The stability of pain coping strategies in young children adolescents, and adults with sickle cell disease over an 18-month period.

OBJECTIVE: The current study assessed stability of pain coping strategies over an 18-month period in adults, adolescents, and young children with sickle cell disease.
DESIGN: Eighteen-month longitudinal study. Assessments of coping strategies were done at baseline, 9 months, and 18 months. PATIENTS: A total of 141 patients with sickle cell disease (SCD) presenting to adult and pediatric sickle cell clinics for regularly scheduled check-ups. OUTCOME MEASURES: Coping Strategy Questionnaire subscales (Coping Attempts, Negative Thinking, and Illness-Focused Strategies).
RESULTS: pearson Product-Moment correlation coefficients comparing baseline and 18-month follow-up coping data were highly significant for Coping Attempts and Negative Thinking/Illness Focused Strategies for adults. For young children, the 18-month follow-up scores on Negative Thinking were significantly correlated with baseline scores, however, no other 18-month correlations were significant. The results from the adolescent subset of subjects indicated no significant correlations on any of the coping strategies from baseline to 18-month-follow-up. Stability was also assessed using intraclass correlations, which incorporates more than two test-retest values on the same subjects. These analyses confirmed that coping strategies in adults were highly stable, whereas for children and adolescents, there was instability ANOVAs indicated that adolescents scored significantly higher than young children on Negative Thinking and Illness-Focused Strategies at baseline and follow-up.
CONCLUSIONS: As compared with the highly stable coping evidenced in adults with SCD, coping in children and adolescents with SCD is more variable. Thus, interventions should target children early before maladaptive coping patterns become entrenched.