Intraindividual pain variability metrics for youth with sickle cell disease: Relations to health outcomes.
Intraindividual pain variability metrics for youth with sickle cell disease: Relations to health outcomes.
复制标题
患有镰状细胞病的青少年的个体内疼痛变异性指标：与健康结果的关系。
DOI：
10.1002/pbc.30194
复制
发表时间：
2023
影响因子：
3.2
通讯作者：
Valrie,Cecelia
中科院分区：
文献类型：
--
作者：
Pascale,Angela;Sisler,India;Smith,Wally;Valrie,Cecelia
背景虽然大多数儿童镰状细胞病(SCD)研究使用平均疼痛强度作为唯一的疼痛衡量标准，但最近的证据表明，仅靠这一衡量标准不足以描述SCD疼痛经历和后续影响的个体内变异性。关于青少年SCD患者的其他个体内疼痛指标，或者它们如何与这一人群的健康结果相关的信息有限。本研究的目的是描述来自生态瞬时评估(EMAS)的SCD青少年个体内疼痛指标的不同模式，并描述这些指标与健康结果之间的独特关系。方法88名SCD青少年患者来自美国三个地区的SCD儿科诊所，年龄8-17岁，平均年龄611.6岁。在基线时，青年及其监护人报告了人口和疾病信息。然后，年轻人每天完成两次EMA，持续长达4周。根据EMA数据计算疼痛指标，包括平均每日疼痛强度(DP)、SD-DP(DP标准差)、疼痛天数比例(PPD)和DP的第90百分位数(P90)。结果高DP和SD-DP与更多的焦虑症状相关，而高SD-DP和P90与更多的抑郁症状相关。高SD-DP与低自尊相关，高DP、高PPD与低镰状细胞自我效能相关。对于因疼痛引起的医疗利用，高P90与更多的急诊科就诊相关，而高DP、P90和PPD与更多的医疗接触相关。结论超越DP的疼痛变异性指标与健康结局有明显的关联。总体而言，这些关联模式表明，这些疼痛测量方法在确定与SCD青年特定健康结果相关的风险时是有用的。
BackgroundWhile the majority of pediatric sickle cell disease (SCD) research has used mean pain intensity as the only pain metric, recent evidence suggests this metric alone is inadequate in describing the intraindividual variability in SCD pain experiences and subsequent impact. There is limited information on other intraindividual pain metrics in youth with SCD, or how they relate to health outcomes in this population. The aims of this study were to describe differing patterns of intraindividual pain metrics derived from ecological momentary assessments (EMAs) of youth with SCD and to characterize the unique relationships between these metrics and health outcomes.MethodsEighty‐eight youth with SCD, aged 8–17 (mean age = 11.6), were recruited from three regional pediatric SCD clinics in the United States. At baseline, youth and their guardians reported on demographic and disease information. Then youth completed twice daily EMAs for up to 4 weeks. Pain metrics derived from EMA data were calculated including mean daily pain intensity (DP), SD‐DP (standard deviation of DP), proportion of pain days (PPD), and 90th percentile of DP (p90). Pearson correlations were calculated between pain metrics and health outcomes.ResultsHigh DP and SD‐DP were correlated with more anxiety symptoms, while high SD‐DP and p90 were correlated with more depression symptoms. High SD‐DP was correlated with low self‐esteem, and high DP and PPD were correlated with low sickle cell self‐efficacy. For healthcare utilization due to pain, high p90 was correlated with more emergency department visits, while high DP, p90, and PPD were correlated with more healthcare contacts.ConclusionThere are distinct associations between pain variability metrics beyond DP and health outcomes. Collectively, the patterns of associations suggest the utility of these pain metrics for determining risk in relation to specific health outcomes for youth with SCD.