Taylor Lou Ella V, Stotts Nancy A, Humphreys Janice, Treadwell Marsha J, Miaskowski Christine
Department of Physiological Nursing University of California, San Francisco.
Department of Physiological Nursing University of California, San Francisco.
Pain Manag Nurs. 2013 Dec;14(4):287-301. doi: 10.1016/j.pmn.2011.06.003. Epub 2011 Dec 14.
Chronic pain in adults with sickle cell disease (SCD) is a complex multidimensional experience that includes biologic, psychologic, sociologic, and spiritual factors. To date, three models of pain associated with SCD (i.e., biomedical model, biopsychosocial model for SCD pain, and Health Beliefs Model) have been published. The biopsychosocial multidimensional approach to chronic pain developed by Turk and Gatchel is a widely used model of chronic pain. However, this model has not been applied to chronic pain associated with SCD. In addition, a spiritual/religious dimension is not included in this model. Because spirituality/religion is central to persons affected by SCD, that dimension needs to be added to any model of chronic pain in adults with SCD. In fact, data from one study suggest that spirituality/religiosity is associated with decreased pain intensity in adults with chronic pain from SCD. A biopsychosocial-spiritual model is proposed for adults with chronic pain from SCD, because it embraces the whole person. This model includes the biologic, psychologic, sociologic, and spiritual factors relevant to adults with SCD based on past and current research. The purpose of this paper is to describe an adaptation of Turk and Gatchel's model of chronic pain for adults with SCD and to summarize research findings that support each component of the revised model (i.e., biologic, psychologic, sociologic, spiritual). The paper concludes with a discussion of implications for the use of this model in research.
患有镰状细胞病（SCD）的成年人的慢性疼痛是一种复杂的多维度体验，包括生物、心理、社会和精神因素。迄今为止，已经发表了三种与SCD相关的疼痛模型（即生物医学模型、SCD疼痛的生物心理社会模型和健康信念模型）。Turk和Gatchel提出的慢性疼痛生物心理社会多维度方法是一种广泛使用的慢性疼痛模型。然而，该模型尚未应用于与SCD相关的慢性疼痛。此外，该模型未包括精神/宗教维度。由于精神性/宗教信仰对于受SCD影响的人至关重要，因此需要将该维度添加到任何患有SCD的成年人慢性疼痛模型中。事实上，一项研究的数据表明，精神性/宗教信仰与患有SCD慢性疼痛的成年人疼痛强度降低有关。本文提出了一种针对患有SCD慢性疼痛成年人的生物心理社会-精神模型，因为它涵盖了整个人。该模型基于过去和当前的研究，纳入了与患有SCD的成年人相关的生物、心理、社会和精神因素。本文的目的是描述对Turk和Gatchel的慢性疼痛模型进行调整以适用于患有SCD的成年人，并总结支持修订后模型各组成部分（即生物、心理、社会、精神）的研究结果。本文最后讨论了该模型在研究中的应用意义。
