Simmons Leigh Ann, Williams Hants, Silva Susan, Keefe Francis, Tanabe Paula
Duke University School of Nursing, Durham, North Carolina.
BioVirtua, San Francisco, California.
Pain Manag Nurs. 2019 Jun;20(3):261-269. doi: 10.1016/j.pmn.2018.10.002. Epub 2019 May 10.
Few investigators have developed and tested nonpharmacological interventions for helping persons with sickle cell disease (SCD) manage persistent pain.
The purpose of this pilot study was to examine the feasibility and acceptability of a mindfulness-based intervention (MBI) in adults with SCD and chronic pain and to gather preliminary data on its efficacy.
Data on feasibility and acceptability, including recruitment, retention, and attendance rates, were collected during a single-site, randomized control trial. Participants were randomly assigned to either a 6-session group telephonic MBI or a wait-listed control. Pain catastrophizing was assessed at baseline and at weeks 1, 3, and 6.
Outpatient, comprehensive, interdisciplinary sickle cell disease center in the Southeast.
PARTICIPANTS/SUBJECTS: Adults at least 18 years of age with a self-reported diagnosis of sickle cell disease who self-identified as having chronic, non-cancer pain that persisted on most days for at least 6 months and adversely affected function and/or well-being.
Seventy-eight adults were recruited; 18 (23%) declined to participate; 60 were randomly assigned to either the MBI (N = 40) or control (N = 20). Of those, 14 (35%) from the MBI and 12 (60%) from the control group withdrew immediately after random allocation, resulting in 34 evaluable cases (MBI: N = 26; control: N = 8).
Among the 26 assigned to MBI, the median number of sessions attended per person was 4; 7 (27%) attended all six sessions. Qualitative findings indicated that MBI participants viewed the program as acceptable and liked the telephonic format, community, and content. Reductions in pain catastrophizing outcomes were identified after intervention.
An MBI is feasible and acceptable for persons with SCD experiencing chronic pain. A larger randomized controlled trial to establish MBI efficacy on pain and related outcomes for SCD will provide nonpharmacologic, behavioral pain management options for nurses and other clinicians caring for persons with SCD and chronic pain.
很少有研究者开发并测试用于帮助镰状细胞病（SCD）患者管理持续性疼痛的非药物干预措施。
这项试点研究的目的是检验基于正念的干预（MBI）对患有SCD和慢性疼痛的成年人的可行性和可接受性，并收集其疗效的初步数据。
在一项单中心随机对照试验中收集关于可行性和可接受性的数据，包括招募率、保留率和出勤率。参与者被随机分配到为期6节的小组电话MBI干预组或等待名单对照组。在基线以及第1、3和6周评估疼痛灾难化程度。
东南部的门诊综合跨学科镰状细胞病中心。
参与者/受试者：至少18岁的成年人，自我报告诊断为镰状细胞病，自我认定患有慢性非癌性疼痛，这种疼痛在大多数日子持续至少6个月，并对功能和/或幸福感产生不利影响。
招募了78名成年人；18人（23%）拒绝参与；60人被随机分配到MBI组（N = 40）或对照组（N = 20）。其中，MBI组的14人（35%）和对照组的12人（60%）在随机分组后立即退出，最终有34例可评估病例（MBI组：N = 26；对照组：N = 8）。
在分配到MBI组的26人中，每人参加课程的中位数为4节；7人（27%）参加了全部6节课程。定性研究结果表明，MBI参与者认为该项目是可接受的，并且喜欢电话形式、团体氛围和课程内容。干预后发现疼痛灾难化程度有所降低。
对于患有慢性疼痛的SCD患者，MBI是可行且可接受的。一项更大规模的随机对照试验，以确定MBI对SCD患者疼痛及相关结局的疗效，将为护理SCD和慢性疼痛患者的护士及其他临床医生提供非药物行为疼痛管理选择。
