You only work with what you know: Healthcare providers’ experiences using non-pharmacological interventions in managing sickle cell crisis pain in adolescents

Abstract

Sickle cell crises are the leading reason for hospitalization in adolescents with sickle cell disease. Non-pharmacological interventions are recommended for sickle cell crisis pain management in high and low-resource settings. Preliminary evidence suggests high use of non-pharmacological interventions among adolescents with sickle cell disease in home settings in Nigeria, including potentially harmful ones, and limited use in hospitals, possibly due to healthcare providers’ reluctance to use them. Using an interpretive description design, this study explored healthcare providers’ perceptions of non-pharmacological interventions and their experience using and recommending these interventions for managing sickle cell crisis pain in adolescents in Nigeria. Individual, semi-structured interviews were conducted. Data were analyzed using constant comparison analysis. Fourteen healthcare providers were recruited from healthcare settings across Nigeria. Five broad themes were identified: 1) Perceptions, 2) Safety and risks of non-pharmacological interventions, 3) Recommended non-pharmacological interventions, 4) Influencing factors, and 5) Non-pharmacological intervention education. Some providers held misconceptions about non-pharmacological interventions, such as believing they were only effective for patients faking pain. These interventions may be recommended for pain management, depending on the provider. The use of questionable interventions, like herbal concoctions, poses a significant health challenge with serious consequences, including death. Identified barriers to the implementation of non-pharmacological interventions include providers’ inadequate knowledge about these interventions. The patients’ desire to use safe, effective interventions should be supported. Developing contextually relevant educational resources on these interventions might equip providers to support their use during hospitalization, potentially improving their pain outcomes and limiting the use of harmful interventions.

Perspective

This article presents a qualitative summary of the experiences of healthcare providers in recommending and using non-pharmacological interventions for pain management. This information can guide clinicians and researchers interested in developing educational resources on how these interventions are used, providers’ educational needs in Nigeria and dissemination avenues for these resources.