Mindfulness Martial Arts Intervention on Reducing Chronic Pain in Adolescents With Sickle Cell Disease

Introduction

According to Sil, Cohen, and Dampier (2016), chronic pain from sickle cell disease among adolescent can lead to a substantial decrease of quality of life, more adolescents dropping out of school and have more serious morbidity from the disease as compared to adolescents suffering from sickle cell disease. Chronic pain is developed as a result of damage and death of tissues. In sickle cell disease, sources of chronic pain incorporate joints' avascular necrosis, bone infraction, chronic osteomyelitis, leg ulcers, and back pain as a result of disk protrusion into vertebral bodies. Unlike acute pain and Vasco-occlusive, chronic pain from sickle cell disease is always common. It has obvious causes and can be related to one of the main issues mentioned above, for instance, pain that develops as a result of disk protrusion. A vaso-occlusive crisis can also develop persistent pain.

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Chronic pain can be the major cause of substantial functional disability that can make adolescents miss school (Owens, Sawshuk & Harbeck-Weber, 2017). The Institute of Medicine (2011) states, unlike cancer, heart disease, and diabetes, chronic pain can affect more people. Because of the effects of chronic pain from sickle cell disease, adolescents can be stigmatized by peers. Consequently, the adolescents will fear to seek for medical assistance; hence they will start missing classes. According to Bediako et al., (2016), adolescents suffering from the sickle cell disease who have been stigmatized about their conditions are highly vulnerable to the increased risk for anxiety, low self-esteem, social withdrawal, and negative self-evaluation. Stigmatization comes as a result of other people considering the adolescents as people who suffer a lot in life. After some time, they will lack understanding, accommodation, and awareness in academic settings. Most adolescents who suffer from pain that come as a result of the sickle cell disease have insufficient functional activity (Khan et al., 2016). This can develop health deterioration. This situation can be avoided by educating the victims of the pain about the importance of exercise program about their situations. While doing this, there is a need for regulating intensity, level, and volume of the exercise regarding reducing the chronic pain. Children suffering from chronic pain that result from sickle cell disease should be engaged in physical activities because it is vital for their normal growth as well as development (CDC, 2012). Chronic pain from the sickle cell disease is likely to manifest during adolescence when children are more likely to be more active. Adolescents suffering from the sickle cell disease have chronic pain that has been limiting them from performing their duties. This limits their social and physical activities in a way that they will not be in a position of meeting their needs. A German-American psychologist, Erikson, who significantly contributed to psychology by proposing the theory of psychological development; this was from 1950 to 1963. Eight stages of development were developed by Erikson. The eight stages had five stages about kids up to the age of eighteen years. Identity vs. role confusion is the childhood and adolescence's five-stage, and they take place between the ages of 12 to 18. Identity is a major issue that most adolescents have been striving for. In high school, they can master their identity through familial circles, friends and social groups. Children suffering from sickle cell disease pain are likely to experience delayed puberty period. According to different scholars, children suffering from chronic pain have been showing stunted growth as well as maturation, unlike their peers (Rhodes et Al., 2009; Zemel, Kawchak, Ohene-Frempong, Schall & Stallings, 2007).

Gibson-Scipio, Gourdin, and Krouse (2015), the critical time of growth as well as development is during adolescence. It is during this period that milestones, for instance, autonomy and identity, are achieved. A sickle cell disease cause, in the vasculature system, crescent shaped-red blood cells resulting in painful VOC. Pain from sickle cell disease is chronic. Chronic pain is often prevention of crisis. The SCD's treatment should start with early diagnosis, penicillin prophylaxis and vaccination against the disease.

Nevertheless, the treatment ought to be done based on the symptoms of an individual. The purpose of treatment is to ensure the daily function of the patient is improved. Nevertheless, some medical specialists have been prescribing medication with the intention of controlling chronic pain. On the other hand, patients suffering from SCD have been looking for a less toxic approach to assist them in controlling their pain (Majumdar, Thompson, Ahmed, Gordon and Addison, 2013). For instance, exercise programs can be used for different diseases, for instance, arthritis to decrease pain in a way that mobility will be maintained.

Nevertheless, this has not been fully explored, especially for patients suffering SDC. Yoga (Majumar & Colleagues, 2013), prayer (Cotton and Colleagues, 2012), touch (Brewer, 2015), mindfulness-based cognitive therapy (Baer, 2014), dialectical behavioral therapy (Baer, 2014), mindfulness-based stress reduction (Baer, 2014) together with acceptance and commitment therapy (Baer, 2014) can be used to treat adolescents suffering from SDC. The outcomes of the desirable treatment are meant for decreasing chronic pain, increasing the perceived controls over the pain as well as increasing functional status among adolescents with SCD.

