title: [Issues and difficulties in the relationship between patients and caregivers in painful sickle cell vaso-occlusive crisis].
abstract: Sickle cell patients in acute pain situation experiment cognitive, behavioral and emotional changes that can accentuate their pain and disrupt communication with caregivers. On the other hand, caregivers have to face pain assessment difficulties and their own psychological reactions to their patient's pain. The gap between the patient's experience and caregiver's evaluation can lead to conflict and non-adherence treatment, and have a direct impact on the sickle cell disease prognosis. There is nothing inevitable about these phenomena, whose knowledge allows the action and opens up prospects for improving the management of sickle cell disease pain. This article is a narrative review updating the interactions between acute pain and some configurations, such as the inability to discern emotions, catastrophizing, post-traumatic stress or feeling ostracized. The overestimation of patient's addiction by caregivers also influences the pain itself. Open communication, as well as some treatments, medicated or not, a consistent institutional organization and a multidisciplinary approach altogether have an analgesic role by acting on pain cognitive and emotional components.
authors.affiliation: Service de psychiatrie, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France. Electronic address: nathalie.dzierzynski@aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Dzierzynski
authors.affiliation: Service de médecine interne, centre de la drépanocytose, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Stankovic Stojanovic
authors.affiliation: Service de médecine interne, centre de la drépanocytose, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Georgin-Lavialle
authors.affiliation: Service de médecine interne, centre de la drépanocytose, hôpital Tenon (AP-HP), 4, rue de la Chine, 75020 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Lionnet
mesh_terms: D059787:Acute Pain / Q000209:etiology; D000755:Anemia, Sickle Cell / Q000150:complications; D017028:Caregivers; D006801:Humans; D010817:Physician-Patient Relations
keywords: Acute pain; Communication; Douleur aiguë; Drépanocytose; Emotions; Psychologie; Psychology; Sickle cell disease; Émotions