title: A randomized controlled pilot study feasibility of a tablet-based guided audio-visual relaxation intervention for reducing stress and pain in adults with sickle cell disease.
abstract: OBJECTIVE
  To test feasibility of a guided audio-visual relaxation intervention protocol for reducing stress and pain in adults with sickle cell disease.
  
  
  BACKGROUND
  Sickle cell pain is inadequately controlled using opioids, necessitating further intervention such as guided relaxation to reduce stress and pain.
  
  
  METHODS
  Attention-control, randomized clinical feasibility pilot study with repeated measures.
  
  
  METHODS
  Randomized to guided relaxation or control groups, all patients recruited between 2013-2014 during clinical visits, completed stress and pain measures via a Galaxy Internet-enabled Android tablet at the Baseline visit (pre/post intervention), 2-week posttest visit and also daily at home between the two visits. Experimental group patients were asked to use a guided relaxation intervention at the Baseline visit and at least once daily for 2 weeks. Control group patients engaged in a recorded sickle cell discussion at the Baseline visit. Data were analysed using linear regression with bootstrapping.
  
  
  RESULTS
  At baseline, 27/28 of consented patients completed the study protocol. Group comparison showed that guided relaxation significantly reduced current stress and pain. At the 2-week posttest, 24/27 of patients completed the study, all of whom reported liking the study. Patients completed tablet-based measures on 71% of study days (69% in control group, 72% in experiment group). At the 2-week posttest, the experimental group had significantly lower composite pain index scores, but the two groups did not differ significantly on stress intensity.
  
  
  CONCLUSIONS
  This study protocol appears feasible. The tablet-based guided relaxation intervention shows promise for reducing sickle cell pain and warrants a larger efficacy trial.
  
  
  BACKGROUND
  The ClinicalTrials.gov Identifier is: NCT02501447.
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA.|Comprehensive Sickle Cell Center, University of Illinois at Chicago, College of Nursing, Illinois, USA.
authors.forename: Miriam O
authors.initials: MO
authors.lastname: Ezenwa
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA.
authors.forename: Yingwei
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Biobehavioral Health, College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Engeland
authors.affiliation: College of Medicine, College of Pharmacy and Comprehensive Sickle Cell Center, University of Illinois at Chicago, Chicago, Illinois, USA.|Jesse Brown VA Medical Center, Chicago, Illinois, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Molokie
authors.affiliation: Department of Biopharmaceutical Sciences, Cancer Center, and Comprehensive Sickle Cell Center, University of Illinois at Chicago, College of Pharmacy, Illinois, USA.
authors.forename: Zaijie Jim
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA.
authors.forename: Marie L
authors.initials: ML
authors.lastname: Suarez
authors.affiliation: Center for End-of-Life Transition Research, Department of Biobehavioral Health Science, University of Illinois at Chicago, College of Nursing, Illinois, USA.|Cancer Center and Comprehensive Sickle Cell Center, University of Illinois at Chicago, College of Nursing, Illinois, USA.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Wilkie
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D059408:Pain Management; D010865:Pilot Projects; D012063:Relaxation; D012064:Relaxation Therapy; D013315:Stress, Psychological / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: PAINReportIt; clinical trial; feasibility study; guided relaxation; non-drug pain treatment strategies; nursing; self-management; sickle cell pain; stress; tablet-based intervention