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Patient self-assessment of hospital pain, mood and health-related quality of life in adults with sickle cell disease.

ABSTRACT: Acute pain is a hallmark of sickle cell disease (SCD) for which frequent hospital admissions may be required, affecting the quality of life of patients. To characterise the relationship between adult patient self-reported sickle cell pain, mood and quality of life during and after hospital admissions. Longitudinal study across three time-points. Secondary care, single specialist sickle cell centre. 510 adult patients with SCD admitted to hospital daycare or inpatient units. Self-assessments of pain, mood and health-related quality of life with health utility (measured on the EQ-5D) on admission, before discharge and at 1-week postdischarge. Mood, general health and quality of life showed significant steady improvements with reduction of pain in patients with SCD on admission to hospital, before discharge and at 1-week follow-up (p<0.01). Health utility scores derived from the EQ-5D showed a negative association with pain in regression analysis over the three time-points. Examining health-related quality of life and health utility in relation to pain during hospital admissions is valuable in terms of targeting appropriate psychological interventions within the context of a multidisciplinary approach to managing sickle cell pain. This has implications for healthcare costs.

SUBMITTER: Anie KA

PROVIDER: S-EPMC3391376 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Patient self-assessment of hospital pain, mood and health-related quality of life in adults with sickle cell disease.

Anie Kofi A KA Grocott Hannah H White Lauren L Dzingina Mendwas M Rogers Gabriel G Cho Gavin G

BMJ open 20120702 4

<h4>Introduction</h4>Acute pain is a hallmark of sickle cell disease (SCD) for which frequent hospital admissions may be required, affecting the quality of life of patients.<h4>Objectives</h4>To characterise the relationship between adult patient self-reported sickle cell pain, mood and quality of life during and after hospital admissions.<h4>Design</h4>Longitudinal study across three time-points.<h4>Setting</h4>Secondary care, single specialist sickle cell centre.<h4>Participants</h4>510 adult ...[more]

PMID: 22761289

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Project description:AimsPsychosocial and sensory factors, including anxiety, depression, and pressure pain threshold have been used to cluster chronic symptoms in irritable bowel syndrome (IBS). This study examined the contribution of psychosocial sensory factors on pain interference and quality of life (QOL) in this population.DesignWe performed a cross-sectional analysis of baseline data from a randomized controlled trial.SettingsTwo gastrointestinal clinics, general communities, and two large campuses of a public university in the Northeastern United States.Participants/subjectsEighty young adults with IBS aged 21 ± 2.57 years (76.25% female).MethodsDemographic and psychosocial factors including anxiety, depression, fatigue, cognition or general concerns, sleep disturbance, self-efficacy, coping, and food intake were measured as independent variables. Quantitative sensory testing was conducted to measure mechanical, thermal, and pressure pain thresholds. Self-reported pain measured by the brief pain inventory (BPI) and IBS-QOL were assessed as the outcome variables. Regression analysis and mediation analysis were conducted to determine the associated factors of IBS pain and QOL.ResultsAge, sex, and psychosocial factors including coping, self-efficacy, alcohol intake, mechanical pain sensitivity, and cold pain threshold were significantly associated with pain interference (all p < 0.05). Coping, and self-efficacy were significantly associated with IBS-QOL (all p < 0.05). In the mediation analysis, coping catastrophizing and self-efficacy were indirectly associated with IBS-QOL mediated by fatigue.ConclusionsPsychosocial factors including coping and self-efficacy, and quantitative sensory testing factors significantly correlate with self-reported pain and QOL among young adults with IBS. This preliminary research calls for further interventional studies that target personalized psychosocial and quantitative sensory factors to improve pain management and quality of life in IBS patients.

Project description:Associations of modulators of quality of life (QoL) and survival duration are assessed in the fatal motor neuron disease, Amyotrophic Lateral Sclerosis. Major categories include clinical impression of mood (CIM); physical health; patient social support; and usage of interventions, pharmaceuticals, and supplements. Associations were assessed at p < 0.05 and p < 0.001 significance thresholds using applicable methods (Chi-square, t-test, ANOVA, logistical regression, random forests, Fisher's exact test) within a retrospective cohort of 1585 patients. Factors significantly correlated with positive (happy or normal) mood included family support and usage of bi-level positive airway pressure (Bi-PAP) and/or cough assist. Decline in physical factors like presence of dysphagia, drooling, general pain, and decrease in ALSFRS-R total score or forced vital capacity (FVC) significantly correlated with negative (depressed or anxious) mood (p < 0.05). Use of antidepressants or pain medications had no association with ALS patient mood (p > 0.05), but were significantly associated with increased survival (p < 0.05). Positive patient mood, Bi-PAP, cough assist, percutaneous endoscopic gastrostomy (PEG), and accompaniment to clinic visits associated with increased survival duration (p < 0.001). Of the 47 most prevalent pharmaceutical and supplement categories, 17 associated with significant survival duration increases ranging +4.5 to +16.5 months. Tricyclic antidepressants, non-opioids, muscle relaxants, and vitamin E had the highest associative increases in survival duration (p < 0.05). Random forests, which examined complex interactions, identified the following pharmaceuticals and supplements as most predictive to survival duration: Vitamin A, multivitamin, PEG supplements, alternative herbs, antihistamines, muscle relaxants, stimulant laxatives, and antispastics. Statins, metformin, and thiazide diuretics had insignificant associations with decreased survival.

Dataset Information

Patient self-assessment of hospital pain, mood and health-related quality of life in adults with sickle cell disease.

Publications

Patient self-assessment of hospital pain, mood and health-related quality of life in adults with sickle cell disease.

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