Abstract
This study examined daily reports of pain, medication use, health care use, and activity reduction in adults with sickle cell disease, and their association with stress. Participants were 53 adults with sickle cell disease. They completed the Daily Hassles questionnaire at the start of the study, and they kept daily records of pain and pain response over the following 14 days. On average, patients reported pain on 6.5 days of the 14-day study period. The average pain intensity rating during a painful episode was 4.4 on a 10-point scale. Pain was most often managed at home. Patients took medication (analgesics and/or narcotics) on 80% of the days they experienced pain, and they were morelikely to use medication, particularly narcotics, as pain levels increased. At higher pain levels some patients also utilized arange of health care services. On average, patients also cut back considerably on household and social activities, especially when pain reached a level of over 5 on the 10-point scale. Those who were employed, however, were likely to continue to work, even when in pain. In addition, stress had significant positive associations with average pain intensity as well as reductions in household and social activities. Furthermore, stress predicted activity reductions even after controlling for pain intensity. Stress was unrelated to medication and health care use in this study.
Similar content being viewed by others
References
Affleck, G., Tennen, H., Urrows, S., & Higgins, P. (1994). Person and contextual features of daily stress reactivity: Individual differences in relations of undesirable daily events with mood disturbance and chronic pain intensity.Journal of Personality & Social Psychology, 66(2), 329–340.
Burman, M. E. (1995). Health diaries in nursing research and practice.Image—the Journal of Nursing Scholarship, 27(2), 147–152.
Charache, S., Lubin, B., & Reid, C. D. (1994).Management and therapy of sickle cell disease (N1H Publication No. 94-2117). Washington, DC: National Institute of Health.
Charache, S., Terrin, M. L., Moore, R. D., Dover, G. J., Barton, F. B., Eckert, S. V., McMahon, R. P., & Bonds, D. R. (1995). Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia.New England Journal of Medicine, 332(20), 1317–1322.
DeLongis, A., Coyne, J., Dakof, G.. Folkman, S., & Lazarus, R. S. (1982). Relationship of daily hassles, uplifts, and major life events to health status.Health Psychology, 1(2), 119–136.
Dinges, D. F., Whitehouse, W. C., Ome, E. C., Bloom, P. B., Carlin, M. M., Bauer, N. K., Gillen, K. A., Shapiro, B. S., Ohene-Frempong, K., Dampier, C., & Ome, M. T. (1997). Self-hypnosis training as an adjunctive treatment in the management of pain associated with sickle cell disease.International Journal of Clinical and Experimental Hypnosis, 45(4), 417–430.
Eich, E., Reeves, J. L., Jaeger, B., & Graff-Radford, S. B. (1985), Memory for pain: Relation between past and present pain intensity.Pain, 23, 375–379.
Fuggle, P., Shand, P. A., Gill, L. J.. & Davies, S. C. (1996). Pain, quality of life, and coping in sickle cell disease.Archives of Disease in Childhood, 75(3), 199–203.
Gil, K. M. (1994). Behavioral assessment of sickle cell disease pain.Journal of Health and Social Policy.5(3/4), 19–38.
Oil, K. M., Abrams, M. R., Phillips, G., & Keefe, F. J. (1989). Sickle cell disease pain; Relation of coping strategies to adjustment.Journal of Consulting & Clinical Psychology, 57, 725–731.
Gil, K. M., Abrams, M. R.,. Phillips, G., & Williams, D. A. (1992). Sickle cell disease pain: 2. Predicting health care use and activity level at 9-month follow-up.Journal of Consulting & Clinical Psychology, 60(2), 267–273.
Gui, L. J., Shand, P. A., Fuggle, P., Dugan, B., & Davies, S. C. (1997). Pain assessment for children with sickle cell disease: Improved validity of diary keeping versus interview ratings.British Journal of Health Psychology, 2, 131–140.
Holahan, C. K., Holahan, C. J., & Belk, S. S. (1984). Adjustment in aging: The roles of life stress, hassles, and self-efficacy.Health Psychology, 3(4), 315–328.
Holm, J. E., Holroyd, K. A., Hursey, K. G., & Penzien, D. B. (1986). The roleof stress in tension head- aches.Headache, 26, 160–167.
Kanner, A. D., Coyne, J. C., Schaefer, C., & Lazarus, R. S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events.Journal of Behavioral Medicine, 4(1), 1–39.
Keefe, F. J., Affleck, G., Lefebvre, J. C., Starr, K., Caldwell, D., & Tennen, H. (1997). Pain coping strat- egies and coping efficacy in rheumatoid arthritis: A daily process analysis.Pain, 69(l-2), 35–42.
Lazarus, R. S., and DeLongis, A. (1983). Psychological stress and coping in aging.American Psychologist, 38(3), 245–254.
Leaved, S. R., & Ford, C. V. (1983). Psychopathology in patients with sickle cell disease.Psychosomatic, 24(1), 23–37.
Linton, S. J., & Melin, L. (1982). The accuracy of remembering chronic pain.Pain, 15, 281–285.
Midence, K., & Elander, J. (1994). Sickle cell disease: A psychosocial approach. Oxford, UK: Radcliff Medical Press.
