Associations between the Use of Pain Management Strategies and Self-Reported Emotional and Behavioral Functioning of Adolescent and Young Adults with Sickle Cell Disease
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".