2.50
Hdl Handle:
http://hdl.handle.net/10755/154733
Type:
Presentation
Title:
Pain in Children with Sickle Cell Anemia
Abstract:
Pain in Children with Sickle Cell Anemia
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Jacob, Eufemia, PhD
P.I. Institution Name:Children's Hospital and Research
Title:Hematology/Oncology Nurse
Objective: The purpose of this study was to examine changes in: 1) pain characteristics; 2) functional status; 3) signs and symptoms associated with vaso-occlusion; 4) CBC values; 5) pharmacologic pain management strategies; and 6) perceptions of pain relief in hospitalized children with sickle cell anemia during vaso-occlusive painful episodes. Design: A descriptive longitudinal design was used. Data was collected once every evening from day of admission to the hospital until the day of discharge. Population, Sample, Setting, Years: Participants were children with sickle cell anemia, age 5 to 19 years, with admitting diagnosis of vaso-occlusive pain, who were hospitalized at Children's Hospital Oakland, California, between July, 26, 2000, and April 30, 2001. Concepts or Variables: The following variables were measured: 1) current, worst, and least pain intensity using the African-American Oucher Pain Scale; 2) pain location and pain quality using the Adolescent Pediatric Pain Tool; 3) amount of sleeping, eating, activity, and pain relief using 0 to 10 Numeric Rating Scales; 4) signs and symptoms associated with vaso-occlusive episodes and CBC results using the Signs & Symptoms Checklist; 5) name, dosage, route, and frequency of all medications prescribed and administered using a Medication Quantification Scale (MQS) Worksheet, and 6) demographic variables using the Demographic/Medical Information and Parent Interview Forms. Methods: Parents/caregivers and children were interviewed regarding the onset of pain on day of admission. Children were asked once every evening to: 1) rate their current, worst, least pain, 2) mark on the APPT the location of their pain, 3) circle the words that describe their pain, and 4) circle the number from 0 to 10 that describe the amount of sleeping, eating, and activity, and the amount of pain relief from medications. Medications were recorded on the MQS worksheet and MQS scores were calculated daily. Demographics and other medical information were collected from medical records. SPSS and SAS were used to analyze data. Findings: Children's ratings of current, worst, and least pain were moderate to severe on day of admission, which decreased by 5% during hospitalization. The magnitude of the change varied widely and pain intensity did not decrease in about 25% of the episodes. The most common sites marked were the abdomen, chest, and back pain. In contrast to the pain intensity ratings, which decreased only slightly, the number of body areas marked and the total amount of surface area of pain location marked on the BOD showed a clinically significant decrease during hospitalization. Children described the quality of the pain associated with sickle cell anemia using sensory, evaluative, and affective words. The mean total number of word descriptors selected did not show significant change during hospitalization. Parents and children reported signs and symptoms associated with VOE an average of 4 days prior to admission. About 4 signs and symptoms were reported with 85% of the children exhibiting general types of signs and symptoms. Gastrointestinal symptoms, as well as respiratory and musculosketal symptoms were also reported. CBC values did not show a significant change during hospitalization. No significant relationships were found between changes in CBC values and pain intensity. The MQS was used to quantify the amount of analgesic use that takes into account not only the type of analgesic as it relates to the degree of potential side effects, but also the dosage levels. This study showed low use of analgesics (Opioids, NSAID's, adjuvants) during hospitalization. Children reported little or no relief from medications. Children also reported poor sleeping, poor eating, and little activity during hospitalization. Conclusions: A wide inter-individual variability in the pain experience of children with sickle cell anemia who were hospitalized for painful episodes, suggest that pain management strategies need to be individualized. Pain intensity ratings decreased only slightly, but the spatial distribution of the pain decreased significantly during hospitalization. The low analgesic use suggests that pain medications were not being titrated to effect according to individual needs. The low analgesic use may have lead to poor outcomes of little or no relief and minimal sleeping, eating, and activity. Implications for Practice: Nurses need to encourage patients to use the amount of medications prescribed so that their relief could be maximized. In determining effectiveness of interventions, nurses need to monitor not only pain intensity, but also, location, quality, and amount of pain relief, and sleeping, eating, and activity levels. Nurses need to evaluate whether increasing analgesic use to at least the amount prescribed would lead to improvement in pain intensity, pain location, pain quality, pain relief and functional status, such as sleeping, eating, and activity.