Associations between the Use of Pain Management Strategies and Self-Reported Emotional and Behavioral Functioning of Adolescent and Young Adults with Sickle Cell Disease
Notice bibliographique
Résumé
Background: Sickle Cell Disease (SCD) often causes significant pain that may require the use of various pain management strategies. These strategies are typically categorized into two broad groups, pharmacological and nonpharmacological, but a need exists to understand how specific strategies may impact an individual's functioning. This understanding is especially critical when considering adolescents and young adults (AYA) with SCD, as this age range may experience increased pain and other SCD complications that coincide with the transition from pediatric to adult care. Methods: Adolescent and young adult patients with SCD completed the Behavioral Assessment System for Children, Third Edition (BASC-3), a measure of emotional and behavioral functioning, and a questionnaire about their pain management strategy use. These strategies were categorized as: Over the Counter Medication (acetaminophen, ibuprofen, naproxen), Prescription Medication (codeine, short-acting morphine, long-acting morphine, oxycodone, hydrocodone, hydromorphone, gabapentin, amitriptyline), Psychological Strategies (deep breathing, imagery, distraction, talking with friends/family, prayer/meditation), and Behavioral Strategies (hydrate, apply heat, apply cold, massage, smoking, rest/sleep). Analyses included Spearman rank correlations to determine the relationship between categories of pain management strategies and self-reported BASC scores. Based on correlation results, independent sample t-tests were conducted to further examine the relationship between the use of specific pain management strategies and self-reported BASC scores. Results: Participants included 94 AYA patients with SCD (Mean age = 18.1 ± 1.5 years; 51.1% female; 52.1% HbSS). Of the pain management categories, Prescription Medication and Behavioral Strategies had significant correlations with self-reported BASC scores. Within the Prescription Medication category, participants that reported use of hydrocodone (40.9%) self-reported higher scores on the Social Stress (p = 0.01) and Somatization (p = 0.001) scales of the BASC-3 as well as lower scores on the Interpersonal Relations (p = 0.048) scale compared to participants that did not use hydrocodone. Those using oxycodone (25%) self-reported higher scores on the Somatization (p = 0.002) scale and lower scores on the Interpersonal Relations (p = 0.036) scale compared to those that did not use oxycodone. Participants that reported use of gabapentin (6.8%) self-reported higher scores on the Social Stress (p = 0.006) and Somatization (p = 0.009) scales compared to those that did not use of gabapentin. Compared to participants that did not use amitriptyline, those that reported use (3.4%) self-reported higher scores on the Somatization (p = 0.017) scale. Within the Behavioral Strategies category, adolescents and young adults that reported the use of smoking to manage pain (7.3%) self-reported higher scores on the Somatization (p < 0.001) and Attention Problems (p < 0.001) scales than those that did not smoke. Additionally, participants that reported the application of cold temperature to manage pain (15.9%) self-reported higher scores on the Attitude to School (p = 0.03) and Attention Problems (p = 0.006) scales compared to those that did not use this strategy. Conclusions: Results indicate that specific pain management strategies may be associated with different social, emotional, and behavioral functioning. Further exploration to understand the mechanisms between specific pain management strategies and patient functioning during the AYA period is warranted. Given the unique challenges of adolescents and young adults with SCD, future work should also investigate how specific pain management strategies may improve the experience of those transitioning from pediatric to adult care.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».