DANGERS OF SMOKING AMONG PATIENTS WITH SICKLE CELL
The Educating patients with Sickle Cell about dangers of smoking with the goal of making them quit
The purpose of this teaching plan is to inform and educate patients with sickle cells on the dangers of smoking. The patients will learn about the causes of sickle cell and its risk factors. The lesson will also educate patients of the pathophysiology of this condition and learn of the link between acute chest syndrome (ACS) and cigarette smoking that mainly occurs among the sickle cell anemia patients. Patients will also get to know that ACS is the leading cause of death and hospitalization among individuals with sickle cell. Previous studies have proven that cigarette smoking has links to increased risk of ACS as well as pain events among patients with SCD.
Pain is always the hallmark of sickle cell disease among adolescents, children, and adults. Patients who smoke are the ones who frequently visit the emergency department. Historically the visits are characterized by distrust, bias and under-treatment. However through understanding personal care patients will be involved in the aggressive management of pain, understand the care guidelines and be part of the clinical pathways. One of the best strategies that patients with sickle cell disease can employ is to quit smoking for them to experience a better way of life and a better analgesia.
Family members will be involved in these training members because some lack knowledge about how their smoking habits affect children and other members of the family who have the sickle cell disease. The training will also inform patients on how their behaviors, as well as psychosocial issues, have an impact on their good being. Thus, the program will educate family members as well as patients that they should quit smoking. It is because there are various detrimental impacts on environmental tobacco smoke (ETS) exposures on the health of nonsmokers. Most importantly the participants will learn that there are various components of ETS among other effects that do displace the hemoglobin‘s oxygen that contributes to an abnormal activation of the activate platelets and injure the vascular endothelium of the nonsmokers.
Participants will get information on the fact that most of the acute clinical infestations of the condition of sickle cell disease also referred to as the sickle cell crises do happen when there is a deoxygenated type S polymerizes of the hemoglobin. It contributes to the production of misshapen and rigid red blood cells that abnormally adhere to the vascular endothelium leading to tissue ischemia and vascular occlusion. The patient will also learn that the activation of the vascular endothelial cell, their inflammation and abnormal platelet activation alongside thrombus formation also plays a significant role to the occurrence of vascular occlusion. Thus, what we commonly know about the exposure to ETS and its biological effect and the vascular occlusion mechanism in among those with SCD, there are high chances of exacerbation of clinical manifestations of the sickle cell diseases through ETS exposure.
Readiness to learn
With the high rate of mortality and morbidity among patients with WSCD patients with Sickle cell disease and their families are willing to take part in this program to understand ways of dealing with the sickle cell crisis. The participants are willing to understand how the exposure to the ETS at home affects both the nonsmokers and the smokers with Sickle Cell disease. Children, adolescents, and adults with SCD as well as the care givers of children and adolescents will take part in this education program. Other willing learners are patients who have visited this clinic with a history of acute chest syndrome and stroke that are life threatening and those with repeated and severe pain crises of verso-occlusive treated for hydroxyurea or long term transfusion of red blood cells.
There is some easy that this program will motivate its students. First, as the facilitator, I have to know each participant by name. I will also engage them in the learning process by asking questions and giving each member a chance to speak. I will praise those who give correct answers. I will use examples that relate to the real lives of students and use these examples freely. The program will also use a wide range of student-active teaching activities such as cooperative learning and teach by discovery activities. The program will also set realistic goals for each participant. For instance, for those who smoke, I will have to acknowledge that quitting is not an easy task, but it takes time. I will encourage them to have a positive attitude that they will one day overcome their smoking problem. I will also provide constructive criticism and free praise. Finally, I will provide students with much control over their learning as possible.
Though most of the participants are non-smokers, they have family members who smoke. T there is only two adults who smoke les frequently. Thus, the program will be for the purpose of encouraging both the patients and their family members to quit smoking. It is by first understanding how the smoking environment affects the patients with SCD (Cohen, Robert, and Rosen, 2013).
How to evaluate reading and comprehension,
Due to the diversity of patients regarding age, cultural, ethnic and educational background not all types of comprehension and reading assessment will be suitable for all students. Some measures for data collection are most appropriate for a specific culture, skill level, and a specific age level. Therefore, the program will make use of multiple kinds of assessments to gather information about the performance of students. Some of the assessment method for reading comprehension includes the Degrees of Reading Power (DRP), Curriculum Based Measurement (CBM), Gray Oral Reading Test IV (GORT – 4) and Test of Word Reading Efficiency (TOWRE). These are assessment methods that have evidence support from research in providing useful information about students.
The teaching method for this program will mainly on the Tips from Former Smokers (Tpeips) campaign which provides the necessary resources in helping patients who smoke and family members who smoke to start living a smoke-free life. The program will also use the evidence-based cessation treatments. The major topics to be covered are how minors gain access to tobacco products, cessation, Youth prevention, Mass-reach health campaign and the dangers of secondhand smoke exposure.
- Participants will learn how environmental tobacco smoke (ETS) exposures affects patients with SCD.
- The impact of second hand smoking to nonsmokers with SCD
- Strategies to quit smoking
Time allotment for class
The class will take two hrs each day from 2 pm top 4 pm. The program will last for one week.
Resources for instruction
- Tips From Former Smokers (Tpeips) campaign
- Handout “Reasons to Quit Smoking”[PDF – 1 MB]
- CDC’s videos, print ads, radio ads, and other Tips campaign materials from the Tips Download Center
- Visit I’m Ready to Quit! Page
Contract between nurse and patient
As a nurse, I will inform each participant who smokes to write down a contract on their reasons for wanting to quit. For example, for the sake of their kids with SCD, so as to feel better, to prevent heart diseases and lung cancer and rid the smoke smell, in a breath, clothe, room, skin and hair.
The smokers will at the end of the lesson receive an evaluation survey form. They will reflect the objectives of the lesson plan and will ask about the issues for improvement in this lesson plan. The survey will also require the participants to state their reasons for quitting and the habits or triggers of their smoking. They will then be expected to write down their personal alternative routines and activities. They will also provide information on the useful strategies that are helping them to quit and what does not work. They will state the changes that they need to make to stop smoking. Finally, participants will mention the important lesson they have learned from the program such as how their smoking habits affect the nonsmokers especially those with SCD (West, Romanano, Azari, and Sandhu 2004).
Cohen, R., Robert, F., and Rosen, C. (2013) Environmental tobacco smoke and airway obstruction in children with sickle cell anemia. Journal Article – research. 144(4): 1323-1329. (7p
West D, Romanano, P, Azari, R, and Sandhu S.(2004) Impact of Environmental Tobacco Smoke on Children With Sickle Cell Disease. Adolescent and Pediatric Medicine 157(12):1197-201