ORCID
0000-0003-3086-8014 (Qayyum)
Document Type
Article
Publication Date
2025
DOI
10.1093/jscdis/yoaf006
Publication Title
Journal of Sickle Cell Disease
Pages
33 pp.
Abstract
Objectives: Readiness for discharge for a sickle cell disease vaso-occlusive crisis is dictated by factors far beyond pain control, including physical function/activity. We therefore designed and tested a functional status-based pain assessment questionnaire in SCD patients hospitalized with vaso-occlusive crises.
Methods: Sickle cell disease patients on a preselected nursing unit rated 10 draft Functional status-Based Pain Assessment items of activities of daily living on a 5 point Likert scale (0-5) from “very easy” to “very difficult” daily on each day of their admission until discharge, at approximately the same time. Concurrently, they reported Numeric Rating Scale (0-10) pain intensity. For validation, we used exploratory factor analysis, confirmatory factor analysis, and item response theory analysis.
Results and Discussion: We analyzed 503 observations from 175 admissions of 88 patients. Half were female, the mean age was 32.1+/- 11.8 years, and the mean length of stay was 7.1 +/-6.9 days. The mean Numeric Rating Scale (6.8 ± 1.9) was inversely correlated with the mean Functional Status-based Pain Assessment (0-50) score (27 ± 8.0, r= -0.4342, p <.0001). Functional Status-based Pain Assessment item means ranged from 2.1 to 3.3. Cronbach’s alpha was 0.91. Exploratory factor analysis showed that all Functional Status-based Pain Assessment items loaded on a single factor. Confirmatory factor analysis found adequate convergent and discriminant validity and showed strong fit of the model to the data. Item response theory analysis showed item discrimination ranging from 0.56 to 4.1, while difficulty ranged from -2.8 to 7.5.
Conclusion: The Functional Status-based Pain Assessment shows strong correlation with daily Numeric Rating Scale, is multidimensional, and demonstrates strong construct validity. It may improve assessment of sickle cell disease vaso-occlusive crisis pain and may enhance vaso-occlusive crisis discharge discussions.
Rights
© The Authors 2025.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits unrestricted reuse, distribution, and re-production in any medium, provided the original work is properly cited.
Data Availability
Article states: "Data used for these analyses are archived at a VCU file storage facility, and may be released, depending on the purpose, upon request of the first (contact) author. Please allow 2-4 weeks for processing time."
Original Publication Citation
Smith, W. R., Qayyum, R., Ulbing, A., Guy, M. S., Sop, D. M., & Zhang, Y. M. (2025). Preliminary validity of a daily functional status pain assessment tool. Journal of Sickle Cell Disease. Advance online publication. https://doi.org/10.1093/jscdis/yoaf006
Repository Citation
Smith, W. R., Qayyum, R., Ulbing, A., Guy, M. S., Sop, D. M., & Zhang, Y. M. (2025). Preliminary validity of a daily functional status pain assessment tool. Journal of Sickle Cell Disease. Advance online publication. https://doi.org/10.1093/jscdis/yoaf006
Included in
Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons, Hemic and Lymphatic Diseases Commons, Pain Management Commons
Comments
This is an accepted manuscript.
Accepted manuscripts are PDF versions of the author’s final manuscript, as accepted for publication by the journal but prior to copyediting or typesetting. They can be cited using the author(s), article title, journal title, year of online publication, and DOI. They will be replaced by the final typeset articles, which may therefore contain changes. The DOI will remain the same throughout.