Learning Objective 1: The learner will be able to describe pain, pain coping and sleep patterns in children and adolescents with sickle cell disease.
Learning Objective 2: The learner will be able to describe factors that predict pain, pain coping and sleep in children and adolescents with sickle cell disease.
The purpose of this study was to examine pain, pain coping and sleep and to examine the relationship among pain, pain coping and sleep in children and adolescents with sickle cell disease. Factors (age, gender and number of pain episodes) that predict pain, pain coping and sleep in children also were examined in this population.
Children (n=39; mean 11.9 ± 1.1 years) and adolescents (n=27; mean 15.5 ± 0.9 years) with sickle cell disease completed an electronic visual analog scale (eVAS), Adolescent Pediatric Pain Tool, Pain Coping Questionnaire, and Pittsburg Sleep Quality Index prior to participating in a wireless intervention program.
Overall pain the past month showed that 23 (34.8%) participants had no pain, 27 (40.9%) had mild (mean 1.8 ± 1.1 on 0 to 10 eVAS); 10 (15.1%) had moderate (mean 5.3 ± 1.0) and 6 (9.0%) had severe (8.1 ± 0.6) pain. The coping strategies used were positive approaches (2.76 ± 0.76), problem focused (2.71 ± 0.81), emotion focused (1.73 ± 0.63), and distraction (2.71 ± 0.92). The majority had mild (n=44; 67%) or moderate (n=18; 27%) sleep disturbance; few were severe (n=4; 0.6%). The most common sleep disturbances, which occurred once or twice a week, were waking up in the middle of the night or early morning (n=19; 26.8%), feeling too cold (n=15; 21.1%), feeling too hot (n=14; 19.7%), and using the bathroom (n=14; 19.7%). Age, gender and number of pain episodes did not have significant effects on pain, pain coping and sleep.
The majority of the children with sickle cell disease experienced mild to moderate pain and mild to moderate disturbed sleep. Identifying pain coping strategies of children with SCD can inform health care managers regarding interventions to facilitate uninterruped sleep and improve children's daytime quality of life.