Muschet, G. R., Miller, D., Clements, B., Pait, G., & Gutterman, D. L. (1996). Impact of sumatriptan on workplace productivity, nonwork activities, and health-related quality of life among hospital employees with migraine.Headache, 36(3), 137–143.
Nadel, C., & Porladin, G. (1977). Sickle cell crises: Psychological factors associated with onset.New York Slate Journal of Medicine, 77, 1075–1078.
Nash, K. B. (Ed.). (1994).Psychosocial aspects of sickle cell disease: Past, present, and future directions of research. Binghamton, NY: Haworth Press.
Norman, G. R., McFarlane, A. H., Streiner, D. L., & Neale, K. (1982). Health diaries: Strategies for compliance and relation to other measures.Medical Care, 20(6), 623–629.
Platt, O. S., Thorington, B. D., Brambilla, D. J., Milner, P. F. Rosse, W. R., Vichinsky, E., & Kinney, T. R. (1991). Pain in sickle cell disease. Rates and risk factors.New England Journal of Medicine, 325(l), 11–16.
Ready, L. B., Sarkis, E., & Turner, J. A. (1982). Self-reported versus actual use of medications in chronic pain patients.Pain, 12, 285–294.
Rucknagel, D. L. (1974). The genetics of sickle cell anemia and related syndromes.Archives of Internal Medicine, 133, 595–606.
Schwartz, J. E., & Stone, A. A. (1993). Coping with daily work problems: Contributions of problem content, appraisals, and person factors. Special issue: Coping with stress at work.Work & Stress.7(1). 47–62.
Schwartz, J. E., & Stone, A. A. (1998). Strategies for analyzing ecological momentary assessment data.Health Psychology, 17(1), 6–16.
Shapiro, B. S., Dinges, D. R., Orne, E. C., Bauer, N., Reilly, L. B., Whitehouse, W. G., Ohene-Frempong, K., & Ome, M. T. (1995). Home management of sickle cell-related pain in children and adolescents: Natural history and impact on school attendance.Pain, 61(1), 139–144.
Shapiro, B. S., Dinges, D. F., Orne, E. C., Ohene-Fremong, K., & Ome, M. T. (1990). Recording of crisis pain in sickle cell disease.Advances in Pain Research Therapy, 15, 313–321.
Smith, W. B., & Safer, M. A., (1993). Effects of present pain level on recall of chronic pain and medication use.Pain, 55(3), 355–361
Stoller, E. P., Forsler, L. E., & Portugal, S. (1993). Self-care responses to symptoms by older people: A health diary study of illness behavior.Medical Care, 31(1), 24–42.
Stone, A. A., Broderick, J. E., Porter, L. S., & Kaell, A. T. (1997). The experience of rheumatoid arthritis pain and fatigue: Examining momentary reports and correlates over one week.Arthritis Care and Research, 10(3), 185–193.
Stone, A. A., Kennedy-Moore, E., & Neale, J. M. (1995), Association between daily coping and end-of-day mood.Health Psychology, 14, 341–349.
Stone, A. A., Kesster, R. C., & Haythomthwaite, J. A. (1991). Measuring daily events and experiences: Decisions for the researcher.Journal of Personality, 59, 575–607.
Stone, A. A., Schwartz, J. S., Neale, J. M., Shiffman, S. S., Marco, C. A., Hickcox, M., Paty, J., Porter, L. S., & Cruise, L. J. (1998), A comparison of coping assessing by ecological momentary assessment and retrospective recall.Journal of Personality and Psychology, 74(6).
Stone, A. A., & Shiffman, S. (1992). Reflections on the intensive measurement of stress, coping, and mood, with an emphasis on daily measures.Psychology & Health, 7(2), 115–129.
Thompson, R. J. J., Gil, K. M., Abrams, M. R., & Phillips, G. (1992). Stress, coping, and psychological adjustment of adults with sickle cell disease.Journal of Consulting & Clinical Psychology, 60(3), 433–440.
Urrows, S., Affleck, G., Tennen, H., & Higgins, P. (1994). Unique clinical and psychological correlates of fibromyalgia tender points and joint tenderness in rheumatoid arthritis.Arthritis & Rheumatism, 17, 1513–1520.
Verbrugge, L. M. (1980), Health diaries.Medical Care, 18(1), 73–95.
Ward, M. M., & Leigh, J. P. (1993). Pooled time series regression analysis in longitudinal studies.Journal of Clinical Epidemiology, 46(7), 645–659.
Weinberger, M., Hiner, S. L., & Tierney, W. M. (1987). In support of hassles is a measure of stress in predicting health outcomes.Journal of Behavioral Medicine, 10(1), 19–31.
White, K. L., Williams, T. F., & Greenberg, B. G. (1961). The ecology of medical care.New England Journal of Medicine, 265, 885–892.
Zarski, J. J. (1984). Hassles and health: A replication.Health Psychology, 3(3), 243–251.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Porter, L.S., Gil, K.M., Sedway, J.A. et al. Pain and stress in sickle cell disease: An analysis of daily pain records. Int. J. Behav. Med. 5, 185–203 (1998). https://doi.org/10.1207/s15327558ijbm0503_1
Issue Date:
DOI: https://doi.org/10.1207/s15327558ijbm0503_1