Date of Conferral

2016

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Mirella Brooks

Abstract

Sickle cell disease (SCD) is a blood disorder that is inherited from both parents and affects millions of people globally. The symptoms of SCD may be debilitating and pose a significant challenge to nursing care. Hydroxyurea (HU), the Food and Drug Administration (FDA) approved treatment for SCD in adults is reportedly effective, but its usage is still minimal among adolescents with SCD. The purpose of this systematic review was to evaluate existing literature on the barriers to HU use in adolescents with SCD. The Johns Hopkins Nursing Evidence-based Practice (JHNEBP) Rating Scales guided this study. An extensive electronic search of Cumulative Index to Nursing and Allied Health (CINAHL), MEDLINE, Your Journal OVID, Academic search premier, and Cochrane Database of Systematic reviews of articles published in English from 2003 to 2013 was conducted. The 5 articles that met the inclusion criteria were organized, tabulated, and analyzed. The results suggest that inadequate knowledge about HU; physician concern about carcinogenic potential; lack of awareness of the National Heart, Lung, and Blood Institute (NHLBI) recommendations on HU use; and lack of belief in the benefits of HU contribute to providers' under-prescribing and minimal usage of the treatment. The implications for social change include knowledge useful for SCD patients, parents/guardians, care providers, and other researchers who are searching for direction in improving the quality of life of SCD patients. Long-term results may include increased HU usage, decreased pain episodes, fewer emergency room visits, and reduced patient mortality and morbidity.

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