Episode 3 of my blog involve OT holistic intervention to provide/improve occupational balance and keep identity while mitigating ill health symptoms.

Cultural considerations and health inequalities   

  Cultural beliefs about illness, pain expression, and healthcare engagement can influence how symptoms are perceived and managed (Peacock & Patel, 2008) In fact, pain is subjective and, depending on the verbal skills of the patient hence it requires a degree of self-awareness and is coloured by the cultural background of the patient (Givler et al., 2023).  

Additionally, structural inequalities and systemic racism, including gender inequalities, have been shown to contribute to delayed diagnosis, undertreatment of pain, and poorer health outcomes (WHO, 2025).   

You can read some of the experiences of black women in the UK healthcare system here  

Or  

Cultural responsiveness involves:   

• Valuing lived experience and cultural identity   

• Recognising potential barriers to accessing services   

• Challenging stigma and advocating for equitable care   

• Collaborating with families, communities, and multidisciplinary teams   

• Healthcare practitioners must be educated about different cultural beliefs   

Occupational impact and the role of OT  

 Occupational Impact  

Both Thalassemia and SCD significantly affect occupational performance across the lifespan and result in chronic anemia, fatigue, organ complications, and psychosocial stressors that disrupt engagement in self-care, productivity, education, work, and leisure occupations (Rodigari et al., 2022).  

Role of Occupational Therapy  

Occupational therapy plays a critical role in enabling participation, promoting self-management, and supporting quality of life for individuals with SCD and Thalassemia. Occupational therapists use an individual’s interest or hobby to support their needs enabling them to become more independent, self-confident, and empowered despite their health condition (Physiofunction, 2025). Using a person-centred and biopsychosocial framework, occupational therapists address both physical limitations and contextual barriers to participation (Gentry et al., 2018).  

The biopsychosocial framework is one of the many frameworks that occupational therapists can use to support an individual. First proposed by George Engel in 1977, the biopsychosocial framework argues that health and illness arise from the combined influence of biological, psychological, and social factors rather than purely physical causes. This model supports a holistic, person‑centred approach to care and is widely applied in fields such as chronic pain management, psychiatry, and general medicine to better understand the full context of an individual’s health (Borrell-Carrió et al., 2004) 

Energy Conservation and Fatigue Management  

Given the prevalence of chronic anaemia and fatigue, OT interventions may include:  

• Activity pacing and graded task modification  

• Energy conservation education  

• Prioritisation and occupational balance planning   

• Supporting pain management and fatigue self-management   

• Adapting activities, environments, and routines to enable participation   

• Promoting engagement in meaningful occupations despite fluctuating health   

• Advocating for reasonable adjustments in education and employment  

These strategies are particularly important for individuals managing transfusion schedules (Thalassemia) or fluctuating symptom severity (SCD). 

Conclusion 

Cultural beliefs, communication, and systemic inequalities all play a significant role in how illness and pain are experienced, expressed, and managed. Pain is inherently subjective and shaped by an individual’s cultural background, personal experiences, and ability to communicate, which can influence how healthcare professionals interpret and respond to symptoms. At the same time, structural inequalities and systemic biases can further compound these challenges, contributing to disparities in diagnosis, treatment, and overall health outcomes. 

This highlights the importance of culturally responsive practice, where healthcare professionals actively value lived experiences, recognise barriers to care, challenge stigma, and advocate for equitable and inclusive services. Developing cultural awareness and sensitivity is essential to ensure that care is both effective and respectful of individual needs. 

From an occupational therapy perspective, conditions such as Sickle Cell Disease and Thalassemia have a profound impact on daily life, affecting participation in meaningful activities across all areas of occupation. Occupational therapists play a crucial role in addressing these challenges through a holistic, person-centred, and biopsychosocial approach. By supporting energy conservation, fatigue management, and engagement in meaningful occupations, occupational therapy enables individuals to maintain independence, improve quality of life, and participate more fully in everyday activities. Overall, integrating cultural responsiveness with holistic, occupation-focused interventions is key to delivering equitable, effective, and person-centred care. 

About the Author

I’m Sialou, a final-year MSc Occupational Therapy student currently on placement with JB Occupational Therapy. I focused on sickle cell and thalassaemia two inherited blood disorder, through this blog to raise awareness of the negative impact on health for individuals living with either of both disorders. As a person living with sickle cell, I aim to reflect lived experience through an occupational therapy lens.

Useful link for sickle cell and thalassaemia  

• Sickle Cell & Thalassaemia Support Project: https://www.sctsp.org.uk/ 

Tel: 01902444076 

Email: info@sctsp.org.uk 

• Community Family Support Service by SCTSP: 01902382288 

Admin: admin.fss@sctsp.org.uk 

Address: Sickle Cell & Thalassemia Support Project 

Paycare House, George Street, 

Wolverhampton, WV2 4DX