Adolescents suffering from SDC are sometimes discouraged from considering being involved in strenuous activities. Because of confusing and unclear recommendations about the increased vaso-occlusive crisis' risks, physicians have always been hesitant when it comes to recommending physical activities among the SCD patients, though there is no support for this concern (Chirico et al., 2015). Based on different findings from different studies, patients with sickle cell disease should avoid or have limited exercise, while others showed positive results. Regular exercise is assumed to be beneficial since they improve antioxidant enzymatic activities and vascular function in healthy people and patients suffering from chronic diseases. It is therefore difficult to determine whether physical activities are safe and effective for individuals suffering from sickle cell disease. Aerobic exercise is not meant for adolescents with SCD, though non-aerobic exercise has not been fully studied.

Purpose of Study

The purpose of this study is to examine how mindfulness martial arts is important and effective on reducing chronic pain, and how the mindfulness martial arts can be used to increase perceived control over chronic pain as well as increasing the function in the adolescents who are suffering from sickle cell disease. Also, this study also aims at testing the effects of mindfulness martial arts interventions in dealing with chronic pain for patients who have sickle cell disease. Adolescents who participate in mindfulness martial arts intervention will have a lower pain score. The mindfulness martial arts intervention's effects on adolescents with SCD's functional status will be tested. About this, adolescents who are from mindfulness martial art intervention are likely to have less interference in function, unlike those who have not completed the mindfulness martial arts intervention. Another thing that the study aims at is to test how the mindfulness martial arts intervention can affect the perceived control over the chronic pain among adolescents with sickle cell disease. There is the likelihood of adolescents having increased perceived control if they have gone through mindfulness martial arts intervention.

Chronic disease, especially for young adults who are suffering from sickle cell disease, is always complex and can occur more often, unlike acute pain. The kind of pain that adolescents with the sickle cell disease are likely to make them absent from school for several days in addition to suffering from increased depression as well as sickness because of tissue death or injuries to the bone. Only a few African-American in America suffer from sickle cell disease. Chronic pain is a kind of pain that can last even for three months. Since chronic pain management is difficult for patients with sickle cell disease, it is important that medication ought to be prescribed based on the condition of the patient. Chronic pain treatment incorporate prescribed medication and over the counter pain medication. Because of several studies that highlight the sickle cell disease treatment with pharmacological interventions, other than opioids, there are several evidence-based no pharmacologic modalities and pharmacologic interventions (Leblanc et al., 2018). So, there is a need for more interventions to be implemented.

For African Americans suffering from sickle cell disease, chronic pain is among the major health concerns. In as much as adolescents have been experiencing changes in their social interaction, hormones together with the desire for personal identity, they have been facing disparities in accessing appropriate pain management in sickle cell disease. For optimal health to be maintained, exercise is important. So, why is it difficult for patients with sickle cell disease to have chronic pain management? For a patient with SCD, exercise is controversial since it is difficult to tell whether the exercise of great help or will make conditions worse for the patient. In as much as patients suffering from the sickle cell disease are not encouraged to be involved in strenuous activities, martial arts interventions are essential for SCD patients. Though pharmacological treatment is highly recommended for treating patients with chronic pain in sickle cell disease, non-pharmacological modalities are also important for such patients. The pharmacological methods can be important for chronic pain management for patients with SCD. This method ought to be administered to the interesting phenomenon and total population of patients. The use of exercise regarding pain control requires further research that can support it. Unless the non-pharmacological modalities are included in the clinical practice to enhance best practices and health outcomes, treatments for a patient with SCD will always be hindered. The reason behind developing chronic pain management for patients with SCD is reducing pain, and increasing patients' physical functioning.

Importance of Controlling Pain

Chronic pain for patients suffering from SCD is a major health problem in America. Medical management is recommended patients with this disease and complications related to the disease. Among adolescent with sickle cell disease, chronic pain is common. The ability to give medical interventions for chronic pain management among adolescents with SDC is limited. Some limitations to controlling chronic pain among patients with sickle cell disease are based on pharmacologic use within the literature. In as much as pharmacological treatment is important when it comes to chronic pain treatment, non-pharmacological modalities are important for such patients, though it requires further investigations.

Nevertheless, some practitioners have never understood the significance of controlling pain using non-pharmacologic modalities. Moreover, it is the responsibility of health care providers to promote individualized as well as regular exercise as a strategy for treating patients with SCD. The same thing is done in other chronic diseases. If this knowledge is not...