Silence as a Coping Strategy: Non-Disclosure of Sickle Cell Disease and its Psychosocial Consequences for Families in Urban Cameroon: An Analytical Cross-Sectional Study
DOI:
https://doi.org/10.47941/ijhs.3688Keywords:
Sickle Cell Disease; Non-Disclosure; Stigma; Psychological Distress; Family FunctioningAbstract
Purpose: This analytical cross-sectional study evaluated the occurrence of non-disclosure and its psychosocial effects among 184 families in two pediatric units in Yaoundé-Cameroon.
Methodology: Predefined questionnaires evaluated disclosure behaviors, stigma perception, emotional distress, family bonding, and social support. Data analysis was done using descriptive statistics, Pearson correlations, and linear regressions.
Findings: Findings indicated that participants (63.6%) do not disclose information partially or completely and non-disclosure had a positive relationship with stigma perception (r = 0.50) and emotional distress (r = 0.40), a negative relationship with family bonding (r = −0.38) and social support (r = −0.30), acting as an independent predictor of psychological distress (β = 0.34). Silence protects against stigma but creates negative social and psychological impacts, demonstrating the need for stigma prevention measures and disclosure assistance.
Unique Contribution to Theory, policy, and Practice: The results of this research indicate that stigma, communication, and psychological outcomes in families with sickle cell disease are related to one another. And, further to that, the data provides information on what to do in terms of policy and the need for reducing stigma through the provision of psychosocial support and the development of guidance for healthcare providers about disclosing sickle cell disease. Lastly, the practice as nurses emphasizes the need for recognizing silence as a sign of vulnerability and delivering culturally competent, family-centered nursing to families impacted by sickle cell disease.
Downloads
References
Adeleke, O. T., Olasinde, Y. T., Folaranmi, O. E., Ayuba, Y. L., Agelebe, E., Rufai, M. M., Adeleke, O. V., Adeoye, O. E., Olabode, A. T., Ajala, D. E., & Akingbola, T. S. (2024). A qualitative enquiry into the lived experience and coping strategies of undergraduates with sickle cell disease in Nigeria. BMC Public Health 2024 24:1, 24(1), 3388. https://doi.org/10.1186/S12889-024-20927-6
Alinda, I., Kabiri, L., & Ssebagala, H. (2025). Hidden stories of caregivers with children living with sickle cell disease in Uganda: Experiences, coping strategies and outcomes. PLOS ONE, 20(3), e0296587. https://doi.org/10.1371/JOURNAL.PONE.0296587
Anie, K. A. (2024a). The intersection of sickle cell disease, stigma, and pain in Africa. Hematology: The American Society of Hematology Education Program, 2024(1), 240. https://doi.org/10.1182/HEMATOLOGY.2024000549
Anie, K. A. (2024b). The intersection of sickle cell disease, stigma, and pain in Africa. Hematology,2024(1),240–245. https://doi.org/10.1182/HEMATOLOGY.2024000549
Ballas, S. K. (2018). Sickle cell disease: Classification of clinical complications and approaches to preventive and therapeutic management. Clinical Hemorheology and Microcirculation, 68(2–3), 105–128. https://doi.org/10.3233/CH-189002;PAGE:STRING:ARTICLE/CHAPTER
Bekui, B. A. A., Ohene, L. A., Badzi, C., Ampomah, M. O., & Aziato, L. (2023). Physical and socioeconomic burden of caregiving on family caregivers of children with cancer at a tertiary hospital in Ghana. Nursing Open, 10(2), 915–925. https://doi.org/10.1002/NOP2.1359;WGROUP:STRING:PUBLICATION.
Blakey, A. O. (2025). A mixed methods examination of the processes underlying disease management in pediatric sickle cell disease.
Camacho, G., Reinka, M. A., & Quinn, D. M. (2020). Disclosure and concealment of stigmatized identities. Current Opinion in Psychology, 31, 28–32. https://doi.org/10.1016/J.COPSYC.2019.07.031.
Foster, S. (2021). Socioeconomic Status and Mental Illness Stigma: How Income Level And Social Dominance Orientation May Help To Perpetuate Stigma. Stigma and Health, 6(4), 487–493. https://doi.org/10.1037/SAH0000339.
Frey, N., LaMotte, J. E., Bouck, J. R., Fancher, L., Parker, G. T., Carter, A., & Jacob, S. A. (2025a). Assessing psychosocial risk factors in children with Sickle Cell Disease. BMC Health Services Research 2025 25:1, 25(1), 99-. https://doi.org/10.1186/S12913-025-12266-Y.
Frey, N., LaMotte, J. E., Bouck, J. R., Fancher, L., Parker, G. T., Carter, A., & Jacob, S. A. (2025b). Assessing psychosocial risk factors in children with Sickle Cell Disease. BMC Health Services Research 2025 25:1, 25(1), 99-. https://doi.org/10.1186/S12913-025-12266-Y.
Larson, S. C., Moore, H. G., Britts, R., Towerman, A. S., Housten, A. J., Griffith, M., Antonoff, K. A., Harris, K. M., King, A. A., & Hoyt, C. R. (2025). Community Support for Caregivers of Children With Sickle Cell Disease: A 3-Year Process Evaluation. Advances in Rehabilitation Science and Practice, 14. https://doi.org/10.1177/27536351251387234.
Lelo, P. V. M., Kitetele, F. N., Akele, C. E., Sam, D. L., Boivin, M. J., & Kashala-Abotnes, E. (2023). Caregivers’ Perspective on the Psychological Burden of Living with Children Affected by Sickle Cell Disease in Kinshasa, the Democratic Republic of Congo. Children 2023, Vol. 10, Page 261, 10(2), 261. https://doi.org/10.3390/CHILDREN10020261.
Munung, N. S., Treadwell, M., Kamga, K. K., Dennis-Antwi, J., Anie, K., Bukini, D., Makani, J., & Wonkam, A. (2023). Caught between pity, explicit bias, and discrimination: a qualitative study on the impact of stigma on the quality of life of persons living with sickle cell disease in three African countries. Quality of Life Research, 33(2), 423. https://doi.org/10.1007/S11136-023-03533-8.
Munung, N. S., Treadwell, M., Kamga, K. K., Dennis-Antwi, J., Anie, K., Bukini, D., Makani, J., & Wonkam, A. (2024). Caught between pity, explicit bias, and discrimination: a qualitative study on the impact of stigma on the quality of life of persons living with sickle cell disease in three African countries. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 33(2), 423–432. https://doi.org/10.1007/S11136-023-03533-8.
Okoibhole, L. O., & Ebenso, B. (2023). A qualitative study on stigma experienced by young adults living with sickle cell disease in Accra, Ghana. International Health, 15(6), 684–691. https://doi.org/10.1093/INTHEALTH/IHAC087.
Onu, N. N., Asinobi, I. N., Ndu, I. K., Ikefuna, A. N., Ezike, T. C., & Onu, J. U. (2025). Perceived stress and social support as correlates of sickle cell anaemia severity in a low-resource setting. BMC Pediatrics 2025 25:1, 25(1), 215-. https://doi.org/10.1186/S12887-025-05572-1
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Mispar Guinyonga Wankam, Pangna Kouotou Ibrahim Cherif, Mtsavara Joseph, Carine Ngah Enjeh, Yembeau Lena Natacha, Kengne Djeudjo Ingrid Fabiola

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.