Journal Article Epublish
PubMed: 40648525 DOI: 10.3390/healthcare13131500
Level of Healthcare Facility and Psychosocial Factors Influence Perceived Self-Efficacy for Appropriate Use of Hydroxyurea: Experience from Caregivers of Children with Sickle Cell Disease in Tanzania.
Healthcare (Basel) 13(13)
Authors: Mwashungi Ally, Deodatus Kakoko, Tone Kristin Omsland, Calvin Swai, Emmy Metta, Kåre Moen, Elia John Mmbaga, Melkizedeck Leshabari, Mbonea Yonazi, Agnes Jonathan, Julie Makani, Emmanuel Balandya
Affiliations
- Sickle Cell Program, Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, 9-United Nations Road, Upanga, Dar-es-Salaam 11103, Tanzania.
- Department of Behavioral Sciences, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam 11103, Tanzania.
- Department of Community Medicine and Global Health, University of Oslo, 0450 Oslo, Norway.
- Department of Educational Psychology and Curriculum Studies, The University of Dodoma, Dodoma 41218, Tanzania.
- Department of Hematology and Blood Transfusion, Muhimbili National Hospital, Dar-es-Salaam 65000, Tanzania.
Abstract
Background: Sickle cell disease (SCD) is associated with high physical and psychosocial burden among patients and their families. Hydroxyurea (HU) improves health-related quality of life by preventing SCD complications. Despite its availability, HU is underutilised in Tanzania. Perceived self-efficacy for appropriate medication use influences medication usage among individuals with chronic illnesses. We studied factors associated with caregivers' perceived self-efficacy for appropriate use of HU and its association with HU usage among children with SCD in Dar-es-Salaam. Methods: We conducted a cross-sectional study from May to August 2023. We enrolled 374 caregivers of children with SCD from two regional and two national hospitals. We adapted the self-efficacy for appropriate medication use scale, a multidimensional perceived social support scale, and a patient health questionnaire for assessment of self-efficacy, social support, and depressive symptoms, respectively. Results: Three-quarters of caregivers had high perceived self-efficacy scores for medication use. Attending national hospitals, high social support, and absence of depressive symptoms were positively associated with perceived self-efficacy (adjusted beta coefficient aβ 2.3, 95% CI 0.5-4.2; aβ 9, 95% CI 7.1-10.9; and aβ 5.3, 95% CI 2.8-7.8, respectively). Caregivers with high self-efficacy were 5.3 times more likely to give HU to their children compared with those with low self-efficacy (incidence rate ratio 5.3, 95% CI 3.3-8.3). Conclusions: Hospital levels and psychosocial factors influence caregivers' perceived self-efficacy for appropriate HU use. We recommend targeted interventions to enhance psychosocial support among caregivers to increase caregivers' perceived self-efficacy and HU utilization among children with SCD in Tanzania.
MeSH
Cells, Quality Of Life, Anemia, Sickle Cell, Incidence, Caregivers, Self Efficacy, Signs And Symptoms, Child, Hydroxyurea