Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20180023
Brazilian Journal of Pain
Original Article

Beliefs and attitudes in patients with chronic low back pain

Crenças e atitudes frente à dor em pacientes com lombalgia crônica

Fernanda Martins Barbosa; Érica Brandão de Moraes Vieira; João Batista Santos Garcia

Downloads: 0
Views: 239

Abstract

BACKGROUND AND OBJECTIVES: Dysfunctional attitudes and beliefs in patients with low back pain may interfere with pain, disability, and mood. The objective of this study was to evaluate the behavior of beliefs and attitudes in chronic low back pain and to correlate them with the intensity of pain, disability, anxiety, and depression. METHODS: We evaluated 82 patients with chronic low back pain according to the Numerical Scale of Pain, Survey of Pain Attitudes, Hospital Scale of Anxiety and Depression, and Oswestry Disability Index.

RESULTS: More than half of the patients were female (51.22%) with a mean age above 40 years. The pain was mild to moderate at 53.65%. Severe disability was observed in 64.63%, anxiety in 63.41% and depression in 41.46%. The solicitude and disability beliefs showed significant associations in all groups. For physical damage, there was an association with disability and anxiety. Medical cure correlated between the anxiety variable.

CONCLUSION: Patients presented dysfunctional beliefs associated with the intensity of pain, anxiety, depression and mainly disability, with a probable influence on the treatment. This relationship shows how important it is to carry out new studies that evaluate therapeutic approaches, such as targeted interventions and educational programs, aimed at the patient’s beliefs with low back pain to determine their impact on pain control and treatment.

Keywords

Anxiety, Back pain, Beliefs, Depression, Disability

Resumo

JUSTIFICATIVA E OBJETIVOS: Atitudes e crenças disfuncionais em pacientes com lombalgia podem interferir nos quadros de dor, incapacidade e humor. O objetivo deste estudo foi avaliar o comportamento das crenças e atitudes na lombalgia crônica e correlacioná-las com a intensidade da dor, incapacidade, ansiedade e depressão. MÉTODOS: Foram avaliados 82 pacientes com lombalgia crônica segundo a Escala Numérica da Dor, Inventário de Atitudes Frente à Dor, Escala Hospitalar de Ansiedade e Depressão, e Índice Funcional de Oswestry.

RESULTADOS: Mais da metade dos pacientes foi do sexo feminino (51,22%) com idade média acima de 40 anos. A dor era leve à moderada em 53,65%. Observou-se incapacidade grave em 64,63%, ansiedade em 63,41% e depressão em 41,46%. As crenças solicitude e incapacidade apresentaram associações significativas com todos os grupos. Para dano físico, houve associação com incapacidade e ansiedade. A cura médica se correlacionou com a variável ansiedade.

CONCLUSÃO: Os pacientes apresentaram crenças disfuncionais associadas à intensidade da dor, ansiedade, depressão e principalmente incapacidade, com provável influência no tratamento. Ao demonstrar essa relação, se evidencia importância da realização de novos estudos que avaliem abordagens terapêuticas, como intervenções dirigidas e programas educacionais, voltadas para as crenças do paciente com lombalgia para determinar seu impacto no controle e tratamento da dor.

Palavras-chave

Ansiedade, Crenças, Depressão, Dor lombar, Incapacidade

References

Wong W, Fielding R. Prevalence and characteristics of chronic pain in the general population of Hong Kong. J Pain. 2011;12(2):236-45.

Salvetti Mde G, Pimenta CA, Braga PE, Corrêa CF. [Disability related to chronic low back pain: prevalence and associated factors]. Rev Esc Enferm USP. 2012;46(Spec nº):16-23.

Rathmell JP. A 50-year-old man with chronic low back pain. JAMA. 2008;299(17):2066-77.

Lamb SE, Lall R, Hansen Z, Withers EJ, Griffiths FE, Szczepura A, Barlow J. Design considerations in a clinical trial of a cognitive behavioural intervention for the management of low back pain in primary care: Back Skills Training Trial (BeST) Tean. BMC Musculoskelet Disord. 2007;8:14.

Abreu AT, Ribeiro CA. Prevalência de lombalgia em trabalhadores submetidos ao programa de reabilitação profissional do Instituto Nacional do Seguro Social (INSS), São Luís, MA. Acta Fisiatr. 2010;17(4):148-52.

Pimenta CA. Dor crônica, terapia cognitiva comportamental e o enfermeiro. Rev Psiquiatr Clín. 2001;28(6):288-94.

