Abstract
Aims: To assess sickle cell pain and coping in children and to examine the relation between these factors and the utilisation of health services.
Methods: Cross sectional study involving 67 children with sickle cell disease attending three London hospitals. Interviews and questionnaires involved measures of pain, health service utilisation, and coping responses (measured with the Coping Strategies Questionnaire (CSQ), revised for children with sickle cell disease). Medical data on complications, haemoglobin (Hb) levels, and foetal haemoglobin (HbF) percentage were also collected.
Results: Pain accounted for about 24% of hospital service use, independent of age, sex, number of with sickle cell disease complications, and Hb levels. However, 42% of patients had not utilised hospital services in the past 12 months. Three higher order factors emerged from analysis of the CSQ (active coping, affective coping, passive adherence coping). Pain severity was predicted by passive adherence coping, while utilisation of hospital services was predicted by active coping.
Conclusions: Sickle cell disease in children involves severe recurrent pain leading to hospitalisation in some cases. Psychological coping patterns are relevant to both pain experience, and the use of acute hospital services. It is likely that children would benefit from community based interventions that incorporate both medical and psychological assessments.
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Selected References
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- Atkin K., Ahmad W. I. Living a 'normal' life: young people coping with thalassaemia major or sickle cell disorder. Soc Sci Med. 2001 Sep;53(5):615–626. doi: 10.1016/s0277-9536(00)00364-6. [DOI] [PubMed] [Google Scholar]
- Charache S., Terrin M. L., Moore R. D., Dover G. J., Barton F. B., Eckert S. V., McMahon R. P., Bonds D. R. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia. N Engl J Med. 1995 May 18;332(20):1317–1322. doi: 10.1056/NEJM199505183322001. [DOI] [PubMed] [Google Scholar]
- Gil K. M., Thompson R. J., Jr, Keith B. R., Tota-Faucette M., Noll S., Kinney T. R. Sickle cell disease pain in children and adolescents: change in pain frequency and coping strategies over time. J Pediatr Psychol. 1993 Oct;18(5):621–637. doi: 10.1093/jpepsy/18.5.621. [DOI] [PubMed] [Google Scholar]
- Gil K. M., Williams D. A., Thompson R. J., Jr, Kinney T. R. Sickle cell disease in children and adolescents: the relation of child and parent pain coping strategies to adjustment. J Pediatr Psychol. 1991 Oct;16(5):643–663. doi: 10.1093/jpepsy/16.5.643. [DOI] [PubMed] [Google Scholar]
- Ohene-Frempong K., Weiner S. J., Sleeper L. A., Miller S. T., Embury S., Moohr J. W., Wethers D. L., Pegelow C. H., Gill F. M. Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood. 1998 Jan 1;91(1):288–294. [PubMed] [Google Scholar]
- Reed W., Vichinsky E. P. New considerations in the treatment of sickle cell disease. Annu Rev Med. 1998;49:461–474. doi: 10.1146/annurev.med.49.1.461. [DOI] [PubMed] [Google Scholar]