Significance: The purpose of this exploratory study is to test the feasibility, accessibility, and effects of a mindfulness-based stress reduction program (MBSR) on reducing pain catastrophizing in persons with sickle cell disease (SCD) and chronic pain. One of the most difficult symptoms for SCD patients to manage is chronic pain. Approximately one-third of SCD patients experience chronic pain, which is associated with pain catastrophizing. Pain catastrophizing is a negative mental state toward pain stimuli and pain experience, and is associated with increased pain severity, pain interference, and lower social functioning, physical functioning, and mental health. There have been no psychobehavioral intervention studies that have attempted to alter the experience of pain catastrophizing in persons with SCD. MBSR is a complementary group-based therapy that emphasizes nonjudgmental awareness of thoughts, feelings, and bodily sensations. With no pharmacological or non-pharmacological treatment for catastrophizing in persons with SCD, MBSR offers a potential solution to this highly significant problem for both SCD patients and providers. This project will be the first randomized controlled trial (RCT) of MBSR to reduce pain catastrophizing, and improve quality of life for SCD patients with chronic pain. Methods: This study will enroll 60 adult patients with SCD and chronic pain from the Duke Adult Sickle Cell Clinic. Patients will be randomized to a MBSR or wait-listed control group. The MBSR group will complete a 6- week, group-based telephonic MBSR program that is administered by a certified MBSR clinician once a week for 90 minutes. MBSR feasibility, acceptability, and effects on pain catastrophizing will be assessed by questionnaires at baseline, week 1, 3, and 6 in both groups. At the end of week 6, 10 randomly selected MBSR participants will complete semi-scripted telephone interviews to help assess intervention acceptability, and the wait-listed control condition will be offered the same MBSR intervention. Training plan: The proposed training plan is designed to enhance my current knowledge of chronic pain research and psychobehavioral interventions, and increase my ability to participate in research design by engaging in coursework, conferences, ethical training, nursing faculty lectures, chronic pain research meetings and education, and psychobehavioral intervention research meetings and education.
Sickle cell disease (SCD) is a chronic disease associated with many medical problems and a shortened life expectancy. Approximately one-third of persons with SCD experience chronic pain, which is associated with pain catastrophizing. Pain catastrophizing is a negative mental state that can lead to increased pain severity, pain interference, and decreased quality of life. We do not know the best way to manage pain catastrophizing in adults with SCD. In this pilot study we test if a mindfulness-based intervention can decrease pain catastrophizing and improve quality of life for SCD patients