Patient perceptions of crisis pain management in sickle cell disease: a cross-cultural study

Sickle cell disease has a variety of signs and symptoms, the most common being painful vaso-occlusive crises. Due to the severity of the pain, narcotic analgesia is described in the literature as the drug of choice for pain relief. The UK, in line with many other countries, uses narcotic analgesia in crisis management. In Jamaica, however, mild analgesia is the usual drug of choice for the patient in crisis. This difference in management approaches between the two countries was seen as an area for exploration to determine the factors which may reflect the nursing strategies used. This paper describes a cross-cultural survey of patients' perceptions of the painful crises and their management within the home and healthcare settings in Jamaica (West Indies) and Birmingham (UK). The results of the study show many areas of similarities, particularly in relation to the causes of the crises, home management and in-patient admissions. However, there were significant differences in crisis length and the in-patient management of crises. The study highlighted areas of crisis management which must be improved in the UK if patients are to receive optimum care from primary care and hospital nurses, as well as from general practitioners