The stress process and chronic illness: Sickle cell disease and its impact on the performance of social roles and mental health among black women

The literature suggests that a significant number of patients with Sickle Cell disease (SCD) experience social and psychiatric impairment. This research explores the manifestations of stress on the mental health of black women affected by a genetic blood disorder known as Sickle Cell disease (SCD). The hallmark of SCD is unpredictable painful episodes. Disease-related stress is conceptualized as an ongoing process that may impact women's performance of valued social roles and their sense of mastery (control). Stress was considered as a risk factor for poor mental health outcomes. The research study was divided into two phases. The snowball method was utilized to construct a sample of 30 women between the ages of 23 and 66. Survey instruments were administered in Phase 1 (N = 30) to explore the relationship between disease severity, role strain, mastery, depressive symptomatology and anxiety. Cross-tabulations and logistic regression were used to analyze the data. In Phase 2, participants (N = 10) were selected from Phase 1 for in-depth interviews to explicate the meaning of stress and its role in the occurrence of painful episodes, ways of coping, the impact of social support networks, and ways to alleviate stress. In Phase 1, a significant relationship existed between mastery and anxiety. Low anxiety scores were associated with high mastery. In Phase 2, the healthcare system, was perceived as a major source of stress for eight of the women interviewed. Stress tended to precede painful episodes for eight of the women interviewed. Ways of coping such as emotion-focused and problem-focused were identified. All of the women relied on family, friends, and co-workers for social support. Suggestions for interventions to alleviate stress were also provided. Findings suggest that definitions of stress may influence black women's perceptions of SCD which might impact their performance of social roles. In addition, the study highlights the role of mastery, social support, and coping as risk factors for anxiety.