Hemophilia — Psychological Factors and Comprehensive Management

Since chronic disease compounds the difficulties of child rearing and increases the incidence of psychological problems in all age groups, patient care emphasizing technology alone is inadequate. Instead, a biopsychosocial approach is necessary to correlate medical care with vital information about the patient's psychological and social state. Hemophilia acts as a chronic recurrent stress on the individual and his family requiring the development of coping behaviors for adaptation. While many hemophiliacs achieve normal psychological development, some are overwhelmed by the illness contributing to maladaptation and a variety of psychological disorders. Accordingly, medical staff efforts and attitudes that promote effective coping are a vital part of comprehensive care. The goals of coping include carrying out acceptable life goals despite illness handicaps, keeping uncomfortable feelings within manageable limits and the maintenance of a positive self‐image. Efforts to support effective coping begin with effective medical care including adequate relief for acute pain, educational programs that promote optimal child rearing and self‐care and the opportunity for the patient and family to talk about concerns and feelings. Comprehensive care also provides for the identification and specific treatment of psychiatric disorders that may develop.