Revise paper

timer Asked: May 16th, 2018
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Question Description

correct feedback in paper from professor

correct feedback in paper from professor

correct feedback in paper from professor

correct feedback in paper from professor

Tutor Answer

School: University of Virginia

Hello, I will mark the question as complete despite not having submitted the work. There are few sections I had corrected that am researching further to re-correct as I wait for your response on data availability. In at most 6 hours the paper will be done.


Dissertation Prospectus
Self-Care and Psychosocial Factors That Predict SCD-Related Outcomes among AfricanAmericans in Illinois, USA




Self-Care and Psychosocial Factors That Predict SCD-Related Outcomes among AfricanAmericans in Illinois, USA
Problem Statement
Sickle cell disease (SCD) is a debilitating illness associated with short-term and longterm complications that present a substantial number of visits to an emergency room and
hospitalization of a patient (Santos, Jones, Wakefield, Grady, & Andemariam, 2016). Despite
being a blood disease, SCD affects the whole body and its pathophysiology sets in early in
infancy (Manwani & Frenette, 2013). The key features of SCD are vaso-occlusion and chronic
hemolytic anemia (Manwani & Frenette, 2013). Self-care across the lifespan is imperative in
managing this chronic disease, preventing complications and boosting the general health and
well-being of the individual. SCD is associated with a number of complications that patients are
more likely to experience. One of the complications is auto infarction, due to sickling of the
erythrocytes, which leads to a non-functioning spleen (Brown, Dada-Adegbola, Trippe, &
Olopade, 2017). This results in functional asplenia that increases the risk of invasive attacks
since the spleen is unable to screen bacteria from circulation.) Therefore, infections mainly from
encapsulated bacterial micro-organisms, such as salmonellae, Haemophilus influenza,
S.pneumoniae, and parasitic infections become prone among this patients (Brousse, Buffet, &
Rees, 2014). Preventing invasive attacks is thus an imperative measure in maintaining well-being
among persons with SCD.
Children with SCD also experience complications, including fever, sepsis, and overt
stroke during their childhood. The major cause of fever is viral infections and the rate of
occurrence of significant bacterial infections is 16% (Fox, 2016). The death rate of SCD has
substantially dropped over the years, but sepsis remains the major cause of death overall, with



S.pneumoniae being the most common cause of mortality linked to bacterial attack in children
with SCD (Brown et al.,2017). Another complication among children with sickle cell disease is
an overt stroke, a neurological complication in SCD. Parents of these SCD children can
experience psychosocial processes, which are a scope of social and interpersonal processes that
influence how one interprets environmental incidents and respond to stressors. Quinn (2013)
found that, in absence of primary prevention measures, overt stroke manifested in 11% of
children with SCD (Hb SS) before the age of eighteen. Preventing this complication thus
requires public health involvement to integrate measures, including transcranial Doppler
assessment for overt stroke and self-care practices for viral infections and sepsis.
Sickle cell trait (SCT) is a hereditary component of a gene that causes SCD when two
SCT couples reproduce. For an individual to be born with SCD, both of his/her parents must be
carriers of a sickle cell gene. Most African-Americans possess a sickle-cell trait (SCT) and
sometimes are unaware of their carrier status (Bean et al., 2014). According to Mayo-Gamble et
al. (2017), most African-American persons also don’t understand the genetic pattern and
transition of sickle cell disease. Owens (2015) identified that most African-American women
have limited information on the hereditary patterns of SCD. This results in a genetic
metamorphosis of sickle-cell disease when such individuals marry others of similar carrier status
and reproduce (North Alabama Sickle Cell Foundation, 2013). There are also perceptions and
information gaps exhibited by African-Americans regarding SCT and SCD. The CDC (2014)
identified information gaps amongst SCT carriers, which indicated the need for the group to
understand the complications, symptoms, and the management choices of the disease.
Information gaps of management affects self-responsibility and self-efficacy in controlling SCD.
According to Mayo-Gamble et al. (2017), the perceptions of African American women of



reproductive age on the inheritance patterns of SCT, perceived necessity of SCT, and perception
of SCT as an illness could hinder public health practices such screening for the disease. Failure
to screen has escalated the occurrence of SCD and SCD health-related outcomes, a phenomenon
attributed to marriages among SCT carriers. Understanding the management choices and
practices is imperative for individuals with SCD to undertake self-care and guaranteeing selfresponsibility practices requires sealing the gaps.
Most practices to maintain the well-being of SCD patients involve the management of the
disease to prevent complications. Primarily, most of these management activities occur at home
and include prevention of complications and infections, ensuring hydration, and pain
management. The frequency of painful events is highest between the age of 19 to 39 years while
re-hospitalization and healthcare utilization peak from the age of 18 to 25 years (Matthie,
Jenerette, & McMillan, 2015). Persons with SCD can also experience psychosocial reactions to
their disease due to coping capabilities, painful events, self-confidence, death, and feeling of
being a burden. Crossby et al. (2015) posit that psychosocial factors put young adults and
adolescents at risk for challenges with the management of the illness. Therefore, psychosocial
factors and self-care practices largely influence the well-being of an SCD patient and also affects
the outcome of the disease. Savage et al. (2015) postulate that areas of SCD control including
prevention, screening, priapism, renal disease management, ophthalmologic complications, and
multi-system organ breakdown are with insufficient reliable investigations to build on
management advocacy. The current management recommendations for SCD often rely on poor
quality evidence, consensus opinions from experts, or adoption of non-empirical evidence from
different patient groups (Savage et al., 2015) which necessitates the conduct of quality studies to
identify barriers to SCD control and management. Illinois is one of the states with a high



population of African-Americans in the US. According to the United States Census Bureau
(2017), the population of African-Americans in Illinois is estimated to be 14.7% of the total
population. With SCD being more common among the African-American population, their
significant concentration makes Illinois the area of consideration to undertake this research. To
add up to the current SCD management studies, this investigation focuses on viewing deeper into
the self-care and psychosocial factors that predict SCD-related outcomes among the AfricanAmericans in Illinois, USA.

SCD complications are traumatic and are associated with significant morbidities and
mortalities. Complications such as overt stroke or silent cerebral infarcts are detrimental and
given their high rates of occurrence (Majumdar et al., 2014) self-care interventions are essential
in managing the disease. Psychosocial factors affecting persons with SCD also largely
compromise the health outcomes of the patients. According to (Crossby et al., 2015), young
adults and adolescents experience psychosocial stressors that negatively influence the
management of SCD by increasing the risk for poor disease care. Therefore, the purpose of this
investigation is to analyze the self-care and psychosocial factors and how they influence SCDrelated outcomes among the African-Americans in Illinois, USA

The significance of this study is to stir useful social change to the African-Americans
with regard to psychosocial factors and self-care. Social change refers to an overtime alteration
in relationships and interactions that modify social and cultural institutions resulting in lasting



consequences (Dunfey, 2017). Self-care is imperative and subscribes to personal pain
management thus preventing p...

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awesome work thanks

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