Factors Influencing the Management of Musculoskeletal Pain among Children with Sickle Cell Disease in Western Kenya

Abstract

Musculoskeletal pain (MSK) is a common and often distressing symptom among children diagnosed with sickle cell disease (SCD). Despite the recurrent and often severe pain episodes these children endure, there has been limited research into the factors that influence the management of this pain. This study sought to delve into the various factors that impact the management of MSK pain in children with SCD in Western Kenya. It took a comprehensive approach, considering psychological, economic, sociocultural, individual, nutritional, environmental, and hospital-related factors. To gather insights, caregivers of 176 children with musculoskeletal pain associated with SCD were interviewed using semi-structured questionnaires. Thematic analysis was employed to identify recurring themes, and a codebook was developed based on findings from the literature and emerging themes. The interviews continued until theoretical saturation was achieved, ensuring that all necessary data was collected. The results of the study revealed seven key themes that significantly influenced the management of musculoskeletal pain in these children. These themes included psychological factors, economic constraints, sociocultural beliefs, individual health status, nutritional challenges, environmental triggers, and healthcare system-related factors. Caregivers often grappled with psychological distress, financial strain, and social stigmatization. Individual factors, such as compromised immune status, played a crucial role in the frequency and severity of pain episodes. Furthermore, inadequate access to nutritious food exacerbated musculoskeletal pain. Additionally, changing weather conditions and previous negative experiences with healthcare facilities hindered effective pain management. In light of these findings, the study underscores the urgent need for a holistic approach to address these challenges. This includes providing psychosocial support, financial assistance, community awareness campaigns, improved healthcare services, education on proper nutrition, climate-related support, and healthcare worker training to better manage MSK pain in children with SCD.