Al-Obaidi SM, Beattie P, Al-Zoabi B, Al-Wekeel S. The relationship of anticipated pain and fear avoidance beliefs to outcome in patients with chronic low back pain who are not receiving workers compensation. Spine. 2005;30(9):1051-7.

Schultz IZ, Crook J, Meloche GR, Berkowitz J, Milner R, Zuberbier OA. Psychosocial factors predictive of occupational low back disability: towards development of a return-to-work model. Pain. 2004;107(1-2):77-85.

Kerns RD, Sellinger J, Goodin BR. Psychological treatment of chronic pain. Annu Rev Clin Psychol. 2011;7:411-34.

Pimenta CA, Cruz Dde A da. [Chronic pain beliefs: validation of the survey of pain attitudes for the Portuguese Language]. Rev Esc Enferm USP. 2006;40(3):365-73.

Tait RC, Chibnall JT. Development of a brief version of the Survey of Pain Attitudes. Pain. 1997;70(2-3):229-35.

Oliveira JT. Aspectos comportamentais das síndromes de dor crônica. Arq Neuro-Psiquiatr. 2000;58(^sSuppl2A):360-5.

Pagano T, Matsutani LA, Ferreira EA, Marques AP, Pereira CA. Assessment of anxiety and quality of life in fibromyalgia patients. São Paulo Med J. 2004;122(6):252-8.

Jensen MP, Karoly P, Huger R. The development and preliminary validation of an instrument to assess patient's attitudes toward pain. J Psychosom Res. 1987;31(3):393-400.

Castro MM, Quarantini L, Batista-Neves S, Kraychete DC, Dalto C, Miranda-Scippa A. [Validity of the hospital anxiety and depression scale in patients with chronic pain. Rev Bras Anestesiol. 2006;56(5):470-7.

Vigatto R, Alexandre NM, Correa Filho HR. Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability and validity. Spine. 2007;32(4):481-6.

Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine. 2000;25(22):2940-52.

Ferreira GD, Silva MC, Rombaldi AJ. Prevalência de dor nas costas e fatores associados em adultos do Sul do Brasil: estudo de base populacional. Rev Bras Fisioter. 2011;15(1):31-6.

Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769-81.

Quiton RL, Greenspan JD. Sex differences in endogenous pain modulation by distracting and painful conditioning stimulation. Pain. 2007;132(Suppl 1):S134-49.

Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 2008;337(a171):154-7.

Linton SJ, Gross D, Schultz IZ, Main C, Côté P, Pransky G. Prognosis and the identification of workers risking disability: research issues and directions for future research. J Occup Rehabil. 2005;15(4):459-74.

Strine TW, Hootman JM, Chapman DP, Okoro CA, Balluz L. Health-related quality of life, health risk behaviors and disability among adults with pain-related activity difficulty. Am J Public Health. 2005;95(11):2042-8.

Dijken C Björck-van, Fjellman-Wiklund A, Hildingsson C. Low back pain, lifestyle factors and physical activity: a population-based study. J Rehabil Med. 2008;40(10):864-9.

Dawson AP, Steele EJ, Hodges PW, Stewart S. Utility of the Oswestry Disability Index for studies of back pain related disability in nurses: evaluation of psychometric and measurement properties. Int J Nurs Stud. 2010;47(5):604-7.

Peters Ml, Vlaeyen JW, Weber WE. The joint contribution of physical pathology, pain-related fear and catastrophizing to chronic back pain disability. Pain. 2005;113(1-2):45-50.

Sardá Jr J, Nicholas MK, Asghari A, Pimenta CA. The contribution of self-efficacy and depression to disability and work status in chronic pain patients: a comparison between Australian and Brazilian samples. Eur J Pain. 2009;13(2):180-95.

Darlow B, Perry M, Stanley J, Mathieson F, Melhoh M, Baxter GD. Cross-sectional survey of attitudes and beliefs about back pain in New Zealand. BMJ Open. 2014;4(5).

McCracken LM. Social context and acceptance of chronic pain: the role of solicitous and punishing responses. Pain. 2005;113(1-2):155-9.

Tait RC, Chibnall JT. Attitude profiles and clinical status in patients with chronic pain. Pain. 1998;78(1):49-57.

Turner JA, Jesen MP, Romano JM. Do beliefs, coping and catastrophizing indenpedently predict functioning in patients with chronic pain?. Pain. 2000;85(1-2):115-25.


Submitted date:
09/15/2017

Accepted date:
03/29/2018

5f1624300e882518339517e3 brjp Articles

BrJP

Share this page
Page Sections