Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200177
Brazilian Journal of Pain
Original Article

Intensity of pain, disability and psychosocial factors in women with chronic pelvic pain: cross-sectional study

Intensidade da dor, incapacidade funcional e fatores psicossociais em mulheres com dor pélvica crônica: um estudo transversal

Jennifer Nogueira Rocha; Luiz Eduardo de Castro; Virgínia Martello Riccobene; Michele Souza Menezes Autran; Leandro Alberto Calazans Nogueira; Felipe José Jandre dos Reis

http://dx.doi.org/10.5935/2595-0118.20200177 BrJP, vol.3, n3, p.239-244, 2020
PDF English
PDF Português
SciELO
Downloads: 0
Views: 637

Abstract

BACKGROUND AND OBJECTIVES: Chronic pelvic pain can be considered one of the main causes of morbidity and functional disability in women. The influence of psychosocial factors on chronic pelvic pain has been little explored in the literature. This study sought to characterize the profile of chronic pelvic pain in women, the presence of psychosocial factors and the association with pain and disability.

METHODS: This cross-sectional study included women with chronic pelvic pain. Data on pain, disability and psychosocial factors was collected using specific questionnaires. Analysis of frequency, central tendency and dispersion were presented. Pearson’s correlation test was used to verify the correlation between pain, disability and psychosocial factors. The statistical significance was set as alpha=95%.

RESULTS: The study consisted of 25 women, with a mean age of 45.4 years. The mean pain intensity at the time of the assessment was 4.76±3.39. The mean disability was 4.01±2.32. Anxiety presented a mean of 7.16±3.36 and stress 7.04±3.16. The level of disability had a negative correlation with pain intensity (r = -0.474; p=0.017), with the pain severity domain (r=-0.566; p=0.003) and with kinesiophobia (r = -0.550; p=0.001).

CONCLUSION: Women with chronic pelvic pain had moderate levels of pain intensity and disability. The psychosocial factors with the highest mean score were anxiety and stress. The intensity of pain and disability were correlated with each other and with kinesiophobia.

Keywords

Chronic pain, Pelvic pain, Psychosocial impact

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor pélvica crônica pode ser considerada uma das principais causas de morbidade e incapacidade funcional para as mulheres. A influência dos fatores psicossociais na dor pélvica crônica foi pouco explorada na literatura. O objetivo deste estudo foi caracterizar o perfil da dor pélvica crônica em mulheres, bem como buscar a presença de fatores psicossociais e a associação com dor e incapacidade.

MÉTODOS: Estudo transversal que incluiu mulheres com dor pélvica crônica. Os dados referentes da dor, incapacidade e os fatores psicossociais foram coletados utilizando questionários específicos. Foram apresentadas as análises de frequência, tendência central e dispersão dos dados. O teste de correlação de Pearson foi utilizado para verificar a correlação entre dor, incapacidade e fatores psicossociais. O valor de significância estatística adotado foi de alfa=95%.

RESULTADOS: O estudo foi composto por 25 mulheres, com média de idade de 45,4 anos. A intensidade de dor média no momento da avaliação foi de 4,76±3,39. A média de incapacidade foi de 4,01±2,32. A ansiedade apresentou média de 7,16±3,36 e estresse 7,04±3,16. O nível de limitação funcional teve correlação negativa com a intensidade da dor (r= -0,474; p=0,017), com o domínio gravidade da dor (r=-0,566; p=0,003) e com cinesiofobia (r= -0,550; p=0,001).

CONCLUSÃO: As mulheres com doença pélvica crônica apresentaram níveis moderados de intensidade de dor e limitação funcional. Os fatores psicossociais com maior pontuação média foram a ansiedade e estresse. A intensidade de dor e o nível de limitação funcional estiveram correlacionados entre si e com a cinesiofobia.

Palavras-chave

Dor crônica, Dor pélvica, Impacto psicossocial

References

Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms - Part I: Topics and Codes (F) Visceral and other syndromes of the trunk apart from spinal and radicular pain. .

Fall M, Baranowski AP, Fowler CJ, Lepinard V, Malone-Lee JG, Messelink EJ, Oberpenning F. EAU guidelines on chronic pelvic pain. Eur Urol. 2004;46(6):681-9.

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(8):781-826.

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.

Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Patterns of diagnosis and referral in women consulting for chronic pelvic pain in UK primary care. Br J Obstet Gynaecol. 1999;106(11):1156-61.

Zondervan K, Barlow DH. Epidemiology of chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14(3):403-14.

Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 1996;87(3):321-7.

Speer LM, Mushkbar S, Erbele T. Chronic pelvic pain in women. Am Fam Physician. 2016;93(5):380-7.

Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH. Chronic pelvic pain in the community--symptoms, investigations, and diagnoses. Am J Obstet Gynecol. 2001;184(6):1149-55.

Basch MC, Chow ET, Logan DE, Schechter NL, Simons LE. Perspectives on the clinical significance of functional pain syndromes in children. J Pain Res. 2015;8:675-86.

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.

Brodal P. A neurobiologist's attempt to understand persistent pain. Scand J Pain. 2017;15:140-7.

As-Sanie S, Kim J, Schmidt-Wilcke T, Sundgren PC, Clauw DJ, Napadow V. Functional connectivity is associated with altered brain chemistry in women with endometriosis-associated chronic pelvic pain. J Pain. 2016;17(1):1-13.

Ferreira Gurian MB, Poli Neto OB, Silva JC, Nogueira AA, Candido dos Reis FJ. Reduction of pain sensitivity is associated with the response to treatment in women with chronic pelvic pain. Pain Med. 2015;16(5):849-54.

Surah A, Baranidharan PG, Morley S. Chronic pain and depression. Continuing Education in Anaesthesia Critical Care & Pain. 2014;14(2):85-9.

Sheng J, Liu S, Wang Y, Cui R, Zhang X. The link between depression and chronic pain: neural mechanisms in the brain. Neural Plast. 2017;2017:9724371.

de Carvalho ACF, Poli-Neto OB, Crippa JAS, Hallak JEC, Osório FL. Associations between chronic pelvic pain and psychiatric disorders and symptoms. Arch Clin Psychiatry. 2015;42(1):25-30.

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9.

Documents and Forms. .

Ferreira KA, Teixeira MJ, Mendonza TR, Cleeland CS. Validation of brief pain inventory to Brazilian patients with pain. Support Care Cancer. 2011;19(4):505-11.

Pimenta CA, Teixeiro MJ. Questionário de dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enferm. 1996;30(3):473-83.

Horn KK, Jennings S, Richardson G, Vliet DV, Hefford C, Abbott JH. The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure. J Orthop Sports Phys Ther. 2012;42(1):30-42.

Costa LO, Maher CG, Latimer J, Ferreira PH, Ferreira ML, Pozzi GC. Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best?. Spine. 2008;33(22):2459-63.

Vaegter HB, Handberg G, Kent P. Brief psychological screening questions can be useful for ruling out psychological conditions in patients with chronic pain. Clin J Pain. 2018;34(2):113-21.

Kent P, Mirkhil S, Keating J, Buchbinder R, Manniche C, Albert HB. The concurrent validity of brief screening questions for anxiety, depression, social isolation, catastrophization, and fear of movement in people with low back pain. Clin J Pain. 2014;30(6):479-89.

Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain. 2014;155(12):2545-50.

Loving S, Thomsen T, Jaszczak P, Nordling J. Female chronic pelvic pain is highly prevalent in Denmark: A cross-sectional population-based study with randomly selected participants. Scand J Pain. 2014;5(2):93-101.

Gurian MB, Mitidieri AM, da Silva JB, da Silva AP, Pazin C, Poli-Neto OB. Measurement of pain and anthropometric parameters in women with chronic pelvic pain. J Eval Clin Pract. 2015;21(1):21-7.

Andersen LN, Juul-Kristensen B, Sørensen TL, Herborg LG, Roessler KK, Søgaard K. Efficacy of tailored physical activity or chronic pain self-management programme on return to work for sick-listed citizens: a 3-month randomised controlled trial. Scand J Public Health. 2015;43(7):694-703.

Nygaard AS, Stedenfeldt M, Øian P, Haugstad GK. Characteristics of women with chronic pelvic pain referred to physiotherapy treatment after multidisciplinary assessment: a cross-sectional study. Scand J Pain. 2019;19(2):355-64.

Nijs J, Roussel N, van Wilgen CP, Köke A, Smeets R. Thinking beyond muscles and joints: therapists' and patients' attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther. 2013;18(2):96-102.

Smart KM, Blake C, Staines A, Doody C. The Discriminative validity of "nociceptive","peripheral neuropathic", and "central sensitization" as mechanisms-based classifications of musculoskeletal pain. Clin J Pain. 2011;27(8):655-63.

