Self-Care Practice among Iraqi Patients with Inherited Bleeding Disorders: A Cross-Sectional Study

Nidal Karim Al-Rahal, Fatma Abd Al Hamza, Maha A. Alnuaimi


This study aimed to evaluate the performance of Iraqi patients with inherited bleeding disorders (InBDs) on self-care practice in terms of general preventive measures, physical activity, and healthy dietary patterns. A total of 75 male patients with InBDs were included. Self-care practice performance was assessed using a self-report questionnaire containing 27 items related to three domains: general preventive measures, physical activities, and dietary pattern practices. Total and component scores for self-care practice performance were evaluated regarding patient and disease characteristics. Overall, mean total scores for self-care practice indicated good performance in 22 (29.3%) patients. The mean scores for general preventive measures (27.2, ranging from 19 to 33), physical activity (19.9, ranging from 13 to 28), and dietary pattern (10.8, ranging from 8 to 13) components were in the range of good, moderate, and moderate-to-good performance, respectively. Good performance scores in overall self-care were more likely in students (p=0.031), in normal-weight patients (p=0.047), in hemophilia A patients (p<0.001). And good performance scores in physical activity were more likely in patients with higher educational attainment (p=0.026), in students (p=0.002), and patients with injection administration made by others (p=0.041). Our findings in Iraqi patients with InBDs revealed an overall favorable performance on self-care practice, while a need for improved self-practice regarding physical activity, particularly after a decrease in parental supervision with the start of self-infusion. Overweight/obesity was evident in a considerable percentage of patients. A need for strategies to promote self-motivation towards better self-care was revealed in obese patients and those with constant joint pain.


Keywords: inherited bleeding disorders, self-care practice, preventive measures, physical activity, obesity.

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BLANCHETTE S, SPARLING C, TURNER C. Inherited bleeding disorders. Baillieres Clinical Haematology, 1991, 4(2): 291-332.

ALLI N, VAUGHAN J, LOUW S, SCHAPKAITZ E, MAHLANGU J. Inherited bleeding disorders. South African Medical Journal, 2018, 108(1): 9-15.

CROOKSTON K, ROSENBAUM L, GOBER-WILCOX J. Coagulation Hereditary bleeding disorders – general. 2019, 2019/2020-06-20.

AMERICAN SOCIETY FOR HEMATOLOGY. Bleeding Disorders., 2020/2020-06-18.

WORLD FEDERATION OF HEMOPHILIA. Report on the Annual Global Survey 2014. Montreal, Canada: World Federation of Hemophilia, 2015.

PEYVANDI F, GARAGIOLA I, BIGUZZI E. Advances in the treatment of bleeding disorders. Journal of Thrombosis and Haemostasis, 2016, 14(11): 2095-2106.

CDC. Preventing Chronic Disease: Eliminating the Leading Preventable Causes of Premature Death and Disability in the United States. Centers for Disease Control and Prevention., 2014/2020-06-10.

MANCO-JOHNSON MJ, ABSHIRE TC, SHAPIRO AD, et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. New England Journal of Medicine, 2007, 357(6):535-544.

BÉRUBÉ S, MOUILLARD F, AMESSE C, & SULTAN S. Motivational techniques to improve self-care in hemophilia: the need to support autonomy in children. BMC Pediatrics, 2016, 16: 4.

YILDIZ M, ÖZDEMIR N, ÖNAL H, et al. Evaluation of Unfavorable Cardiovascular and Metabolic Risk Factors in Children and Young Adults with Haemophilia. Journal of Clinical Research in Pediatric Endocrinology, 2019;11(2):173-180.

KAHAN S, CUKER A, KUSHNER RF, et al. Prevalence and impact of obesity in people with haemophilia: Review of literature and expert discussion around implementing weight management guidelines. Haemophilia, 2017, 23(6): 812-820.

WILDING J, ZOURIKIAN N, DI MINNO M, KHAIR K, et al. Obesity in the global haemophilia population: prevalence, implications and expert opinions for weight management. Obesity Reviews, 2018, 19(11): 1569-1584.

CDC. Report on the Universal Data Collection Program. Centers for Disease Control and Prevention, 2011/2020-06-10.

LIMJOCO J, THORNBURG CD. Risk factors for cardiovascular disease in children and young adults with haemophilia. Haemophilia, 2018, 24(5): 747-754.

SRIVASTAVA A, BREWER AK, MAUSER-BUNSCHOTEN EP, KEY NS, KITCHEN S, LLINAS A, et al. Guidelines for the management of hemophilia. Haemophilia, 2013, 19(1): e1-47.

NAZZARO A-M, OWENS S, HOOTS WK, LARSON KL. Knowledge, attitudes, and behaviors of youths in the US hemophilia population: results of a national survey. American Journal of Public Health, 2006, 96(9): 1618-1622.

FROMME A, DREESKAMP K, POLLMANN H, et al. Participation in sports and physical activity of haemophilia patients. Haemophilia, 2007, 13(3): 323-327.

LINDVALL K, COLSTRUP L, WOLLTER IM, et al. Compliance with treatment and understanding of own disease in patients with severe and moderate haemophilia. Haemophilia, 2006, 12(1): 47-51.


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