Little is known about the effects of self-managed relaxation interventions on pain, stress, and autonomic responses in patients with sickle cell disease (SCD). This pre-post randomized controlled pilot study was conducted to determine the feasibility of using computer tablets for relaxation intervention delivery; acceptability of study procedures; and intervention effects on pain, stress, and indicators of relaxation. The 30 research participants ranged in age from 22 years to 59 years. All were African American; 53% were male. They were randomized to an experimental group that watched a relaxation video or a control group that discussed their disease. All participants completed the study, indicating feasibility. Acceptability rates were also high. Data were obtained for the intervention’s immediate effect on pain, stress, respiration, pulse, finger skin temperature, and self-reported relaxation. These preliminary findings will guide future, higher-powered studies to determine the intervention’s efficacy and mechanism in SCD.
AhlesT. A.BlanchardE. B.RuckdeschelJ. C. (1983). The multidimensional nature of cancer-related pain. Pain, 17(3), 277–288.
2.
AisikuI. P.SmithW. R.McClishD. K.LevensonJ. L.PenberthyL. T.RoseffS. D.. . . RobertsJ. D. (2009). Comparisons of high versus low emergency department utilizers in sickle cell disease. Annals of Emergency Medicine, 53(5), 587-593.
3.
AnieK. A.GreenJ. (2012a). Psychological therapies for sickle cell disease and pain. Cochrane Database of Systematic Reviews (2), CD001916. doi:10.1002/14651858.CD001916.pub2
4.
AnieK. A.GreenJ. (2012b). Psychological therapies for sickle cell disease and pain. Cochrane Database of Systematic Reviews2, CD001916. doi:10.1002/14651858.CD001916.pub2
5.
AnieK. A.GreenJ. (2015). Psychological therapies for sickle cell disease and pain. Cochrane Database of Systematic Reviews (5), CD001916. doi:10.1002/14651858.CD001916.pub3
BarakatL. P.SchwartzL. A.SalamonK. S.RadcliffeJ. (2010). A family-based randomized controlled trial of pain intervention for adolescents with sickle cell disease. Journal of Pediatric Hematology/oncology, 32(7), 540-547. doi:10.1097/MPH.0b013e3181e793f9
8.
BenjaminL. J.DampierC. D.JacoxA. K.OdesinaV.PhoenixD.ShapiroB.. . . TreadwellM. (1999). Guidelines for the management of acute and chronic pain in sickle-cell disease. Glenview, IL: American Pain Society.
9.
BorofficeO. B. (1991). Self-help in sickle-cell disease in NigeriaHealth Promotion International, 6(4), 241-246.
10.
BroomeM. E.MaiklerV.KelberS.BaileyP.LeaG. (2001). An intervention to increase coping and reduce health care utilization for school-age children and adolescents with sickle cell disease. Journal of National Black Nurses’ Association, 12(2), 6-14.
11.
BrousseauD. C.OwensP. L.MossoA. L.PanepintoJ. A.SteinerC. A. (2010). Acute care utilization and rehospitalizations for sickle cell disease. JAMA, 303(13), 1288-1294. doi:10.1001/jama.2010.378
12.
BurgessD. J.GrillJ.NoorbaloochiS.GriffinJ. M.RicardsJ.van RynM.PartinM. R. (2009). The effect of perceived racial discrimination on bodily pain among older African American men. Pain Medicine, 10(8), 1341-1352.
13.
ClarkeT. C.BlackL. I.StussmanB. J.BarnesP. M.NahinR. L. (2015). Trends in the use of complementary health approaches among adults: United States, 2002-2012. National Health Statistics Reports, 10(79), 1-16.
14.
CMS Mobility Inc. (2015). Acc U Rate® CMS 500D (Version 1.2 ed.). Stafford, TX: CMS Mobility Inc.
15.
CorlessI. B. (1988, March25). For healthful, loving living, video and discussion. Key aspects of comfort management of pain, fatigue and nausea. Chapel Hill, NC: University of North Carolina at Chapel Hill.
EzenwaM. O.MolokieR. E.WangZ. J.YaoY.SuarezM. L.DyalB.. . . WilkieD. J. (2018). Differences in sensory pain, expectation, and satisfaction reported by outpatients with cancer or sickle cell disease. Pain Management Nursing, 19(4), 322-332. doi:10.1016/j.pmn.2017.11.010
18.
EzenwaM. O.MolokieR. E.WangZ. J.YaoY.SuarezM. L.PullumC.. . . WilkieD. J. (2016). Safety and utility of quantitative sensory testing among adults with sickle cell disease: Dndicators of neuropathic pain?Pain Practice, 16(3), 282-293. doi:10.1111/papr.12279
19.
EzenwaM. O.YaoY.EngelandC. G.MolokieR. E.WangZ. J.SuarezM. L.WilkieD. J. (2016). A randomized controlled pilot study feasibility of a tablet-based guided audio-visual relaxation intervention for reducing stress and pain in adults with sickle cell disease. Journal of Advanced Nursing, 72(6), 1452-1463. doi:10.1111/jan.12895
20.
EzenwaM. O.YaoY.NguyenM.MandernachM. C.HunterC.YoonS.. . . WilkieD. J. (2018). The effects of relaxation intervention on pain, stress, and autonomic responses among adults with sickle cell pain in the outpatient setting. The Journal of Pain, 19(3), S32-S33. https://doi.org/10.1016/j.jpain.2017.12.083
21.
