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Health-Related Quality of Life and Adaptive Behaviors of Adolescents with Sickle Cell Disease: Stress Processing Moderators

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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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Acknowledgments

This project was supported in part through a Comprehensive Sickle Cell Center Grant P60-HL-62148. The authors wish to thank the patients and their families of the Marian Anderson Sickle Cell Center for their participation, and the pediatric research team at Drexel University for their dedication to this project.

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Authors and Affiliations

  1. Division of Oncology, The Children’s Hospital of Philadelphia, 3501 Civic Center Blvd., 10303 CTRB, Philadelphia, PA, 19104, USA

    Maisa S. Ziadni, Chavis A. Patterson & Lamia P. Barakat

  2. University of Miami Miller School of Medicine, Miami, FL, USA

    Elizabeth R. Pulgarón

  3. St. Christopher’s Hospital for Children, Philadelphia, PA, USA

    M. Renée Robinson

  4. Drexel University College of Medicine, Philadelphia, PA, USA

    M. Renée Robinson

  5. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Lamia P. Barakat

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  1. Maisa S. Ziadni
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  2. Chavis A. Patterson
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  5. Lamia P. Barakat
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Correspondence to Lamia P. Barakat.

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Ziadni, M.S., Patterson, C.A., Pulgarón, E.R. et al. Health-Related Quality of Life and Adaptive Behaviors of Adolescents with Sickle Cell Disease: Stress Processing Moderators. J Clin Psychol Med Settings 18, 335–344 (2011). https://doi.org/10.1007/s10880-011-9254-3

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