A cross-cultural study of psychosocial aspects of sickle cell disease in the UK and Nigeria

Pain experience, health service utilization and psychological coping in adult patients with sickle cell disease were compared cross-culturally between the UK and Nigeria. Patients in the UK experienced a significantly greater number of pain episodes and of longer duration, with more frequent visits to accident and emergency departments compared with those in Nigeria. The Nigerian patients, on the other hand, applied more psychologically active coping strategies such as distraction to deal with their sickle cell pain in the community. These significant differences are explained in relation to external health locus of control factors including beliefs, and the cost of healthcare in relation to the use of health services. Clinical implications of these findings are also considered.