Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190003
Brazilian Journal of Pain
Original Article

Chronic pelvic pain portraits: perceptions and beliefs of 80 women

Retratos da dor pélvica crônica: percepções e crenças de 80 mulheres

João Elias de Godoi; Dário Rafael Macêdo dos Reis; Jakeline Resende Carvalho; José Miguel de Deus

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Abstract

BACKGROUND AND OBJECTIVES: Because of its expressive prevalence and difficult clinical management, chronic pelvic pain is an important cause of morbidity, disability, and reduction of quality of life in women. Psychological factors influence the perception of pain and can interfere in the medical approach, justifying the application of projective tools, such as the pain portrait, previously not applied in women with chronic pelvic pain. The objective of this study was to obtain a greater clarification about the psychological component in the assessment of the chronic pelvic pain by applying the pain portrait in women with chronic pelvic pain.

METHODS: This is an exploratory cross-sectional study conducted with 80 women with chronic pelvic pain. It was applied a pre-structured interview to collect sociodemographic, behavioral and clinical data. The pain portrait was applied to investigate the perceptions and beliefs about pain. The drawings were classified by content analysis and consensus among the authors.

RESULTS: The average age of the participants was 39.40±9.21 years, average pain intensity of 7.03±2.58 and average pain duration of 8.84±7.65 years. The main portraits referred to negative feelings (37.50%), harmful instruments (33.75%) and geometric forms (25%), with a predominance of cold colors (63.70%). More than 60% of the participants put hope only in medical procedures, while 25% believed that there was no solution to their pain.

CONCLUSION: Women represented their chronic pelvic pain in an affective way, with the use of few and cold colors. They considered themselves having a passive role in their treatment and related their pain to family losses.

Keywords

Chronic pain, Pain assessment, Pelvic pain, Psychosocial effects of the disease, Women

Resumo

JUSTIFICATIVA E OBJETIVOS: Por sua expressiva prevalência e difícil manuseio clínico, a dor pélvica crônica é importante causa de morbidade, incapacidade e redução da qualidade de vida em mulheres. Fatores psicológicos podem influenciar a percepção da dor e interferir na abordagem médica, justificando a aplicação de recursos projetivos, como o retrato da dor, anteriormente não aplicado em mulheres com dor pélvica crônica. Objetivou-se trazer maior esclarecimento sobre a influência do componente psicológico na avaliação da dor pélvica crônica, por meio da aplicação do retrato da dor em mulheres com dor pélvica crônica.

MÉTODOS: Trata-se de um estudo de corte transversal exploratório realizado com 80 mulheres com dor pélvica crônica. Utilizou-se de entrevista pré-estruturada para coletar dados sociodemográficos, comportamentais e clínicos e, para investigar percepções e crenças sobre a dor, aplicou-se o retrato da dor. Os desenhos foram avaliados e classificados por meio de análise de conteúdo e consenso entre os autores.

RESULTADOS: As participantes tinham média de idade de 39,40±9,21 anos, intensidade álgica média de 7,03±2,58 e duração média de 8,84±7,65 anos. Os principais retratos remetiam a sentimentos negativos (37,50%), instrumentos lesivos (33,75%) e formas geométricas (25%), com predomínio de cores frias (63,70%). Mais de 60% das participantes depositavam esperança apenas em procedimentos médicos, enquanto 25% delas acreditavam não haver solução para sua dor.

CONCLUSÃO: As mulheres retrataram sua dor pélvica crônica de modo afetivo, com uso de poucas cores e cores frias. Consideraram-se em papel passivo no tratamento, além de relacionar a sua dor a perdas familiares.

Palavras-chave

Avaliação da dor, Dor crônica, Dor pélvica, Efeitos psicossociais da doença, Mulheres

References

ACOG Practice Bulletin No. 51. Chronic pelvic pain. Obstet Gynecol. 2004;103(3):589-605.

Howard FM. The role of laparoscopy in chronic pelvic pain: promise and pitfalls. Obstet Gynecol Surv. 1993;48(6):357-87.

Barcelos PR, Conde DM, Deus JM, Martinez EZ. Quality of life of women with chronic pelvic pain: a cross-sectional analytical study. Rev Bras Ginecol Obst. 2010;32(5):247-53.

Luz RA, Rodrigues FM, Vila VS, Deus JM, Conde DM. Qualidade de vida de mulheres com dor pélvica crônica. Rev Eletr Enf. 2015;17(3):1-7.

Sewell M, Churilov L, Mooney S, Ma T, Maher P, Grover SR. Chronic pelvic pain - pain catastrophizing, pelvic pain and quality of life. Scand J Pain. 2018;18(3):441-8.

Da Luz RA, de Deus JM, Conde DM. Quality of life and associated factors in Brazilian women with chronic pelvic pain. J Pain Res. 2018;11:1367-74.

Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141-7.

Silva GP, Nascimento AL, Michelazzo D, Alves Junior FF, Rocha MG, Silva JC. High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery. Clinics. 2011;66(8):1307-12.

Coelho LS, Brito LM, Chein MB, Mascarenhas TS, Costa JP, Nogueira AA. Prevalence and conditions associated with chronic pelvic pain in women from São Luís, Brazil. Braz J Med Biol Res. 2014;47(9):818-25.

Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R. Consensus guidelines for the management of chronic pelvic pain. J Obstet Gynaecol Can. 2005;27(9):869-910.

Yosef A, Allaire C, Williams C, Ahmed AG, Al-Hussaini T, Abdellah MS. Multifactorial contributors to the severity of chronic pelvic pain in women. Am J Obstet Gynecol.. 2016;215(6):760.e1-760.e14.

Howard FM. Chronic pelvic pain. Obstet Gynecol. 2003;101(3):594-611.

Deus JM, Santos AF, Bosquetti RB, Pofhal L, Alves Neto O. Analysis of 230 women with chronic pelvic pain assisted at a public hospital. Rev Dor. 2014;15(3):191-7.

Loduca A, Müller BM, Amaral R, Souza AC, Focosi AS, Samuelian C. Chronic pain portrait: pain perception through the eyes of sufferers. Rev Dor. 2014;15(1):30-5.

Loduca A, Samuelian C. Avaliação psicológica: do convívio com dores crônicas à adesão ao tratamento na clínica de dor. Dor, princípios e prática. 2009.

Courtney CA, O'Hearn MA, Franck CC. Frida Kahlo: portrait of chronic pain. Phys Ther. 2017;97(1):90-6.

Elliot AJ, Maier MA. Color psychology: effects of perceiving color on psychological functioning in humans. Annu Rev Psychol. 2014;65(1):95-120.

Laurence B. Análise de conteúdo. 2004.

Custódio LL, Leitão IM, Gomes IL, Mendes LC. Drawing pain for children with sickle cell anemia: the pain that hurts, really hurts. Rev Dor. 2017;18(4):321-6.

Goethe JW. Theory of Colours. 1840.

As-Sanie S, Clevenger LA, Geisser ME, Williams DA, Roth RS. History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain. Am J Obstet Gynecol. 2014;210(4):317.e1-8.

Allaire C, Williams C, Bodmer-Roy S, Zhu S, Arion K, Ambacher K. Chronic pelvic pain in an interdisciplinary setting: 1-year prospective cohort. Am J Obstet Gynecol. 2018;218(1):114.e1-114.e12.

Kreis S, Molto A, Bailly F, Dadoun S, Fabre S, Rein C. Relationship between optimism and quality of life in patients with two chronic rheumatic diseases: axial spondyloarthritis and chronic low back pain: a cross sectional study of 288 patients. Health Qual Life Outcomes. 2015;13:78.

Wiech K. Deconstructing the sensation of pain: The influence of cognitive processes on pain perception. Science. 2016;354(6312):584-7.

Brünahl CA, Dybowski C, Albrecht R, Gregorzik S, Löwe B. Psychiatric comorbidity in patients with chronic pelvic pain syndrome (CPPS). J Psychosom Res. 2016;85:58.

Brünahl C, Dybowski C, Albrecht R, Riegel B, Höink J, Fisch M. Mental disorders in patients with chronic pelvic pain syndrome (CPPS). J Psychosom Res. 2017;98:19-26.

Alappattu MJ, Bishop MD. Psychological factors in chronic pelvic pain in women: relevance and application of the fear-avoidance model of pain. Phys Ther. 2011;91(10):1542-50.

Silva FU, Alcântara MA, Barroso OL. Crenças em relação às condições crônicas de saúde: uma revisão crítica de instrumentos adaptados para a língua portuguesa. Fisioter Mov. 2010;23(4):651-62.

Porto CC, Branco RFGR, Cantarelli GCF, Oliveira AM. Relação Médico-Paciente. Semiologia Médica. 2014:21-37.

Dybowski C, Löwe B, Albrecht R, Brünahl CA. Pain perception and the anticipation of stigmatization due to mental illness - associations within a sample of patients with chronic pelvic pain syndrome (CPPS). J Psychosom Res. 2017;97:146-7.

Twiddy H, Bradshaw A, Chawla R, Johnson S, Lane N. Female chronic pelvic pain: the journey to diagnosis and beyond. Pain Manag. 2017;7(3):155-9.

Picard-Destelan M, Rigaud J, Riant T, Labat JJ. What type of psychotherapy in the management of chronic pelvic and perineal pain?. Prog Urol. 2010;20(12):1111-5.

Neubern MS. Psicoterapia, dor & complexidade: construindo o contexto terapêutico. Psicol Teor Pesq. 2010;26(3):515-23.

Sturgeon JA, Zautra AJ. Social pain and physical pain: shared paths to resilience. Pain Manag. 2016;6(1):63-74.

Alschuler KN, Kratz AL, Ehde DM. Resilience and vulnerability in individuals with chronic pain and physical disability. Rehabil Psychol. 2016;61(1):7-18.

Hassett AL, Finan PH. The role of resilience in the clinical management of chronic pain. Curr Pain Headache Rep. 2016;20(39):1-9.

Náfrádi L, Kostova Z, Nakamoto K, Schulz PJ. The doctor-patient relationship and patient resilience in chronic pain: a qualitative approach to patients' perspectives. Chronic Illn. 2018;14(4):256-70.


Submitted date:
09/27/2018

Accepted date:
12/14/2018

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