PAIN IN SICKLE CELL EPIDEMIOLOGIC STUDY

描述：（改编自研究者摘要）镰状细胞病疼痛 是很难被认识、衡量和对待的。虽然痛苦的插曲是 最常见的原因镰状细胞患者寻求护理，研究很少直接 详细测量疼痛。在迄今为止的研究中， 变量本身只能部分解释观察到的疼痛发作的差异 频率.此外，对疼痛反应的差异知之甚少 包括家庭管理与医疗保健利用。本队列的目标 研究是为了测量疼痛的变异性和对疼痛的反应， 细胞疾病，并建立多变量模型来解释患者的疼痛 以及他们对疼痛的反应，特别是对医疗保健的利用。模特的 结果变量将包括平均疼痛、疼痛发作和各种类型 使用事件，包括非麻醉性镇痛剂使用，麻醉剂使用， 门诊、急诊（艾德）和住院。一个 其他结果将是每个患者疼痛发作的百分比 这导致各种类型的利用。成果将付诸实施 使用6个月内收集的每日疼痛日记。回顾过去24 小时后，患者将在顺序（0-9）量表上回忆最大疼痛，痛苦， 和残疾，判断他们是否处于“危机”中，并注意疼痛部位 以及它们的各种利用方式。每日疼痛强度评级将是 使用公式化的疼痛阈值将其转换为疼痛发作计数， 插曲。该公式根据以下各项单独计算每个患者的阈值： 他/她的疼痛评分。这些模型将衡量几类 解释变量（人口统计学、疾病相关、心理社会和 准备利用护理），使用原始数据进行操作并验证 仪器.将从中部和潮水地区招募患者 弗吉尼亚州，将进行初步调查电池，图表审查，并简要介绍 最终调查、静脉穿刺和尿液采样，以及每日完整的疼痛日记 6个月这项研究将促进对病因和影响的认识 疼痛和疼痛反应的研究。通过揭示潜在的 可变的解释变量，该研究的结果将建议的目标 生物行为治疗干预。该研究还将推进 测量镰状细胞病的疼痛和疼痛反应。通过测量疼痛 直接，同时利用，我们的结果可以验证或 使之前的研究无效。本研究结果可用于改善镰刀 细胞疼痛的诊断和治疗，并消除有关镰状细胞疼痛的神话。

DESCRIPTION: (adapted from investigator's abstract) Pain in sickle cell disease is poorly recognized, measured, and treated. Although painful episodes are the most common reason sickle cell patients seek care, studies have seldom directly measured pain in detail. In studies to date, biological and demographic variables alone only partly explain the observed variance in painful episode frequency. Further, little is known about differences in pain responses including home management versus health care utilization. Aims of this cohort study are to measure the variability in pain and response to pain in sickle cell disease, and to build multivariate models to explain both patients' pain and their response to pain, especially, utilization of health care. The models' outcome variables will include mean pain, painful episodes, and various types of utilization episodes, including non-narcotic analgesic use, narcotic use, office visits, emergency department (ED visits, and hospitalization. An additional outcome will be the percentage of each patient's painful episodes that result in various types of utilization. Outcomes will be operationalized using daily pain diaries collected over 6 months. Reflecting on the prior 24 hours, patients will recall on an ordinal (0-9) scale maximum pain, distress, and disability, judge whether they were in a "crisis," and note pain locations andtheir various types of utilization. Daily pain intensity ratings will be transformed into pain episode counts using a formulaic threshold for a painful episode. The formula calculates each patient's threshold individually, based on his/her pain ratings. The models will measure the effect of several classes of explanatory variables (demographic, disease-related, psycho social, and readiness to utilize care), operationalized using primary data and validated instruments. Patients will be recruited from the central and Tidewater regions of Virginia, will undergo an initial survey battery, chart review, and a brief final survey, venipuncture and urine sampling, and complete pain diaries daily for 6 months. This study will advance knowledge of the etiology and influences on pain and pain response in sickle cell disease. By revealing potentially mutable explanatory variables, the study's results will suggest targets of biobehavioral treatment interventions. The study will also advance methods of measuring pain and pain response in sickle cell disease. By measuring pain directly, simultaneously with utilization, our results may validate or invalidate prior studies. Results of this study can be used to improve sickle cell pain diagnosis and treatment and to dispel myths about sickle cell pain.