THE EFFECT OF COGNITIVE BEHAVIORAL INTERVENTION ON COPING SKILLS, QUALITY OF LIFE AND EMOTIONAL WELLBEING OF UNDERGRADUATES WITH SICKLE CELL DISEASE IN THE UNIVERSITY OF IBADAN

Abstract

Introduction Sickle cell disease (SCD) is now a global health challenge. The disease is prevalent in sub-Saharan Africa with Nigeria having the highest prevalence, with over 150,000 live births yearly. With the improvement in health care services, more individuals living with the SCD now have improved outcomes, growing into adulthood with better chances of survival. However, as a result of the various physical, mental and emotional challenges they face, psychopathologies have been documented extensively amongst them ranging from anxiety, depression, and suicidal ideation among others. These psychopathologies, in addition to a chronic, sometimes debilitating illness have been documented to impact on their quality of life. Various coping mechanisms have also been employed to enable them deal with these challenges with varying degrees of success. This study explored the effect of cognitive behavioural intervention on coping, quality of life and emotional wellbeing in undergraduates with sickle cell disease in the University of Ibadan. Methods It was a quasi-experimental pre and post-study, that employed purposive sampling method of all consenting undergraduates with sickle cell disease that had been seen at the university health centre, who scored 8 and above on either the anxiety or depression sub-scale of the Hospital Anxiety and Depression Scale (HADS), outcome measures of anxiety and depression, coping skills and quality of life were collected before and after 6weeks following the intervention. It was a group-based cognitive behavioural intervention and its effect on their quality of life, coping strategies and emotional wellbeing was assessed thereafter. Data was analysed using the SPSS version 20, Hospital Anxiety and Depression Scale, Coping skills and Quality of life scores were presented using means and standard deviations, the association between outcome measures and clinical variables were assessed using independent t-test, differences in mean of the outcome measure scores pre and post-intervention was analysed using paired t-test, Results All the participants had depressive and anxiety symptoms pre-intervention, however post-intervention none of the participants had depressive symptoms and only 11% (2) still had symptoms of anxiety, about 72% had started employing active coping skills in dealing with sickle cell disease above the 50th percentile compared to 44% pre intervention, a reduction in the number of those using affective-negative skills above the cut-off from 33% to 22% post-intervention and an increase in the number of participants using passive coping skills above the same cut-off from 72% to 89%. The reduction in both anxiety and depressive symptoms was statistically significant, HADS-A (t = 7.20, p< 0.001), HADS-D (t =2.64, p< 0.02), there was also a significant increase in active coping (t = 2.19, p< 0.04) and passive coping (t = -2.20, p < 0.04) skills as well as an increase in the social functioning domain of the SF-36 quality of life scores (t = -5.10, p < 0.001) post-intervention. Conclusion This result shows that group-based cognitive behavioural intervention appears helpful in reducing anxiety and depressive symptoms, improve adaptive coping skills and improve social functioning in the quality of life of young people living with sickle cell disease in Nigerian universities.