Physical and cognitive-behavioral activities used in the home management of sickle pain: A daily diary study in children and adolescents

Background. There is little information documenting the use of cognitive-behavioral and physical pain relieving activities by children and adolescents for management of pain related to sickle cell disease (SCD). Methods. Thirty-seven subjects (aged 6-21 years) used a daily self-report pain diary for 6 months to 3 years to report their home pain experience and its pharmacologic and non-pharmacologic management. Results. A total of 514 vaso-occlusive pain episodes (2,592 days) were reported. Cognitive-behavioral or physical pain management activities were used alone on 7.5% of these pain days, and with analgesics on 77%. Female gender (P=0.003) and increasing pain intensity (P=0.04) were associated with an increased number of activities used. Increasing pain intensity was also associated with usage of several specific activities. Conclusions. Patients and families frequently used cognitive-behavioral and physical activities in addition to oral analgesics to treat sickle cell-related pain at home, and may benefit from additional training and support. (C) 2004 Wiley-Liss, Inc.