Abstract
Management of sickle cell pain in adolescent and pediatric patients is inadequate, and the employment of proper management guidelines and practices are highly variable among different regions and populations. APPT, the multidimensional adolescent pediatric pain tool, promotes optimal pain management and introduces best practical guidelines for pain management. The goal of this study is to assess pain and pain management among young patients diagnosed with sickle cell disease (SCD) by introducing the APPT as a tool for pain management, and analyze factors contributing to pain management. Information relevant to demographic data, SCD characteristics, APPT assessment, and satisfaction of patients regarding pain management were collected using a structured questionnaire. Results showed that SCD is highly associated with gender (p = 0.022), consanguinity (p = 0.012), and number of surgeries (p = 0.013). Most patients (58.9%) indicated the involvement of more than six body areas affected during pain crisis. Severe pain was described by more than half the patients (55.6%), while moderate pain was reported by 31.1%. Most patients described their pain by sensory, affective, and temporal words. The number of painful areas, pain intensity, and use of descriptive pain words was correlated and interpreted by age, BMI, school absence, and number of surgeries. Results of this study could provide guidance to healthcare providers to improve current practices for SCD pain management in order to improve health outcomes and patients’ satisfaction.
Highlights
The global burden of hemoglobin disorders cannot be ignored; they contribute to about 3.4% of mortality in children aged less than five years [1,2]
Pain crisis continues to play an integral part in increasing morbidity and mortality among patients with sickle cell disease (SCD)
Understanding the nature of SCD and pain crisis by health care providers will be instrumental in offering the best managements of pain
Summary
The global burden of hemoglobin disorders cannot be ignored; they contribute to about 3.4% of mortality in children aged less than five years [1,2]. Worldwide survival depends on the economic status of the country in which the person is born; in high-income countries, affected children live longer, suffering mainly from chronic disorders, while in low-income countries, affected children die before the age of five [1,3]. Sickle cell disease (SCD) is a worldwide, common hereditary blood disorder affecting red blood cells [1]. SCD, a group of autosomal recessive genetic disorders depicted by the sickle hemoglobin (HbS) variant, is frequent in most populations of sub-Saharan Africa, the Middle East, India, as well as Western Europe, and the eastern coast of the Americas following migrations of people from affected areas [1,4,5]. Brain Sci. 2019, 9, 182 traits in newborns was found to be 3.17%, while the estimated prevalence was expected to be 4.45%. SCD displays several symptoms and complications including chronic anemia, acute chest syndrome, stroke, renal dysfunction, susceptibility to bacterial infections, and pain crisis [4,7]
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