Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.
Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Pediatr Blood Cancer. 2021 Jun;68(6):e29013. doi: 10.1002/pbc.29013. Epub 2021 Mar 19.
Integration of nonpharmacological therapies, such as cognitive and behavioral pain management strategies, is recommended to support comprehensive disease and pain management among children and adolescents with sickle cell disease (SCD). The Comfort Ability Program for Sickle Cell Pain (CAP for SCP) introduces psychological and biobehavioral pain management strategies to children and adolescents with SCD. This study aimed to pilot the implementation of the CAP for SCP in a group setting to children and adolescents hospitalized for SCD pain examining feasibility, acceptability, and preliminary effectiveness on improving pain knowledge and coping efficacy.
Adaptation of CAP for SCP into a three-session group format was guided by four phases of the Dynamic Adaptation Process model: Exploration, Preparation, Implementation, and Sustainment. Youth with SCD (n = 57) hospitalized for pain participated in at least one session and completed self-report of knowledge of pain management skills, pain coping efficacy, and treatment acceptance. Completion rates of sessions and qualitative feedback were gathered to evaluate feasibility and acceptability.
Feasibility of conducting inpatient group sessions was suboptimal; however, patients and medical providers reported moderate to high levels of treatment acceptance. Patients also reported significant improvements in knowledge of pain management skills following session 1.
CAP for SCP is a patient-centered first-line psychoeducational intervention that can be integrated into clinical practice settings to introduce youth to cognitive and behavioral pain management strategies to support SCD pain management.
建议整合非药物疗法,如认知和行为疼痛管理策略,以支持儿童和青少年镰状细胞病(SCD)的全面疾病和疼痛管理。镰状细胞疼痛舒适能力计划(CAP for SCP)向患有 SCD 的儿童和青少年介绍心理和生物行为疼痛管理策略。本研究旨在试点以小组形式实施 CAP for SCP,以评估其在改善疼痛知识和应对效能方面对因 SCD 疼痛住院的儿童和青少年的可行性、可接受性和初步效果。
根据动态适应过程模型的四个阶段:探索、准备、实施和维持,将 CAP for SCP 改编为三阶段小组形式。患有 SCD 的青少年(n=57)因疼痛住院,至少参加了一次会议,并完成了疼痛管理技能知识、疼痛应对效能和治疗接受度的自我报告。收集会议的完成率和定性反馈,以评估可行性和可接受性。
进行住院小组会议的可行性欠佳;然而,患者和医疗服务提供者报告了较高的治疗接受度。患者在第 1 次会议后报告疼痛管理技能知识显著提高。
CAP for SCP 是一种以患者为中心的一线心理教育干预措施,可整合到临床实践环境中,向青少年介绍认知和行为疼痛管理策略,以支持 SCD 疼痛管理。