Factors affecting the quality of life for a child with sickle cell disease:
(1) pain (painful crises, persistent pain)
(2) shortness of breath (asthma, chest syndrome)
(3) fatigue
(4) other complications (avascular necrosis, etc)
(5) depression
(6) inability to participate in activities (social, school, work, recreation, etc)
(7) negative response from others to illness (stigma, lack of support from teachers or co-workers, etc)
Identifying and addressing problems so that the impact is mitigated and the patient feels more in control can significantly improve the quality of life.