Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20180024
Brazilian Journal of Pain
Original Article

How interdisciplinary psychoeducational programs with a psychodrama approach can help the chronic pain treatment compliance

Como programas psicoeducativos interdisciplinares de abordagem psicodramática podem ajudar na adesão ao tratamento para dores crônicas

Adrianna Loduca; Barbara M. Müller; Alessandra S. Focosi; Claudio Samuelian; Lin Tchia Yeng

http://dx.doi.org/10.5935/2595-0118.20180024 BrJP, vol.1, n2, p.122-126, 2018
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Abstract

BACKGROUND AND OBJECTIVES: Psychoeducational programs with a cognitive behavioral approach are pointed out in the literature as effective tools in the management of chronic pain. The objective of this study was to evaluate if a psychodrama approach of the program has similar effects, as well as identifying if there are benefits in developing them at the beginning multidisciplinary treatments to foster the compliance to the proposed treatments.

METHODS: The study was a quasi-experimental one, with a non-probabilistic sample, for convenience. Ninety patients with chronic pain of several etiologies who started treatment in a tertiary hospital in the city of São Paulo in the period from 2015 to 2017, were invited. Among them, 81 concluded one of the 6 programs. Patients were evaluated with several resources before and at the end of the program.

RESULTS: The results obtained are similar to the ones in the literature: reduction of anxious and depressive traits, and intensity of pain; increase in active strategies of confrontation and alteration in the period of the change stage. Moreover, to deal with pain as a chronic process interferes with the patients’ identity, which can be observed by the change in the pattern of living with the pain, that can contribute or disturb the compliance to the proposed multidisciplinary treatments.

CONCLUSION: The development of psychoeducational programs with a different approach (Psychodrama) for people who suffer from chronic pain can have beneficial effects, similar to the groups described in the literature.

Keywords

Chronic pain, Health education, Psychodrama

Resumo

JUSTIFICATIVA E OBJETIVOS: Programas psicoeducativos de abordagem cogntivo-comportamental são apontados na literatura como ferramentas eficazes no manejo de dores crônicas. O objetivo deste estudo foi avaliar se o programa sob abordagem psicodramática tem efeitos similares, assim como identificar se há benefícios desenvolvê-los no início dos tratamentos multidisciplinares para a adesão aos tratamentos propostos.

MÉTODOS: Trata-se de um estudo quase-experimental, com amostra não probabilística por conveniência. Foram convocados 90 pacientes com dores crônicas de diversas etiologias que iniciaram tratamento em um hospital terciário da cidade de São Paulo no período de 2015 a 2017, dentre os quais 81 deles concluíram um dos 6 programas. Os pacientes foram avaliados por diversos recursos antes e ao final do programa.

RESULTADOS: Os resultados obtidos são semelhantes aos da literatura: diminuição de traços ansiosos, depressivos e de intensidade de dor; aumento de estratégias de enfrentamento ativas e alteração do estágio de mudança. Além disso, lidar com a dor como um processo crônico interfere na identidade dos pacientes, o que pode ser observado pela mudança do padrão de convívio com a dor, podendo contribuir ou atrapalhar na adesão aos tratamentos multidisciplinares propostos.

CONCLUSÃO: O desenvolvimento de programas psicoeducativos para as pessoas que sofrem com dores crônicas em outras abordagens (Psicodrama) também podem ter efeitos benéficos semelhantes aos grupos descritos na literatura.

Palavras-chave

Dores crônicas, Educação em saúde, Psicodrama

References

Martinez MC, Latorre MD, Fischer FM. Validity and reliability of the Brazilian version of the Work Ability Index questionnaire. Rev Saude Publica. 2009;43(3):525-32.

Phaneth S, Panha P, Sopheap T, Harlacher U, Polatin P. Education as treatment for chronic pain in survivors of torture and other violent events in Cambodia: experiences with implementation of a group-based "Pain School" and evaluation of its effect in a pilot study. J Appl Biobehav Res. 2014;19(1):53-69.

Loduca A, Müller BM, Amaral R, Souza AC, Focosi AS, Samuelian C. Retrato de dores crônicas: percepção da dor através do olhar dos sofredores. Rev Dor. 2014;15(1):30-5.

Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971-9.

Mead K, Theadom A, Byron K, Dupont S. Pilot study of a 4-week Pain Coping Strategies (PCS) programme for the chronic pain patient. Disabil Rebahil. 2007;29(3):199-203.

Dysvik E, Vinsnes AG, Eikeland OJ. The effectiveness of a multidisciplinary pain management programme managing chronic pain. Int J Nurs Pract. 2004;10(5):224-34.

Fisher K. Assessing clinically meaningful change following a programme for managing chronic pain. Clin Rehabil. 2008;22(3):252-9.

Barlow J, Turner A, Swaby L, Gilchrist M, Wright C, Doherty M. An 8-yr follow-up of arthritis self-management programme participants. Rheumatology. 2009;48(2):128-33.

Wong M, Rietzschel J, Mulherin D, David C. Evaluation of a multidisciplinary outpatient pain management programme based at a community hospital. Musculoskeletal Care. 2009;7(2):106-20.

Budh C Norrbrink, Kowalski J, Lundeberg T. A comprehensive pain management programme comprising educational, cognitive and behavioural interventions for neuropathic pain following spinal cord injury. J Rehabil Med. 2006;38(3):172-80.

Man AK, Chu MC, Chen PP, Ma M, Gin T. Clinical experience with a chronic pain management programme in Hong Kong Chinese patients. Hong Kong Med J. 2007;13(5):372-8.

Lin PC, Chiang HW, Chiang TT, Chen CS. Pain management: evaluating the effectiveness of an educational programme for surgical nursing staff. J Clin Nurs. 2008;17(15):2032-41.

Luciano JV, Martínez N, Peñarrubia-María MT, Fernandez-Vergel R, García-Campayo J, Verduras C. Effectiveness of a psychoeducational treatment program implemented in general practice for fibromyalgia patients: a randomized controlled trial. Clin J Pain. 2011;27(5):383-91.

Salvetti Mde G, Cobelo A, Vernalha Pde M, Vianna CI, Canarezi LC, Calegare RG. Effects of a psychoeducational program for chronic pain management. Rev Lat Am Enfermagem. 2012;20(5):896-902.

Jensen MP, Turner JA, Romano JM. Changes after multidisciplinary pain treatment in patient pain beliefs and coping are associated with concurrent changes in patient functioning. Pain. 2007;131(1):38-47.

Flor H, Fydrich T, Turk DC. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review. Pain. 1992;49(2):221-30.

Kelly A. The minimum clinically significant difference in visual analog scale pain score does not differ with severity of pain. Emerg Med J. 2001;18(3):205-7.

Fors T, Damsgård E, Røe C, Anke A. Readiness to adopt a self-management approach to pain-Are profiles of subscale scores on the Pain Stages of Change Questionnaire useful?. Eur J Pain. 2010;14(10):1051-8.

Loduca A, Focosi AS, Müller BM, Samuelian C. Dores crônicas: como melhorar a adesão ao tratamento. 2015.

Rollnick S, Miller WR, Butler CC. Entrevista motivacional no cuidado da saúde: ajudando pacientes a mudar o comportamento. 2009.

Canel RC, Pelicioni MC. Psicodrama pedagógico: uma técnica participativa para estratégias de promoção de saúde. Mundo Saúde. 2007;31(3):426-33.

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.

Botega NJ. Prática Psiquiátrica no Hospital Geral: Interconsulta e Emergência. 2012.

Submitted date:
03/13/2018

Accepted date:
04/27/2018

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