title: Pediatric patients with sickle cell disease: use of complementary and alternative therapies.
abstract: OBJECTIVE
  Despite clinical advances, sickle cell disease (SCD) remains a difficult, chronic medical condition for many children and youth. Additional treatment strategies, including complementary and alternative medicine (CAM) therapies, would be welcome to enhance the clinical care of SCD patients. This study's objective was to identify CAM therapies that are currently used by families for children with SCD, and to investigate SCD families' interest in CAM.
  
  
  METHODS
  Fifty-seven (57) parents of pediatric SCD patients participated in this cross-sectional telephone survey in early 2000. A SCD Severity Scale was developed by combining the general health assessment and four measures of SCD severity (Cronbach's alpha = 0.81).
  
  
  RESULTS
  Fifty-four percent (54%) of the sample used CAM therapies for the SCD children. Forty-two percent (42%) used bioenergetic therapies (prayer, spiritual and energy healing), 28% used lifestyle/mind?body CAM (relaxation techniques, exercise, imagery, and diet), 12% used biochemical therapies (herbal medicines, megavitamins, and folk remedies), and 5% used biomechanical therapy (massage). CAM use for the SCD children was positively associated with the child's age, SCD Severity Scale score, respondent education, and respondent CAM use. The use of relaxation techniques was associated with greater SCD severity. Most respondents (83%) felt that CAM can be helpful.
  
  
  CONCLUSIONS
  The use of CAM therapies is common for children with SCD. Prayer, relaxation techniques, and spiritual healing were the most commonly reported CAM therapies. Because clinical studies have shown the benefit of spiritual and relaxation practices for SCD and this study shows that these CAM therapies are being used commonly by SCD families, future research should focus on spiritual and relaxation practices for children with SCD.
authors.affiliation: Division of General Pediatrics & Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. esibinga@jhmi.edu
authors.forename: Erica M S
authors.initials: EM
authors.lastname: Sibinga
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Shindell
authors.forename: James F
authors.initials: JF
authors.lastname: Casella
authors.forename: Anne K
authors.initials: AK
authors.lastname: Duggan
authors.forename: Modena H
authors.initials: MH
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000451:nursing / Q000628:therapy*; D002648:Child; D002654:Child Care / Q000379:methods*; D002662:Child Health Services / Q000458:organization & administration; D002669:Child Welfare / Q000706:statistics & numerical data*; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D029221:Faith Healing / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011159:Population Surveillance; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States