GilK. M.EdensJ. L.WilsonJ. J.RaezerL. B.KinneyT. R.SchultzW. H.DaeschnerC. (1997). Coping strategies and laboratory pain in children with sickle cell disease. Annals of Behavioral Medicine, 19(1), 22-29.
22.
GilK. M.WilsonJ. J.EdensJ. L.WebsterD. A.AbramsM. A.OrringerE.. . . JanalM. N. (1996). Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease. Health Psychology, 15(1), 3-10.
23.
GreenC. R.BakerT. A.SmithE. M.SatoY. (2003). The effect of race in older adults presenting for chronic pain management: A comparative study of black and white Americans. The Journal of Pain, 4(2), 82-90.
24.
KaslowN. J.CollinsM. H.RashidF. L.BaskinM. L.GriffithJ. R.HollinsL.EckmanJ. E. (2000). The efficacy of a pilot family psychoeducational intervention for pediatric sickle cell disease (SCD). Families, Systems & Health, 18(4), 381-404.
25.
KeizerD.van WijheM.PostW. J.UgesD. R.WierdaJ. M. (2007). Assessment of the clinical relevance of quantitative sensory testing with Von Frey monofilaments in patients with allodynia and neuropathic pain. A pilot study. European Journal of Anaesthesiology, 24(8), 658-663. doi:10.1017/S0265021507000221
26.
KwekkeboomK. L.GretarsdottirE. (2006). Systematic review of relaxation interventions for pain. Journal of Nursing Scholarship, 38(3), 269-277.
27.
LanzkronS.CarrollC. P.HaywoodC.Jr. (2010). The burden of emergency department use for sickle-cell disease: An analysis of the national emergency department sample database. American Journal of Hematology, 85(10), 797-799.
28.
MolokieR. E.WangZ. J.WilkieD. J. (2011). Presence of neuropathic pain as an underlying mechanism for pain associated with cold weather in patients with sickle cell disease. Medical Hypotheses, 77(4), 491-493. doi:10.1016/j.mehy.2011.06.018
29.
MolokieR. E.WilkieD. J.WittertH.SuarezM. L.YaoY.ZhaoZ.. . . WangZ. J. (2014). Mechanism-driven phase I translational study of trifluoperazine in adults with sickle cell disease. European Journal of Pharmacology, 723, 419-424. doi:10.1016/j.ejphar.2013.10.062
30.
PageG. G.Ben-EliyahuS. (1997). The immune-suppressive nature of pain. Seminars in Oncology Nursing, 13(1), 10-15.
31.
PlattO. S.BrambillaD. J.RosseW. F.MilnerP. F.CastroO.SteinbergM. H.KlugP. P. (1994). Mortality in sickle cell disease. Life expectancy and risk factors for early death. New England Journal of Medicine, 330(23), 1639-1644. doi:10.1056/NEJM199406093302303
32.
R Development Core Team. (2011). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.
33.
RaphaelJ. L.DietrichC. L.WhitmireD.MahoneyD. H.MuellerB. U.GiardinoA. P. (2009). Healthcare utilization and expenditures for low income children with sickle cell disease. Pediatric Blood & Cancer, 52(2), 263-267. doi:10.1002/pbc.21781
RosenstielA. K.KeefeF. J. (1983). The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain, 17(1), 33-44.
36.
SchulzK. F.AltmanD. G.MoherD. (2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Annals of Internal Medicine, 152(11), 726-732. doi:10.7326/0003-4819-152-11-201006010-00232
37.
SmithK. E.NormanG. J. (2017). Brief relaxation training is not sufficient to alter tolerance to experimental pain in novices. PLOS One, 12(5), e0177228. doi:10.1371/journal.pone.0177228
38.
ThomasV. N. (2000). Cognitive behavioural therapy in pain management for sickle cell disease. International Journal of Palliative Nursing, 6(9), 434-442.
39.
ThomasV. N.Wilson-BarnettJ.GoodhartF. (1998). The role of cognitive-behavioural therapy in the management of pain in patients with sickle cell disease. Journal of Advanced Nursing, 27(5), 1002-1009.
40.
ThompsonW. E.EriatorI. (2014). Pain control in sickle cell disease patients: use of complementary and alternative medicine. Pain Medicine, 15(2), 241-246. doi:10.1111/pme.12292
41.
UgaldeA.HaynesK.BoltongA.WhiteV.KrishnasamyM.SchofieldP.. . .LivingstonP. (2017). Self-guided interventions for managing psychological distress in people with cancer - A systematic review. Patient Education and Counseling, 100(5), 846-857. doi:10.1016/j.pec.2016.12.009
42.
WilkieD.BerryD.CainK.HuangH. Y.MekwaJ.LewisF.. . .KoN. Y. (2010). Effects of coaching patients with lung cancer to report cancer pain. Western Journal of Nursing Research, 32(1), 23-46.
43.
WilkieD. J.MolokieR.Boyd-SealD.SuarezM. L.KimY. O.ZongS.. . .WangZ. J. (2010). Patient-reported outcomes: Descriptors of nociceptive and neuropathic pain and barriers to effective pain management in adult outpatients with sickle cell disease. Journal of the National Medical Association, 102(1), 18-27.
44.
WilliamsH.TanabeP. (2016). Sickle cell disease: A review of nonpharmacological approaches for pain. Journal of Pain and Symptom Management, 51(2), 163-177. doi:10.1016/j.jpainsymman.2015.10.017
