Health-Related Quality of Life and Adaptive Behaviors of Adolescents with Sickle Cell Disease: Stress Processing Moderators |
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Authors: | Maisa S Ziadni Chavis A Patterson Elizabeth R Pulgarón M Renée Robinson Lamia P Barakat |
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Institution: | (1) Division of Oncology, The Children’s Hospital of Philadelphia, 3501 Civic Center Blvd., 10303 CTRB, Philadelphia, PA 19104, USA;(2) University of Miami Miller School of Medicine, Miami, FL, USA;(3) St. Christopher’s Hospital for Children, Philadelphia, PA, USA;(4) Drexel University College of Medicine, Philadelphia, PA, USA;(5) University of Pennsylvania School of Medicine, Philadelphia, PA, USA; |
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Abstract: | The objective of this study was to examine resilience among adolescents with sickle cell disease (SCD), focusing on the interaction
of health-related quality of life with stress processing to explain adaptive behavior. Forty-four adolescents with SCD completed
paper-and-pencil measures of health-related quality of life, appraisals (hope), pain coping strategies (e.g. adherence), and
adaptive behavior. Self-reported health-related quality of life was significantly associated with adaptive behavior, as was
adherence. Findings for moderation were mixed. Pain coping strategies moderated the association of health-related quality
of life with adaptive behavior such that at lower levels of Coping Strategies Questionnaire (CSQ) Adherence, better quality
of life was associated with higher adaptive behavior. Similarly, at higher levels of hope, better quality of life was associated
with higher adaptive behavior, and poorer quality of life was associated with lower adaptive behavior. Adolescents with SCD
showed resilience, particularly in terms of personal adjustment, that may be explained by their appraisals and stress processing
strategies. Interventions to support an optimistic or hopeful outlook and improve adherence to recommendations for medical
management of sickle cell pain may result in improved resilience/adaptive behavior. |
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