Pain Management and Quality of Life for Sickle Cell Disease Patients Cynthia Evans
Pain Management and Quality of Life for Sickle Cell Disease Patients This is a review of literature examining how frequent recurring episodes of pain affect the quality of life in the sickle cell disease patients. Several studies conducted concerning pain management and quality of life for sickle cell disease patients indicate additional studies needed. Identifying additional effective complementary alternate therapies is vital for a more improved quality of life. This will be necessary in order to reduce the number of painful episodes experienced by the sickle cell patient. Sickle cell disease is a genetic disorder of the red blood cells and further characterized by painful acute vaso-occlusive episodes where the sickle cell is stuck in the blood vessels, blocking the blood flow. This is one of the most common reasons leading up to hospitalization, the vaso-occlusive episodes. These episodes can lead to ischemia and infarctions over the entire body region with painful recurring, unpredictable, intense, and relentless episodes, lasting approximately 3-14 days (Yaster, Kost-Byerly, & Maxwell, 2000). According to Granados and Jacob (2009), the purpose of their study was to examine pain experienced and the effectiveness of analgesics for hospitalized adults with sickle cell disease. The literature review indicates a variety of reasons why inadequate pain management is ongoing in the adult (SCD) patients admitted with vaso-occlusive episodes. The focus is mainly on factors that affect the management of pain, including methods of analgesic administration, and non-pharmacologic regimens, therefore the perception of the provider is important in regards to treating sickle cell pain as identified in the study by (Shapiro, Benjamin, Payne & Heidrich, 1997; Steinberg, 1999; Yale et al., 2000). Little attention in the way of research studies has been examined in relation to the pain experience of the sickle cell adults. Ballas and Lusardi (2005) evaluated the sequence of hospital admissions of patients with sickle cell disease, reviewing the causes of recurring admissions, and the importance of the patient’s outcome of illness. All readmissions examined specifically within seven to thirty days from the initial admission discharge assessing for the rationale of the recurrence of hospital admission and relation to the prognosis of the sickle cell disease patient. The researchers evaluated the pain by a descriptive underlying research design knowledgeable by the sickle cell disease patients for intensity, location, and quality of pain. Fifty percent of patients admitted for intense painful episodes were readmitted within one month after discharge, and another estimated 16% were readmitted within one week after discharge. Severe pain is described as a degree of pain greater than six on a zero to ten numerical rating scales. A mean score of seven or greater indicates prematurity in discharging the sickle cell disease patients from the hospital. In conclusion, the patients admitted to the hospital with high pain scores were more likely to have lengthy hospitalizations, and to be discharged home with equally higher pain scores. The pain intensity scores from the previous discharge examined by the researchers indicated 71 readmission, in which 52 patients were readmitted for vaso-occlusive episodes, (Ballas & Lusardi, 2005). The pain score of study participants indicated a high pain intensity score, and the scores did not change consequently during prolonged episodes. Even higher pain intensity more so on days seven and eight were indicated for increase pain significance. Researchers further indicated that the main reason for hospital readmissions were early discharge to home settings, signs and symptoms of medication/drug withdrawal, that brought about the intense reoccurring episodes of...
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