A Scoping Review of Social Determinants of Health and Pain Outcomes in Sickle Cell Disease

Abstract

Background: Sickle cell disease (SCD) is a hereditary blood disorder with chronic pain that affects over 100,000 people in the United States. Previous research suggests a complex interaction between SCD pain outcomes and social determinants of health (SDOH).

Objective: To explore the impact of SDOH on pain outcomes in SCD.

Design: We used a scoping review design to explore the broad topic of social factors that affect SCD pain.

Data sources: We searched the PubMed/MEDLINE, CINAHL, and Embase databases using combined search and Medical Subject Headings terms ("social determinants of health," "sickle cell," and "pain").

Review methods: We used a content analysis with a summative approach to identify and describe interactions between SDOH and SCD pain outcomes.

Findings: Eight articles reporting studies with 7,992 total participants and a focus on SCD pain outcomes met the inclusion criteria. Three themes related to SDOH and pain were produced: education and employment, social and emotional functioning, and healthcare access.

Conclusion: The key findings highlight the complex interplay between socioeconomic, psychological, and biological factors in SCD pain experiences. This underscores the need for nursing care to consider SDOH in an integrated, holistic approach to SCD pain.

Implications for nursing: To improve pain management among their SCD patients, nurses can assess pain holistically, develop customized individual pain management plans with educational and health literacy support options, and strengthen social support.

Keywords: Health inequities; Health status disparities; Pain management; Sickle cell disease; Social determinants of health.