self-care education among people living with SCD in Nigeria. The study was designed to investigate the outcome of nursing intervention (self-care education and supportive supervision) on self-care ability and QoL of adolescents living with SCD in Oyo and Ekiti states.

A quasi-experimental study was conducted in Oyo and Ekiti States. Ring Road State Hospital Ibadan, Ekiti State University Teaching Hospital and Federal Medical Centre, Ido-Ekiti were purposively selected because they have similar functional SCD clinics. Oyo State was randomly assigned as Experimental group (EG) and Ekiti State was the Control group (CG). A total of 115 adolescents; 59 in EG and 56 in CG were recruited for the study. At baseline (P1), the participants in both groups completed a semi-structured questionnaire on Self-care Ability (SCA) with a minimum score of 30 and a maximum score of 112 and Sickle Cell Disease Quality of Life (SCD-QoL) with a minimum score of 15 and a maximum score of 60. The participants in EG received routine care, nursing intervention in the form of self- care education and supportive supervision (home visit), while participants in CG received only routine care. Post intervention data on SCA and SCD-QoL were collected at the 12th week during the rainy season (P2) and at the 24th week in dry season (P3) respectively. Data were analysed using descriptive statistics, independent t-test and repeated measures ANOVA at α0.05.

The mean age of participants in the EG (15.7±2.7 years) and CG (14.8±3.8 years) were not significantly different. The mean SCA scores also were not significantly different at P1 in EG 58.31±11.84 and in CG 63.48±9.45. At P2,the mean SCA scores were 88.14±8.76 in EG and in CG 68.01±7.90, while at P3, SCA scores in EG was 88.97±6.97 and 70.04±9.43 in CG. However, the higher value in EG denoted improved SCA. The SCD-QoL scores were not significantly different at P1 in EG (41.94±7.62) and CG (39.54±7.63); but there was an increase in mean QoL scores at P2 in EG (48.08±6.20) compared to CG (40.73±8.02) and at P3, EG (49.20±5.51) compared to CG (37.84±7.30). The higher value in EG showed improved QoL among adolescents.

Self-care education and supportive supervision were essential in developing the aptitude towards independent care among adolescents living with sickle cell disease in Oyo and Ekiti states. Hence, community health nurses should consider adoption of these modes of intervention in the management of adolescents with sickle cell disease.