Attitudes and Beliefs of Nurses and Nurse Assistants toward Patients with Sickle Cell Disease: A Mixed Methods Study.

Background: Pain experienced among individuals with sickle cell disease (SCD) is the primary requirement for hospitalization.

Purpose: This study examined the relationship of age, race, and years of experience among medical-surgical nurses and nursing assistants to their attitudes in caring for SCD patients and identified barriers that influence pain management care.

Design, Setting, Participants: An explanatory sequential mixed-methods study design was used. Online survey data were collected among 56 participants and online interviews were conducted among three participants.

Methods: The General Perceptions of Sickle Cell Patients (GPSCP) Scale-17, composed of four subscales, assessed providers attitudes toward patients with SCD. Two subscales assessed providers' attitudes behaviors related to acute and chronic pain management.

Results: There was no relationship between age and years of experience to scores on four subscales. White/Caucasian study participants scored higher on the Red Flag Behaviors subscale, indicating that White/Caucasian participants had stronger beliefs concerning drug-seeking behaviors among SCD patients as compared to other ethnicities/races. Themes generated from the qualitative interview data analysis were: 1) reflections on one's own practice compared to others' practice; 2) communication as a barrier/facilitator to providing care; 3) lack of national guidelines; and 4) adjunct staff are critical to facilitating holistic care.

Conclusions: Racial and ethnic differences exist among medical-surgical nurses and nursing assistants' attitudes. Poor communication and lack of national standards of care are barriers to providing high quality care.

Clinical Implications: Culturally sensitive care, based on current practice guidelines, is needed for improved pain management care for patients with SCD.