UF College of Nursing Associate Professor Miriam O. Ezenwa, PhD, MSN, BSN, RN, FAAN, received a $2.6 million grant from the National Institute of Nursing Research to study pain management and stress relief among patients with sickle cell disease. The grant is titled “A Stress and Pain Self-management m-Health App for Adult Outpatients with Sickle Cell Disease” and aims to reduce pain and stress due to sickle cell disease using self-management interventions, like guided relaxation therapy.

Sickle cell disease is a rare, painful blood disorder that mainly occurs in the Black population. Opioids are currently the primary therapy used to help mitigate pain in patients with sickle cell disease. There are various stigmas associated with this patient population because they are a disparate group suffering from both acute and persistent pain, and opioid use only magnifies these stigmas, Ezenwa said.

Through this grant, Ezenwa and her research team aim to create an intervention that allows sickle cell disease patients to use a balanced approach to pain management. The project, called “You Cope, We Support,” provides patient-centered guided relaxation/distraction exercises that help reduce stress and, thus, pain. Stress releases certain hormones, like cortisol, norepinephrine and epinephrine, which trigger a fight-or-flight reaction and intensify pain response.

Relaxation exercise evokes positive hormones, like endorphins, that reduce inflammation and pain. In this study, guided relaxation comes in the form of video clips with a soothing voice that instructs the viewer to observe the cloud-like formations on the screen and concentrate on breathing techniques. Controlled breathing sends direct messages to the brain, which then sends messages to the body and helps control pain levels.

Building on previous pilot studies, the You Cope, We Support project will be conducted with patients from the UF Health Shands Hospital pediatric and adult sickle cell programs, with the ultimate goal of having guided relaxation techniques to become an accepted prescription by health care providers for sickle cell disease patients worldwide.

“I believe in a balanced approach to care,” Ezenwa said. “There is a place for both drug and non-drug therapies in pain management, and there is also a place for patients to become active partners in their own care. It is our hope that the You Cope, We Support intervention will help patients relax and heal without the need to take large amounts of opioids.”

Anna McDaniel, PhD, RN, FAAN, dean and the Linda Harman Aiken Professor, said this research could not have come at a better time.

“The recent racial and social movements within our country put a clear focus on the populations who have suffered from health disparities for so long,” McDaniel said. “At the College of Nursing, we are proud of the work we are doing to move racial and social justice forward. Dr. Ezenwa’s research on pain management for patients with sickle cell disease is a significant step toward creating balance and equality in health care.”

Co-investigators from the College of Nursing include Diana Wilkie, PhD, RN, FAAN; Yingwei Yao, PhD; and Robert Lucero, PhD, MPH, RN, FAAN.