Factors influencing willingness to utilize the emergency department when experiencing sickle cell disease pain crises

IF 2.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the National Medical Association Pub Date : 2025-07-23 DOI:10.1016/j.jnma.2025.07.007

Elizabeth A. Ibiloye , Ayobami A. Aiyeolemi , Jamie C. Barner , Carolyn M. Brown , Hyeun Ah Kang , Benita A. Bamgbade

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引用次数: 0

Abstract

Background

The emergency department (ED) is essential for treating sickle cell disease (SCD) pain crises. However, there is limited understanding of factors influencing intentions to seek ED care during these crises. Guided by the Theory of Planned Behavior (TPB), this study aimed to determine factors influencing willingness to use the ED among individuals with SCD during pain crises.

Methods

A national web-based cross-sectional survey was conducted among adults (≥ 18 years) with SCD who had visited the ED for pain crises. The survey assessed direct and indirect TPB constructs (willingness, attitude, subjective norm, and perceived behavioral control), as well as additional variables such as stigma, prior ED experience, and sociodemographic and personal characteristics. Participants were recruited through a Texas-based SCD advocacy group and a national platform that enables patients to share their disease experiences with external stakeholders. Descriptive statistics and hierarchical regression analyses were used to address the study aim.

Results

A total of 259 responses were received, of which 114 were included in the analysis. The TPB model explained 61 % of the variance in willingness (R²=0.610, p < 0.0001). Direct attitude toward going to the ED (β=0.50, p < 0.0001) and frequency of previous ED visits (β=0.57, p = 0.0005) were the only significant predictors of willingness while controlling for sociodemographic and personal characteristics. The addition of stigma and prior ED experiences did not significantly improve the predictive utility of the TPB model.

Conclusion

Findings support the utility of the TPB in predicting willingness to use the ED among individuals with SCD during pain crises. Intervention strategies aimed at addressing patient attitudes may enhance willingness to use the ED during pain crises as well as the overall ED experience of individuals with SCD.

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当经历镰状细胞病疼痛危机时影响利用急诊科意愿的因素。

背景：急诊科（ED）是必不可少的治疗镰状细胞病（SCD）疼痛危机。然而，在这些危机中，人们对影响寻求急诊科护理意图的因素了解有限。本研究以计划行为理论（TPB）为指导，探讨影响疼痛危机期SCD患者使用ED意愿的因素。方法：对因疼痛危象到急诊科就诊的成人（≥18岁）SCD患者进行了一项全国性的基于网络的横断面调查。该调查评估了直接和间接的TPB结构（意愿、态度、主观规范和感知行为控制），以及其他变量，如耻辱、既往ED经历、社会人口统计学和个人特征。参与者是通过位于德克萨斯州的SCD倡导小组和一个使患者能够与外部利益相关者分享其疾病经验的国家平台招募的。采用描述性统计和层次回归分析来解决研究目的。结果：共收到回复259份，其中114份纳入分析。TPB模型解释了61% %的意愿方差（R2=0.610, p ）。结论：研究结果支持TPB在预测疼痛危机期间SCD患者使用ED的意愿方面的效用。旨在解决患者态度的干预策略可能会提高在疼痛危机期间使用ED的意愿，以及SCD患者的整体ED体验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the National Medical Association 医学-医学：内科

CiteScore

4.80

自引率

3.00%

发文量

139

审稿时长

98 days

期刊介绍： Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.