Sickle cell disease (SCD) is a major healthcare and societal problem that affects millions of people worldwide. Sickle cell pain is the hallmark feature of SCD and includes manageable and unmanageable persistent pain that affects every aspect of an individual's life. Most of the research on pain in SCD has focused on children with acute vaso-occlusive episodes. Consequently, significant gaps exist in our knowledge of the occurrence and characteristics of manageable and unmanageable persistent pain in adults with SCD.
The specific aims of this study in a sample of adults with SCD were to: 1) determine the occurrence of persistent SCD pain and compare those with manageable and unmanageable persistent SCD pain on demographic and clinical characteristics, as well as, pain-related measures; 2) compare those with manageable and unmanageable persistent SCD pain on coping strategies; and 3) determine which factors influence quality of life (QOL) in these patients.
One hundred and three patients who were ≥18 years with SCD completed questionnaires on demographic, clinical, and pain characteristics, as well as, the Pain Catastrophizing Scale (PCS), the Duke Religious Index (DRI), and the Medical Outcomes Study Short-Form (SF-36). Patients were divided into those with manageable (average pain intensity ≤5) and unmanageable pain (average pain intensity >5) based on established cutpoints. Final analyses were done on 94 patients.
Seventy percent of patients had manageable pain and 30% had unmanageable pain. Patients with unmanageable pain reported higher ratings for all of the items on the Pain Quality Assessment Scale (PQAS); were more likely to be taking only a short-acting opioid; reported less relief from analgesic medications, and reported significantly lower SF-36 scores. Significant negative correlations were found between pain catastrophizing and religiosity/spirituality, and physical and mental health. Several variables were found to have an influence on QOL. These findings suggest that persistent pain in adults with SCD is a significant problem. More research needs to evaluate how adults with SCD cope with persistent pain and its impact on their QOL.
|Commitee:||Humphreys, Janice, Stotts, Nancy A., Treadwell, Marsha J.|
|School:||University of California, San Francisco|
|School Location:||United States -- California|
|Source:||DAI-B 74/11(E), Dissertation Abstracts International|
|Subjects:||Nursing, Epidemiology, Health care management|
|Keywords:||Chronic pain, Pain management, Persistent pain, Sickle cell disease|
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