Graduation Semester and Year




Document Type


Degree Name

Doctor of Philosophy in Nursing



First Advisor

Carolyn Cason


For the individual with sickle cell disease (SCD), the lifespan is increasing but adults report decreased quality of life (QOL), low self-efficacy, and ineffective coping skills. The care of adult patients with SCD requires a complex multidisciplinary team approach with focus not only on physiological, psychological, and social needs, but also on spiritual needs. Quality of life, spirituality, and self-efficacy have been sparsely and separately studied in individuals with SCD. These three constructs have never been combined in one study in the adult SCD population. Objective: The purpose of this study was to explore and describe the relationships among spirituality, self-efficacy, and QOL in adults with SCD. The specific aims were to: 1) describe the relationships among spirituality, self-efficacy, and QOL in adults with SCD, and 2) explore variation in these relationships based on selected demographic characteristics. Methods: This study used a descriptive correlational design. Prospective participants, 18 years and older, with SCD who receive services from Sickle Cell Disease Associations were invited to participate in the study through a mail out and electronic survey. The instruments that were used include the Functional Assessment of Cancer Therapy-General (FACT-G) to measure QOL, the Functional Assessment of Chronic Illness Therapy-Spirituality (FACIT-Sp) to measure spirituality, and the Sickle Cell Self-efficacy Scale (SCSES) to measure self-efficacy. Results: Individuals who reported high levels of spirituality and self-efficacy reported high levels of QOL. Reports of self-efficacy and spirituality predict QOL among adults with SCD. Spirituality and self-efficacy accounted for more than fifty percent, a significant amount of QOL variability. Spirituality accounted for 6.6%, and self-efficacy accounted for 34.6% of total variance in QOL. The ANOVA indicated no significant interaction between selected demographic variables and the study variables. There was strong correlation between spirituality, self-efficacy, and QOL, with correlation coefficients of .63 to .68. Implications: This study provides information about the role that spirituality, self-efficacy, and QOL play in the lives of adults with SCD, and gives direction for developing holistic interventions with the inclusion of spirituality.


Medicine and Health Sciences | Nursing


Degree granted by The University of Texas at Arlington

Included in

Nursing Commons