This descriptive, exploratory study is designed as a feasibility study to examine the effectiveness of comfort measures used for children in vaso- occlusive crisis (VOC) of sickle cell disease (SCD).
The Specific Aims are: (1) To identify and describe the nature and range of comfort measures used for children during VOC both in the home and in the hospital; 2. To describe children's and parents' perceptions of the effectiveness of comfort measures; 3. To build a descriptive model of the effectiveness of comfort measures for the pain of VOC in children; and 4. To determine the feasibility of conducting a multidisciplinary, collaborative intervention study designed to examine the effects of specific comfort measures for children during VOC. Triangulation will be the method used to generate and integrate both qualitative and quantitative data about the effectiveness of comfort measures in this proposed study. Twenty native-born, African-American boys and girls aged 5 - 19 years and one parent will comprise the sample for both the qualitative and quantitative components of the study. All qualitative data will be collected by the PI while quantitative data will be collected by a research assistant. Data collection for both components will occur simultaneously and will involve the observation of children under two conditions: a painful episode and a painfree episode. Using a qualitative descriptive approach, qualitative data will be obtained from participant observation, child-parent interviews, and chart reviews. Analysis will include the identification of data groupings, categories, and themes from transcriptions of these data. Using a descriptive and factorial design, quantitative data will be obtained from the child, including measures of pain intensity, pain affect, pain location, number of pain sites, and analgesic dosages. Quantitative analysis will involve the use of descriptive statistics and correlational procedures to identify patterns and fluctuations in the data and relationships among variables. A four factor MANOVA with repeated measures on three variables will be used to examine within subject differences during painful and painfree episodes. The findings from qualitative and quantitative approaches will be integrated (Specific Aim 3) for the purpose of building a descriptive model about comfort measures for children during V0C. Consultants will be utilized for their expertise in this synthesizing process. Finally, the feasibility (Specific Aim 4) of developing a larger, multidisciplinary intervention study to test comfort measures with children during VOC will be examined, and a preliminary proposal will be completed.
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|Beyer, J E; Simmons, L E; Woods, G M et al. (1999) A chronology of pain and comfort in children with sickle cell disease. Arch Pediatr Adolesc Med 153:913-20|