Pain, Sickle Cell Disease, Stress
Conditions
Brief summary
Our goal is to improve the self-management of pain and stress in adult outpatients with sickle cell disease (SCD) by determining the feasibility of a self-managed guided relaxation (GR) stress reduction intervention using a tablet-based mobile device. Currently, opioid analgesics are primarily used to treat SCD pain while self-managed behavioral modalities such as GR, are rarely used. Little is known about the effects or mechanisms of GR on pain and stress, in adults with SCD. Emerging evidence from the hypothalamic pituitary adrenal (HPA) axis theory offer insights for understanding the mechanisms. Adding GR as a supplement to analgesic therapies will address the paucity of self-management strategies for controlling pain in SCD. GR is a simple and cost-effective non-drug intervention that could reduce pain and stress in outpatients with SCD. GR is an intervention where outpatients with SCD are directed to listen to and view audio-visual recordings while they visualize themselves being immersed in that scene.
Detailed description
The investigator will recruit adult outpatients with sickle cell disease (SCD) from the University of Florida Health Hematology Clinics and conduct study visits in a research room located at the College of nursing. The investigator will stratify participants on worst pain intensity (\<=5 and \>5) and randomly assign 15 adults to attention control (stress/pain tracking; 12-min SCD experience discussion) and 15 adults to experimental (stress/pain tracking; 12-min GR video clip) groups. The immediate intervention effects will be examined for pain (primary) and stress (secondary) outcomes. Vital signs for determining relaxation responses (mediators) will be collected immediately before and after the 12-min interventions.
Interventions
BEHAVIORALGuided Relaxation video clip
This intervention is a 12-minute guided audio-visual relaxation intervention.
This intervention is a 12-minute computer-administered sickle cell disease experience discussion.
Sponsors
University of Florida
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Has SCD diagnosis; * Reports pain 3 or greater in the previous 24 hours (0-10 scale) * Receives care at the University of Florida (UF) Health/Shands * Speaks and reads English * 18 years of age or older * Self-identifies as being of African or Hispanic descent
Exclusion criteria
* Legally blind * Physically or cognitively unable to complete study measures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Current pain | Immediate (baseline) | Patient-Reported Outcomes Measurement Information System (PROMIS) Pain intensity scale: A 3-item scale that asks patients to report their pain now, worst, and average on a scale of 1 to 5 where 1 is had no pain and 5 is very severe. We will estimate intervention effects using regression analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Current stress | Immediate (baseline) | Stress intensity scale: A 3-item scale that asks patients to report their current, least, and worst stress intensity today, on a scale of 0 to 10, where 0 is no stress and 10 is stress as bad as it could be. We will estimate intervention effects using linear regression. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Physiologic markers of relaxation (pulse, respiration, finger temperature) | Immediate (baseline) | Physiological markers of relaxation (pulse, respiration, finger temperature) will be measured using a standard vital sign measuring device. We will estimate intervention effects using regression analysis. We expect to observe trends for the immediate GR effect in terms of decreases in relaxation indicators (respiration rate, heart rate) and increases in skin temperature. |
Countries
United States
Outcome results
None listed