CHAPTER ONE

           INTRODUCTION:

1.0     BACKGROUND OF THE STUDY.

Sickle cell disease is an inherited disease of the red blood cell in which there is an abnormal type of haemoglobin (HB-S). The globin chain structure is changed by the substitutions of one amino acid and this effectively changes the behavior of the whole molecule. Sickle cell disease occurs almost exclusively among black Americans and black Africans. Sickle cell trait is a heterozygous state; the individual has inherited the Hb-S gene from only one parent. Only a small amount of the individual’s haemoglobin is type Hb-S. The person with sickle cell trait is   usually asymptomatic and is often unaware of the condition which is only reliably detected by haemoglobin electrophoresis.

In sickle cell disease, certain red blood cell becomes crescent-shaped (Ogamdi, 1994).

These abnormal haemoglobin known as haemoglobin S, are fragile. A person who has sickle cell can become more likely to infection because the damaged cells eventually clog the spleen.

Sickle cell crises is a pain that can begin suddenly and last several hours to several days. It happens when sickled red blood cells block small vessels that transport blood during blood circulation. The pain can be throbbing, sharp, dull or stabbing.

The knowledge, attitude and practice of sickle cell crises prevention has been identified and acknowledged as a strategy for prevention of sickling crisis.

This research work has explored into the knowledge, attitude and practice of sickle cell crises prevention among diagnosed patients attending LUTH. It has further discussed the concept of sickle cell disease, inheritance pattern of sickle cell disease, incidence of sickle cell disease, attitude of patients, types of sickle cell disease, type of sickle cell crises, symptoms, complications as well as prevention of sickle cell crises.

 

1.1     STATEMENT OF THE PROBLEM

There has been an alarming rate in the number of patients with sickle cell anemia in our society. These patients were sources of problem to their families as they often fall sick or have crisis. The frequent crisis by the children who are carriers has led to their continuous absence in School and have seriously affected their academic performance. Also in adult their continuous absenteeism from work as a result of sickle cell crisis has led to the loss of many hours at work place and consequently decreases productivity.

The treatment of sickle cell patients has equally been a primary source of concern to the nurses and the hospital management. Traditionally, people believe that sickle cell has cure but medically, sickle cell has no cure according to scientists.

This has necessitated the knowledge, attitude and practice of sickle cell crises prevention among diagnosed patients attending L.U.T.H.

However, I developed interest in this study because of my experience as a nurse about sickle cell patients’ knowledge, attitude and practice of sickle cell crises prevention.

1.2     OBJECTIVES OF THE STUDY IS TO:

(I)      Assess the knowledge of diagnosed sickle cell patients about sickle cell anaemia;

(II)     Assess if the knowledge of sickle cell patients influence the practice of prevention of sickle cell crises.

(III)    Examine the influence of knowledge and attitude about the practice of prevention on the incidence of the disease.

1.3     SIGNIFICANCE OF THE STUDY

To help the nurses to intensify efforts on the practice of preventive measure of crises towards the patients.

To improve on the knowledge of sickle cell patients as well as the practice of sickle cell crises prevention.

It will also enable the government to review the work force in terms of remuneration, equipments and facilities in the nursing department and prolong life span so that sufficient man power will be available to care for the victims.

 

1.4     SCOPE OF THE STUDY AND LIMITATION

The study was limited to diagnosed sickle cell patients attending Lagos University Teaching Hospital, Lagos, because of time constrain, fund and resources in the cause of the research project.

1.5     OPERATIONAL DEFINITION OF TERMS

Knowledge: The level of awareness about a particular phenomenum.

Attitude: It is a mental State, position or feeling with regard to a fact.

Crises: A decisive point in acute disease, the turning point towards recovery or death

Prevention: To keep an event or situation from happening.

Haemoglobin: The complex protein molecule contained within the red blood cells which give them their red colour and which oxygen is transported.

Anaemia: Deficiency in either quantity or quantity of red blood corpuscles in the blood.

Patient: Is a person who is undergoing treatment for sickle cell disease.

Gene: One of the biological units of heredity, self-reproducing, located at a definite position on a particular chromosome.

Diagnosis: Determination of the nature of sickle cell disease.

 

 

 

1.6     RESEARCH QUESTIONS

1. What is the level of knowledge of the diagnosed sickle cell patients about sickle cell anemia?
2. What is the attitude of the diagnosed sickle cell patients towards the practice of prevention of sickle cell crises?

 

1.7     RESEARCH HYPOTHESIS

Hypothesis 1

Ho: There is no significant relationship between the educational level of the diagnosed sickle cell patients and their level of knowledge about sickle cell crises prevention.

H1: There is significant relationship between the educational level of the diagnosed sickle cell patients and their level of knowledge about sickle cell crises prevention.

Hypothesis 2

H0: There is no significant relationship between the attitudes of diagnosed sickle cell patients towards the practice of sickle cell crises prevention.

Hi: There is significant relationship between the attitude of diagnosed sickle cell patients towards the practice of sickle cell crises prevention.

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