Date of Award
Doctor of Philosophy (PhD)
Lindsey L. Cohen, Ph.D. - Chair
Erin B. McClure Tone, Ph.D.
Leslie L. Jackson, Ph.D.
Lisa Armistead, Ph.D.
Introduction: Sickle cell disease (SCD) affects predominately African Americans and is one of the most prevalent diseases in the United States (Schecter, 1999). Research has not sufficiently examined whether pain associated with SCD impacts quality of life or whether coping impacts this relation. The purpose of this study was to examine the relation between pain and quality of life in children with SCD and to determine whether coping moderates the relation. A secondary aim was to examine associations between age and pain, quality of life, and coping. A final exploratory aim was to examine the relation between racial identity and study variables. Method: 104 children (M = 12.93 years, SD = 3.17 years) with SCD and their parents participated during a regularly scheduled SCD-related medical visit. Parents completed a demographic form. Children completed the Pediatric Pain Questionnaire (PPQ), the Pain Coping Questionnaire (PCQ), the Pediatric Quality of Life Inventory (PedsQL), Sickle Cell Disease Quality of Life (SCD-QoL), and the Multidimensional Inventory of Black Identity (MIBI). Results: After controlling for site and gender, regression analyses revealed that pain (ƒÒ = -0.37) and emotion-focused avoidance coping (ƒÒ = -0.39) were significant predictors of overall generic quality of life (PedsQL Total Score), total R2 = 0.44, F (5, 93) = 13.88, p < 0.001. There was no significant pain x coping interactions found for overall generic quality of life. Child age was not associated with study variables. Exploratory analyses revealed the MIBI Centrality Scale was associated with PCQ Approach Coping, r (80) = -0.24, p < 0.05, and the MIBI Regard Scale was correlated with PCQ Problem-Focused Avoidance Coping, r (84) = 0.30, p < 0.01. Discussion: This study found that pain and emotion-focused avoidance coping were inversely associated with quality of life in children with SCD. Coping was not found to moderate the relation between pain and overall quality of life. The associations between racial identity and coping demonstrate the importance of further examining cultural factors in children with SCD. In addition, there continues to be a need for future research to focus on the psychosocial functioning of children with SCD.
Lim, Crystal Marie Stack, "Pain, Quality of Life, and Coping in Pediatric Sickle Cell Disease." Dissertation, Georgia State University, 2009.