The world is bent on addressing issues related to infectious diseases, resulting in less focus on other diseases that are equally fatal such as sickle cell disease (SCD). Sickle cell disease is a monogenic disease, which results from an error in a single gene, and it affects millions of people all over the world. The World Health Organization (WHO) indicates that 10 out of 1000 neonates have a single gene disease. However, the global burden of each disease has not been accurately determined, largely due to few researches about this disease (Centers for Disease Control and Prevention, 2011). The SCD is common in “Sub-Saharan Arica, India, Saudi Arabia, Cuba, South and Central America, and some Mediterranean countries” (World Health Organization, 2014).
Investigating sickle cell anemia is very important in nursing practice because it aims at improving health services through evidence-based practice (Polit & Beck 2012, p. 25). Individuals with sickle cell anemia experience vaso-occlusive episodes associated with the polymerization of hemoglobin. Sickle cell disease pain is the peak of this disease, and many emergencies results due to this pain. In a recent study by Morris et al. (2013), analgesics and hydration were shown to have been the main mode of therapy for a long time, but this study showed effectiveness of opioid. There is need for more novel therapies to help in the management of sickle cell disease pain. The novel therapy of concern in this discussion is the integration of behavioral and opioid in comparison to the use of opioid alone.
What is the socioeconomic status of children with sickle cell disease pain?
Only participants who have received a pneumococcal vaccination will be included. According to Polit & Beck (2012, p. 77-78), it is necessary to consider the factors that may impede researchability of the research questions. The feasibility of this question may seem unachievable for children, who have no material property added to their names, but they will acquire the social status of their parents. In addition, people may not be willing to disclose information on their income; thus, indicators such as occupation, residential area and apparent expenses like education cost will enhance the feasibility of this question. Assistance from experts in this field will be sought to help in the making o decisions about executing this planned study.
What are the demographic characteristics of children with sickle cell disease pain?
This question is achievable and aims at defining the people affected based on age, ethnicity and gender. This is the most feasible question that is based on observation and hospital records for date of birth.
What is the effect of integrated mild opioid use and behavioral management of vaso-occlusive pain in children with sickle cell disease pain?
This question is feasible because it is based on indicators such as pain scores and days spent in the hospital.
What is the effect of opioid use in the management of vaso-occlusive pain in children with sickle cell disease pain?
Once a good rapport is developed with the participants, they will reveal their experiences. Use of therapy will help alleviate pain; thus, they will be in a position to respond to questions.
What is the most effective intervention in the management of sickle cell disease pain?
This will be achieved by analyzing all the other four questions through appropriate statistical software and expertise, which are readily available.
PICO question as per the description by Davies (2011) is “Integrated use of mild opioid and behavioral management of vaso-occlusion pain in comparison to sole use of opioid among children with sickle cell disease.”
P: Pre-school children between 3 and 5 years
This entails an understanding of the population under study in relation to the social class, ethnicity, gender and age.
I: Behavioral therapy and mild opioid use
This is the therapy being evaluated for effectiveness
C: Sole opioid use
This is a therapy that has been associated with reduced pain upon administration.
O: Reduced vaso-occlusive pain and length of hospital stays
Pain scores on a range of 0 to 10 on a 10-cm observable analog scale will be used to quantify pain while the days spent in hospital will be equated to length of hospital stays.
This study aims at comparing two therapies that can be used in the management of sickle cell disease pain, namely, opioid use only and integrated opioid use and behavioral management. The chosen research design to answer this PICO question will be a randomized clinical trial. The question is feasible when all the requirements of the research process are fulfilled. An ethical clearance to authorize investigation is important. In addition, it is necessary to seek approval from the participants using the informed consent forms that they will assent to by appending their signatures (Newcomb, 2010; The American Nurses Association, 2001).
Keywords for use include Sickle-cell, Sickle Cell Anemia, Sickle-Hemoglobin C Disease, Sickle Beta-Plus Thalassemia, Sickle Beta-Zero Thalassemia, prevalence, Sickle Cell Disease, statistics, population affected, vaso-occlusive pain, treatment, intervention, management, therapy, opioid, behavioral management, warmth, fluid intake, pain
The rationale for selecting these keywords is based on the variables under study, and their synonyms. Sickle cell disease, the disease under study, comprises of different types, but the most common is sickle cell anemia. Words like sickle cell are important to get some background information about the issue. Addition of keywords such as statistics/prevalence helps to obtain known figures of the disease while use of population helps to know the people affected by this disease. Warmth and fluid intake are defining elements of behavioral management of sickle cell disease (Hartree, 2012).
References
Centers for Disease Control and Prevention. (2011).Sickle Cell Disease(SCD). Web.
Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80.
Hartree, N. (2012). Sickle Cell Disease and Sickle Cell Anaemia. Patient.co.uk. Web.
Morris, C., Kuypers, F., Lavrisha, L., Ansari, M., Sweeters, N., Stewart, M., … Vichinsky, E. (2013). A randomized, placebo-controlled trial of arginine therapy for the treatment of children with sickle cell disease hospitalized with vaso- occlusive pain episodes. Haematologica, 98(9), 1375-1382.
Newcomb, P. (2010). Evolving fairness in research on human subjects. Journal of Child and Adolescent Psychiatric Nursing, 23(3), 123–124.
Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA: Lippincott Williams & Wilkins.
The American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Web.
World Health Organization. (2014). Genes and human disease. Genomic Resource Centre. Web.