Effect of family counsellling on psychological distress among caregivers of children with sickle cell anaemia in a Tertiary Hospital in North Central Nigeria

Abstract

Background: Sickle Cell Anaemia (SCA) is a haematological disorder of red blood cells, caused by mutation in the beta globin gene. Caring for patients with the disorder poses a significant psychological burden on the sufferers, the caregivers and their families, thereby affecting their quality of life. Family counselling has been suggested to be vital in relieving the psychological distress and improving the quality of life. The study aimed to determine the effect of family counselling on psychological distress on caregivers of children with sickle cell anaemia in order to improve the quality of care of the SCA patients.

Method: The study was a single blinded Randomised controlled trial involving  caregivers of children with sickle cell anaemia presenting in the sickle cell disease clinic at the FMC Keffi, Nasarawa State in North Central Nigeria. The participants that satisfied the inclusion criteria were consecutively selected and randomized into Intervention and Control groups, with 28 participants in each group. Allocation into each group was done by use of two different envelops each containing two ballot papers labelled 1 and 2. Those who picked the even numbers were allocated into the intervention group while those who picked the odd numbers were allocated into the control group. Participants in both groups were matched for sex. The Intervention group had structured family counselling, while the Control group had routine  counselling. Both groups had 3 counselling sessions at four weekly intervals for 12 weeks. The primary outcome of intervention was the level of psychological distress measured using the 12-item general health questionnaire. Chi square test was used to compare categorical variables. P values of <0.05 were considered significant for all analysis.

Results: At baseline, 25% and 71.4% of the participants in the Intervention group had moderate and severe psychological distress respectively. Only one participant had mild psychological distress. After the intervention, those with mild  psychological distress comprised 28.6%, while 71.4% had moderate psychological distress. None had severe psychological distress. In the Control group, at baseline, those with moderate psychological distress comprised 32.1% while 67.9% had severe psychological distress. None had mild psychological distress. After the  intervention those with moderate psychological distress comprised of 35.7% while 64.3% had severe psychological distress.

Conclusion: Caregivers of children with SCA experienced considerable psychological distress from their children's illness. Intervention such as family counselling was found to ameliorate the psychological distress.