The use of abstract animations and a graphical body image for assessing pain outcomes among adults with sickle cell disease
Painimation, a novel digital pain assessment tool, allows patients to communicate their pain quality, intensity, and location using abstract animations (painimations) and a paintable body image. This study determined the construct validity of painimations and body image measures by testing correlations with validated pain outcomes in adults with sickle cell disease (SCD). Analyses used baseline data from a multisite randomized trial of 359 adults with SCD and chronic pain. Participants completed questionnaires on demographics, pain severity, frequency and interference, catastrophizing, opioid use, mood and quality of life, plus the Painimation app. Participants were categorized by selected painimations, and were split into groups based on the proportion of painted body image. Potential confounding was evaluated by age, gender, race, education, disability, site, depression, and anxiety. The 'shooting' painimation was strongly associated with daily pain intensity, pain interference, frequency, and severity. 'Electrifying' was associated with daily pain and opioid misuse, while greater body area in pain correlated with worse outcomes across all pain measures. Both painimations and body image measures correlated with validated pain outcomes, quality of life and mental health measures. This demonstrates animations and body image data can assess SCD pain severity, potentially with more accuracy than a 0-10 scale. Future research will explore whether Painimation can differentiate biological and psychosocial pain components. PERSPECTIVE: This article presents the preliminary construct validity of Painimation in SCD by examining the associations of "painimations" and body area image data with daily e-diary and traditional self-report pain outcomes.
Authors
- Kaleab Z. Abebe (ORCID: https://orcid.org/0000-0002-3644-8419)
- Victor R. Gordeuk (ORCID: https://orcid.org/0000-0003-4725-7295)
- Christina M. Lalama (ORCID: https://orcid.org/0000-0001-6711-481X)
- Charles R. Jonassaint (ORCID: https://orcid.org/0000-0002-5662-5806)
- Megan Hamm (ORCID: https://orcid.org/0000-0002-7842-5290)
- Raymona H. Lawrence (ORCID: https://orcid.org/0000-0001-6554-3354)
- Santosh L. Saraf (ORCID: https://orcid.org/0000-0002-8584-4194)
- Darla Liles (ORCID: https://orcid.org/0000-0003-1480-7887)
- Michael R. DeBaun (ORCID: https://orcid.org/0000-0002-0574-1604)
- Julia A. O’Brien (ORCID: https://orcid.org/0000-0002-3208-3344)
- Tonya M. Palermo (ORCID: https://orcid.org/0000-0001-6036-6715)
- Lakiea Bailey
- Sherif M. Badawy (ORCID: https://orcid.org/0000-0002-4739-265X)
- Robert Michael Cronin (ORCID: https://orcid.org/0000-0003-1916-6521)
- Sophie Lanzkron (ORCID: https://orcid.org/0000-0002-2878-0251)
- Jennifer Nan Stinson (ORCID: https://orcid.org/0000-0002-9969-8052)
- Laura M. De Castro (ORCID: https://orcid.org/0000-0002-2380-8198)
- Leshana Saint‐Jean (ORCID: https://orcid.org/0000-0001-8982-8426)
- Nirmish Shah (ORCID: https://orcid.org/0000-0002-7506-0935)
- Ektha Parchuri (ORCID: https://orcid.org/0000-0003-3862-3919)
- Cassandra Trimnell (ORCID: https://orcid.org/0000-0003-4481-9424)
- C. Patrick Carroll (ORCID: https://orcid.org/0000-0001-7511-916X)
- Chitra Lalloo
Institutions
- Johns Hopkins University (US)
- University of Pittsburgh (US)
- Duke University (US)
- East Carolina University (US)
- Vanderbilt University (US)
- Johns Hopkins Medicine (US)
- University of Illinois Chicago (US)
- Georgia Southern University (US)
- Behavioral Pharma (United States) (US)
- Seattle Children's Hospital (US)
- Lurie Children's Hospital (US)
- Clinical Research Consortium (US)
- Institute for Work & Health (CA)
- Cell Medica (Switzerland) (CH)
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
- The Ohio State University (US)
- Vanderbilt University Medical Center (US)
Publication Details
- Journal
- Journal of Pain
- Published
- 2024-10-22
- DOI
- https://doi.org/10.1016/j.jpain.2024.104720
- Citations
- 1
- Primary Topic
- Hemoglobinopathies and Related Disorders
- Type
- article
- Field-Weighted Citation Impact
- 0.44
Funders
- Patient-Centered Outcomes Research Institute
- University of Pittsburgh
- National Institute of Mental Health
- National Institute of Nursing Research
- H2020 European Research Council