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePain in Children with Sickle Cell Anemiaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154733-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Pain in Children with Sickle Cell Anemia</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Jacob, Eufemia, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Children's Hospital and Research</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Hematology/Oncology Nurse</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ejacob@samuelmerritt.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purpose of this study was to examine changes in: 1) pain characteristics; 2) functional status; 3) signs and symptoms associated with vaso-occlusion; 4) CBC values; 5) pharmacologic pain management strategies; and 6) perceptions of pain relief in hospitalized children with sickle cell anemia during vaso-occlusive painful episodes. Design: A descriptive longitudinal design was used. Data was collected once every evening from day of admission to the hospital until the day of discharge. Population, Sample, Setting, Years: Participants were children with sickle cell anemia, age 5 to 19 years, with admitting diagnosis of vaso-occlusive pain, who were hospitalized at Children's Hospital Oakland, California, between July, 26, 2000, and April 30, 2001. Concepts or Variables: The following variables were measured: 1) current, worst, and least pain intensity using the African-American Oucher Pain Scale; 2) pain location and pain quality using the Adolescent Pediatric Pain Tool; 3) amount of sleeping, eating, activity, and pain relief using 0 to 10 Numeric Rating Scales; 4) signs and symptoms associated with vaso-occlusive episodes and CBC results using the Signs &amp; Symptoms Checklist; 5) name, dosage, route, and frequency of all medications prescribed and administered using a Medication Quantification Scale (MQS) Worksheet, and 6) demographic variables using the Demographic/Medical Information and Parent Interview Forms. Methods: Parents/caregivers and children were interviewed regarding the onset of pain on day of admission. Children were asked once every evening to: 1) rate their current, worst, least pain, 2) mark on the APPT the location of their pain, 3) circle the words that describe their pain, and 4) circle the number from 0 to 10 that describe the amount of sleeping, eating, and activity, and the amount of pain relief from medications. Medications were recorded on the MQS worksheet and MQS scores were calculated daily. Demographics and other medical information were collected from medical records. SPSS and SAS were used to analyze data. Findings: Children's ratings of current, worst, and least pain were moderate to severe on day of admission, which decreased by 5% during hospitalization. The magnitude of the change varied widely and pain intensity did not decrease in about 25% of the episodes. The most common sites marked were the abdomen, chest, and back pain. In contrast to the pain intensity ratings, which decreased only slightly, the number of body areas marked and the total amount of surface area of pain location marked on the BOD showed a clinically significant decrease during hospitalization. Children described the quality of the pain associated with sickle cell anemia using sensory, evaluative, and affective words. The mean total number of word descriptors selected did not show significant change during hospitalization. Parents and children reported signs and symptoms associated with VOE an average of 4 days prior to admission. About 4 signs and symptoms were reported with 85% of the children exhibiting general types of signs and symptoms. Gastrointestinal symptoms, as well as respiratory and musculosketal symptoms were also reported. CBC values did not show a significant change during hospitalization. No significant relationships were found between changes in CBC values and pain intensity. The MQS was used to quantify the amount of analgesic use that takes into account not only the type of analgesic as it relates to the degree of potential side effects, but also the dosage levels. This study showed low use of analgesics (Opioids, NSAID's, adjuvants) during hospitalization. Children reported little or no relief from medications. Children also reported poor sleeping, poor eating, and little activity during hospitalization. Conclusions: A wide inter-individual variability in the pain experience of children with sickle cell anemia who were hospitalized for painful episodes, suggest that pain management strategies need to be individualized. Pain intensity ratings decreased only slightly, but the spatial distribution of the pain decreased significantly during hospitalization. The low analgesic use suggests that pain medications were not being titrated to effect according to individual needs. The low analgesic use may have lead to poor outcomes of little or no relief and minimal sleeping, eating, and activity. Implications for Practice: Nurses need to encourage patients to use the amount of medications prescribed so that their relief could be maximized. In determining effectiveness of interventions, nurses need to monitor not only pain intensity, but also, location, quality, and amount of pain relief, and sleeping, eating, and activity levels. Nurses need to evaluate whether increasing analgesic use to at least the amount prescribed would lead to improvement in pain intensity, pain location, pain quality, pain relief and functional status, such as sleeping, eating, and activity.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T13:14:03Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T13:14:03Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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