Paper
Thursday, 20 July 2006
This presentation is part of : Acute Care Models and Strategies
Pain Experience in Hospitalized Adults with Sickle Cell Disease
Renee Granados, RN, MSN, Department of Nursing & Health Sciences, California State University, East Bay, Hayward, CA, USA and Eufemia Jacob, PhD, RN, TCH Center for Clinical Research, Baylor College of Medicine, Houston, TX, USA.
Learning Objective #1: describe the intensity, location, and quality of pain during acute painful episodes in adult patients with sickle cell disease.
Learning Objective #2: evaluate amount of pain relief from analgesics during acute painful episodes in adult patients with sickle cell disease.
Acute painful vaso-occlusive episodes are the most common manifestation of sickle cell disease (SCD) and is the most common cause of hospitalization in adults with SCD.  Very little is known about the characteristics of pain during acute painful episodes.  The purpose of this study was to examine the intensity, location, and quality of pain during painful episodes and evaluate relief from analgesics.  Participants were asked once every evening from the day of admission until the day of discharge, 1) to complete a multidimensional pain assessment tool, 2) rate his/her current, worst, and least pain using the Numeric Rating Scale (NRS), 3) rate his/her pain before and after analgesics using NRS, and 4) rate the amount of relief after pain medication using the NRS.  Results showed that adults with SCD (N=18; mean age 33.3 ± 9.54; 8 males; 10 females; mean length of stay 5.9 ± 2.9) had a mean worst pain intensity score of 8.5 ± 1.4 and least pain intensity score of 5.9 ± 2.1 during hospitalization.  The mean total number of areas marked on a body outline diagram was 13.1 ± 6.8.  The most frequent locations of pain were the lower extremities and back.  The most frequently used words to describe the quality of pain were throbbing (64.0%), hurting (50.0%), and uncomfortable (58.2%).  There was a significant difference in pain intensity before (8.5 ± 1.4) and after (6.4 ±  2.1) analgesics (p < 0.0001).  The amount of perceived pain relief was 40.6% ± 20.5%.  These results showed that even though there was a significant difference in pain intensity before and after analgesics, the perceived amount of pain relief was inadequate.   Future studies need to evaluate the pain regimens during hospitalization and examine different strategies to optimize relief during acute painful episodes in adult patients with sickle cell disease.

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