Changes in coping, pain, and activity after cognitive-behavioral training: a randomized clinical trial for pediatric sickle cell disease using smartphones.

Objectives: We examined the outcomes of a cognitive-behavioral therapy (CBT) intervention for pain in pediatric sickle cell disease (SCD) using smartphones as a novel delivery method.

Materials And Methods: Forty-six children with SCD received CBT coping skills training using a randomized, waitlist control design. The intervention involved a single session of CBT training and home-based practice using smartphones for 8 weeks.

Information-seeking coping behaviors during painful procedures in African-American children with sickle cell disease.

This study examined the frequency of information-seeking coping behaviors in 37 African-American children (ages 5-17 years) with sickle cell disease during venipuncture. The relationships between coping behaviors and child- and parent-reported pain and observational distress were also assessed. The majority of children attended to the procedure, but did not seek information via questions.

Sensitization to acute procedural pain in pediatric sickle cell disease: modulation by painful vaso-occlusive episodes, age, and endothelin-1.

Unlabelled: The impact of pain early in life is a salient issue for sickle cell disease (SCD), a genetic condition characterized by painful vaso-occlusive episodes (VOEs) that can begin in the first year of life and persist into adulthood. This study examined the effects of age and pain history (age of onset and frequency of recent VOEs) on acute procedural pain in children with SCD. Endothelin-1, a vaso-active peptide released during VOEs and acute tissue injury, and its precursor, Big Endothelin, were explored as markers of pain sensitization and vaso-occlusion.

Responsiveness of the PedsQL to pain-related changes in health-related quality of life in pediatric sickle cell disease.

Objective: To determine if caregiver report of the pediatric quality of life inventory (PedsQL) is responsive to changes in health-related quality of life (HRQL) associated with pain episodes in pediatric sickle cell disease (SCD).

Methods: 81 caregivers of children ages 2-19 years with SCD completed the PedsQL as part of routine psychosocial screenings at 2 time points, ranging from 6 to 18 months apart. Frequency of SCD-related pain episodes between time points was assessed using medical chart review.

Criterion and convergent validity for 4 measures of pain in a pediatric sickle cell disease population.

Objective: To evaluate the psychometric properties of 4 measures of acute pain in youth with sickle cell disease (SCD) during a medical procedure.

Methods: Heart rate, child self-report, parent proxy-report, and observable pain behaviors were examined in 48 youth with SCD ages 2 to 17 years. Criterion validity for acute pain was assessed by responsiveness to a standardized painful stimulus (venipuncture) in a prospective pre-post design.

Use of handheld wireless technology for a home-based sickle cell pain management protocol.

Purpose: To evaluate use of a handheld electronic wireless device to implement a pain management protocol for participants with sickle cell disease (SCD).

Methods: Participants were 19 patients with SCD aged 9-20 who experienced vaso-occlusive pain. A single-session training on the use of cognitive-behavioral coping skills was followed by instruction on how to practice these skills and monitor daily pain experience using the device.

Time out based discipline strategy for children's non-compliance with cystic fibrosis treatment.

Purpose: To evaluate a time out based discipline strategy designed to decrease treatment avoidance in children with cystic fibrosis (CF) who displayed non-compliant behaviour to their parents' treatment requests.

Method: A single-subject reversal design was used to compare baseline compliance when a time out based discipline strategy was in effect. Outcome measures included observational assessments of compliance, parent ratings of child treatment-related behaviour problems and parent reported preference for the time out strategy.

Validity of the Pediatric Quality Of Life Inventory for youth with sickle cell disease.

Objective: Evaluate the validity of the Pediatric Quality of Life Inventory (PedsQL) for sickle cell disease (SCD).

Methods: Sixty-eight parent-child dyads (children 5-18 years) completed the PedsQL. Medical record review assessed history of specific morbidities.

Neurodevelopmental screening in toddlers and early preschoolers with sickle cell disease.

Sickle cell disease is associated with an elevated risk for neurologic complications beginning in early childhood. Detecting higher-risk cases with developmental screening instruments may be a cost-effective method for identifying young children in need of more frequent or intensive assessment. We evaluated the validity of the Denver II test as a tool to detect lower levels of developmental attainment and their association with neurologic risk in 50 young children with sickle cell disease.

Sickle cell disease as a neurodevelopmental disorder.

Sickle cell disease (SCD) is a blood disorder; however, the central nervous system (CNS) is one of the organs frequently affected by the disease. Brain disease can begin early in life and often leads to neurocognitive dysfunction. Approximately one-fourth to one-third of children with SCD have some form of CNS effects from the disease, which typically manifest as deficits in specific cognitive domains and academic difficulties.

Pediatric procedural approach-avoidance coping and distress: a multitrait-multimethod analysis.

Objective: To evaluate the construct validity of children's approach-avoidance coping and distress during immunizations, and to examine the instruments used to assess these domains.

Methods: We used a multitrait-multimethod matrix to examine the validity of the approach-avoidance coping and distress constructs for 62 4- to 6-year-old children receiving immunization injections. Assessment instruments of both constructs consisted of child, parent, and nurse ratings, and three behavior observation scales.

A child-focused intervention for coping with procedural pain: are parent and nurse coaches necessary?

Objective: To examine the efficacy of training children to cope with immunization pain without the assistance of trained coaches and determine whether untrained parents or nurses are more effective at decreasing children's distress.

Methods: We compared the procedural coping and distress behavior of 31 3- to 7-year-old children trained in coping skills to 30 who did not receive training. The behavior of the untrained parents and nurses was evaluated as it related to child coping and distress.