Why Wont My Teenager Comply?

A Look into Adolescents with Sickle Cell Anemia

Raising a teenager is no easy task. Between wavering hormone levels, discovering their identity, and struggling with autonomy, this is a complex and often stressful stage of their life. Adding a chronic disease into that mixture creates even more stress for adolescents as well as their families. Sickle cell anemia is an incurable illness that children are born with. A normal blood cell is round and flexible; making it easy to pass through veins and arteries. In sickle cell anemia, blood cells are sickle shaped and firm (see picture below). This causes the blood cells to get stuck in veins and create clots that often block blood flow to arms and legs, causing immense pain.

Although there are methods to prevent painful episodes, studies have shown that teenagers are not persistent in following these guidelines. When their pain is uncontrolled it can result in hospital admissions, missing school, and the agony of being in intense pain. Caregivers may feel frustrated that their adolescent is aware of what to do but chooses not to. A recent study in Childrens Health Care has looked into the reasons this particular age group struggles with

adherence. The study concluded that difficulty incorporating treatment aspects into their routine and wanting to fit in with peers were the primary reasons for noncompliance. The sickle cell treatment regimen involves many activities. Taking multiple medications, exercising regularly, staying well hydrated, and making scheduled appointments are just a few of the suggested ways to stay well. Consider that most kids go to school full time, are involved in after school activities, and enjoy an active social life. It is easy to understand how they might forget to take a pill or be too busy to find time to exercise. Most teenagers find it helpful to rely on parents to remind them of what to do. Placing reminder cards in a place that is sure to be seen every day (on the bathroom mirror or on the refrigerator) is another good way to remember daily activities. For every recommended action to do to stay well there is a suggested action to avoid. Sickle cell patients should not consume alcohol or smoke cigarettes. At a time where fitting in with peers is important, it can be challenging to avoid these activities. Parents can discuss the consequences of engaging in these activities; not only to avoid pain but to promote general health and well being. It can also be embarrassing or stressful to miss school for blood transfusions or checkups. Scheduling transfusions ahead of time or on school vacations can provide adequate time to plan for the appointment. It is necessary to recognize that adolescents with this disease feel different and at times misunderstood by their peers. If your child feels isolated by their disease, talk to your primary care provider about support groups and resources in your area. There are things you can do with your child to decrease painful episodes and promote a healthy lifestyle. It is important to have an open line of communication to discuss the hardships that accompany having a chronic disease. Although it can be challenging, do not get angry when your child does not comply. Instead, discuss the situation and work together to find solutions. Understanding your teenagers point of view is critical and can not only increase their adherence, but also improve your relationship.

Resources Modi A.C., Crosby, L.E., Gulifoyle, S.M., Lemanek., K.L., Witherspoon, D., & Mithcell, M.J. Barriers to treatment adherence for pediatric patients with sickle cell disease and their families. (2009) Childrens Health Care, 38(2). Retrieved from http://web.ebscohost.com.ezproxy.neu.edu/ehost/pdfviewer/pdfviewer?sid=6d2bdabe3917-4d13-9970-71ddae2eb984%40sessionmgr198&vid=20&hid=103 [Photograph of father and son]. Retrieved August 2, 2013, from: http://howtoparentateen.wordpress.com/ [Photograph of mother and daughter]. Retrieved August 2, 2013, from: http://www.goodtoknow.co.uk/family/galleries/8062/child-development-stages-age-1316/2 [Photograph of sickled blood cell]. Retrieved August 6, 2013, from: http://www.aurorahealthcare.org/yourhealth/healthgate/getcontent.asp?URLhealthgate=1 1561.html

This article is written for parents of sickle cell anemia patients. It could be encountered in a medical parenting magazine or online website specifically about sickle cell anemia. The article discusses why adolescents may not be adherent to treatment and briefly touches upon general interventions for parents to try. In the first paragraph I discussed what sickle cell anemia was and what causes the pain associated with the illness. Although many parents may know about this already, it is possible a newly diagnosed family might be reading the article as well. I also provided some information about what the treatment regimen involves for the same reason. I tried to keep the language simple and the paragraphs short as to not overwhelm the reader. This writing piece would make my portfolio more diverse` and display my ability to connect with the public. The previous two assignments had been writing for health care professionals, but as a nurse communicating with non medical personal is a key component of our job. The ability to break down a complex subject verbally or in writing is a valuable skill to have in this field.