Hsu AL, Sinaii N, Segars J, Nieman LK, Stratton P. Relating pelvic pain location to surgical findings of endometriosis. Obstet Gynecol. 2011;118(2):223-30.

Berghmans B. Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource. Int Urogynecol J. 2018;29(5):631-8.

Caumo W, Antunes LC, Elkfury JL, Herbstrith EG, Sipmann RB, Souza A. The Central Sensitization Inventory validated and adapted for a Brazilian population: psychometric properties and its relationship with brain-derived neurotrophic factor. J Pain Res. 2017;10:2109.

Levesque A, Riant T, Ploteau S, Rigaud J, Labat JJ. Clinical criteria of central sensitization in chronic pelvic and perineal pain (Convergences PP Criteria): Elaboration of a clinical evaluation tool based on formal expert consensus. Pain Med. 2018;19(10):2009-15.

Roth RS, Punch MR, Bachman JE. Patient beliefs about pain diagnosis in chronic pelvic pain: relation to pain experience, mood and disability. J Reprod Med. 2011;56(3-4):123-9.

Roth RS, Punch MR, Bachman JE. Educational achievement and pain disability among women with chronic pelvic pain. J Psychosom Res. 2001;51(4):563-9.

Siqueira-Campos VME, Da Luz RA, de Deus JM, Martinez EZ, Conde DM. Anxiety and depression in women with and without chronic pelvic pain: prevalence and associated factors. J Pain Res. 2019;12:1223-33.

Kellner R, Slocumb JC, Rosenfeld RC, Pathak D. Fears and beliefs in patients with the pelvic pain syndrome. J Psychosom Res. 1988;32(3):303-10.

Romão AP, Gorayeb R, Romão GS, Poli-Neto OB, dos Reis FJ, Rosa-e-Silva JC. High levels of anxiety and depression have a negative effect on quality of life of women with chronic pelvic pain. Int J Clin Pract. 2009;63(5):707-11.

Miller-Matero LR, Saulino C, Clark S, Bugenski M, Eshelman A, Eisenstein D. When treating the pain is not enough: a multidisciplinary approach for chronic pelvic pain. Arch Womens Ment Health. 2016;19(2):349-54.

Depression and other common mental disorders: global health estimates. 2017.

Abdallah CG, Geha P. Chronic pain and chronic stress: two sides of the same coin?. Chronic Stress (Thousand Oaks). 2017;1:2470547017704763.

Rosenbloom BN, Katz J, Chin KY, Haslam L, Canzian S, Kreder HJ. Predicting pain outcomes after traumatic musculoskeletal injury. Pain. 2016;157(8):1733-43.

Tesarz J, Eich W, Treede RD, Gerhardt A. Altered pressure pain thresholds and increased wind-up in adult patients with chronic back pain with a history of childhood maltreatment: a quantitative sensory testing study. Pain. 2016;157(8):1799-809.

Meltzer-Brody S, Leserman J, Zolnoun D, Steege J, Green E, Teich A. Trauma and posttraumatic stress disorder in women with chronic pelvic pain. Obstet Gynecol. 2007;109(4):902-8.

Pierce AN, Christianson JA. Stress and chronic pelvic pain. Prog Mol Biol Transl Sci. 2015;131:509-35.

Vlaeyen JW, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012;153(6):1144-7.

Vlaeyen JW, Crombez G, Linton SJ. The fear-avoidance model of pain. Pain. 2016;157(8):1588-9.

Crombez G, Vlaeyen JW, Heuts PH, Lysens R. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999;80(1-2):329-39.

Swinkels-Meewisse IE, Roelofs J, Verbeek AL, Oostendorp RA, Vlaeyen JW. Fear of movement/(re)injury, disability and participation in acute low back pain. Pain. 2003;105(1-2):371-9.

Somers TJ, Keefe FJ, Pells JJ, Dixon KE, Waters SJ, Riordan PA. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage. 2009;37(5):863-72.

Heuts PH, Vlaeyen JW, Roelofs J, de Bie RA, Aretz K, van Weel C. Pain-related fear and daily functioning in patients with osteoarthritis. Pain. 2004;110(1-2):228-35.

Lentz TA, Sutton Z, Greenberg S, Bishop MD. Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology. Arch Phys Med Rehabil. 2010;91(4):557-61.

Submitted date:
03/02/2020

Accepted date:
05/29/2020

5f6a556d0e8825c5059fefc6 brjp Articles
2595-3192 (Electronic) 2595-0118 (Printed)
BrJP ©2024 All rights reserved.

BrJP

Share this page
Page Sections