Researchers showed that the use of questionnaires to track the stress levels of patients with sickle cell disease (SCD) can show sensitivity to subtle stress changes, as published in the European Journal of Haematology

SCD is characterized by fluctuations and exacerbations in pain. In addition, pain in patients with SCD has also been associated with chronic diseases. Studies indicate that a majority of patients with SCD reported being in pain over 50% of the time, and many of these patients use opioid analgesics to deal with pain symptoms.

One of the recurring events that are associated with increased pain in patients with SCD is vaso-occlusive crises. These are caused by deformed red blood cells, coupled with an inflammatory response. Patients with SCD experiencing vaso-occlusive crises reported feeling stress from the uncertainty of whether the crises require hospitalization, as well as the potential increase in the utilization of healthcare facilities.

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The authors of this study developed a questionnaire to better understand stress in the context of SCD. Their hope is that a well-designed stress questionnaire for patients with SCD will help physicians better tackle the feelings of stress among patients.

They developed and refined questionnaires that touch on many aspects of stress. One was based on an existing 3-item Likert scale and another 10-item questionnaire was developed specifically to measure SCD stress. The questionnaires were sent to a total of 55 patients from an adult SCD clinic, and researchers then attempted to analyze and validate the assessments made.

“Both the 3- item and the 10-item stress scales exhibited good face, construct, concurrent, and predictive validity as well as moderate test-retest reliability,” the researchers wrote. They hoped that these questionnaires will help physicians to be better able to implement specific interventions to reduce SCD-associated levels of stress. 


Smith WR, McClish DK, Bovbjerg VE, Singh HK. Development and validation of the sickle cell stress scale-adultEur J Haematol. Published online May 18, 2022. doi:10.1111/ejh.13789