title: A biopsychosocial-spiritual model of chronic pain in adults with sickle cell disease.
abstract: Chronic pain in adults with sickle cell disease (SCD) is a complex multidimensional experience that includes biologic, psychologic, sociologic, and spiritual factors. To date, three models of pain associated with SCD (i.e., biomedical model, biopsychosocial model for SCD pain, and Health Beliefs Model) have been published. The biopsychosocial multidimensional approach to chronic pain developed by Turk and Gatchel is a widely used model of chronic pain. However, this model has not been applied to chronic pain associated with SCD. In addition, a spiritual/religious dimension is not included in this model. Because spirituality/religion is central to persons affected by SCD, that dimension needs to be added to any model of chronic pain in adults with SCD. In fact, data from one study suggest that spirituality/religiosity is associated with decreased pain intensity in adults with chronic pain from SCD. A biopsychosocial-spiritual model is proposed for adults with chronic pain from SCD, because it embraces the whole person. This model includes the biologic, psychologic, sociologic, and spiritual factors relevant to adults with SCD based on past and current research. The purpose of this paper is to describe an adaptation of Turk and Gatchel's model of chronic pain for adults with SCD and to summarize research findings that support each component of the revised model (i.e., biologic, psychologic, sociologic, spiritual). The paper concludes with a discussion of implications for the use of this model in research.
authors: Department of Physiological Nursing University of California, San Francisco. Electronic address: louella.taylor@ucsf.edu.
authors: Lou Ella V
authors: LEV
authors: Taylor
authors: Department of Physiological Nursing University of California, San Francisco.
authors: Nancy A
authors: NA
authors: Stotts
authors: Department of Family Health Care Nursing University of California, San Francisco.
authors: Janice
authors: J
authors: Humphreys
authors: Sickle Cell Center, Children's Hospital and Research Center, Oakland, California.
authors: Marsha J
authors: MJ
authors: Treadwell
authors: Department of Physiological Nursing University of California, San Francisco.
authors: Christine
authors: C
authors: Miaskowski
mesh_terms: D000223:Adaptation, Psychological; D000755:Anemia, Sickle Cell / Q000453:epidemiology / Q000451:nursing* / Q000523:psychology*; D059350:Chronic Pain / Q000451:nursing* / Q000523:psychology*; D015897:Comorbidity; D020022:Genetic Predisposition to Disease; D005838:Genotype; D018939:Holistic Nursing / Q000379:methods; D006801:Humans; D008960:Models, Psychological; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D029181:Spirituality