Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20210057
Brazilian Journal of Pain
Artigo Original

Catastrophic thinking and functional disability in Primary Health Care chronic pain patients

Pensamentos catastróficos e incapacidade funcional em portadores de dor crônica na Atenção Primária à Saúde

José Jefferson da Silva Cavalcanti Lins; João Paulo Lopes dos Passos; Antônio Plauto Oliveira Lima; Polyana Felipe Ferreira da Costa; Américo Danuzio Pereira de Oliveira; Rita di Cássia de Oliveira Angelo

http://dx.doi.org/10.5935/2595-0118.20210057 BrJP, vol.4, n4, p.321-326, 2021
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Abstract

BACKGROUND AND OBJECTIVES: Catastrophic thoughts are an important evaluative factor because they interfere with pain management and degree of disability since they affect responses to pain. The study aimed to investigate the relationship between catastrophic thoughts and the dimensions of functional disability in patients with chronic musculoskeletal pain in primary health care.

METHODS: A cross-sectional descriptive study that included 50 patients of both genders, aged 18 to 59 years, with chronic musculoskeletal pain, with intensity from 3 to 7 by the visual analog scale. To evaluate pain catastrophization, the Brazil validated Pain Catastrophizing Scale (B-PCS) was used and the interference of pain on function was assessed by the Pain Disability Index (PDI).

RESULTS: The majority of patients were female (94%), mean age 42±10.3 years, median pain 7 [6-7], basic schooling level (62%), unemployed (66%), and sedentary (76%). Catastrophizing (56%). The regions with the highest prevalence of pain were thoracolumbar (38%), anterior knees (32%), lumbosacral and face (30%). There was a direct and significant correlation between the PCS and PDI scores (ρ=0.56; p<0.01), as well as between the PDI scores and the subdomains: rumination (ρ=0.34; p <0.01), magnification (ρ=0.57; p <0.01) and helplessness (ρ=0.53; p <0.01).

CONCLUSION: People with chronic pain demonstrate a tendency towards the most unpleasant aspects of pain, resulting in less participation in daily activities, with impacts on functional capacity.

Keywords

Catastrophization, Chronic pain, Musculoskeletal pain, Primary health care

Resumo

JUSTIFICATIVA E OBJETIVOS: Os pensamentos catastróficos são fatores avaliativos importantes porque interferem no gerenciamento da dor e no grau de incapacidade, uma vez que mediam as respostas à dor. O estudo objetivou investigar a relação entre pensamentos catastróficos e as dimensões de incapacidade funcional em portadores de dores crônicas de origem musculoesquelética no âmbito da atenção básica a saúde.

MÉTODOS: Estudo descritivo transversal que incluiu 50 pacientes de ambos os sexos, com idade entre 18 e 59 anos, portadores de dor crônica musculoesquelética, com intensidade de 3 a 7 pela escala analógica visual. Para avaliação da catastrofização da dor foi utilizada a Escala de Pensamentos Catastróficos sobre a Dor (B-PCS) e a interferência da dor na funcionalidade foi avaliada pelo Índice de Incapacidade Relacionada à Dor (PDI).

RESULTADOS: A maioria dos pacientes foi do sexo feminino (94%), com média etária de 42±10,3 anos, mediana da dor 7 [6-7], nível fundamental de escolaridade (62%), sem emprego (66%) e sedentários (76%). Catastrofização (56%). A maior prevalência de dor foi identificada nas regiões toracolombar (38%), anterior dos joelhos (32%), lombossacral e face (30%). Houve correlação direta e significativa entre os escores da PCS e do PDI (ρ=0,56; p<0,01) e entre os escores do PDI e os subdomínios ruminação (ρ=0,34; p<0,01), magnificação (ρ=0,57; p<0,01) e desesperança (ρ=0,53; p<0,01).

CONCLUSÃO: Os portadores de dor crônica apresentaram orientação mental em direção aos aspectos mais desagradáveis da dor, acarretando menor participação nas atividades cotidianas, com repercussão sobre a capacidade funcional.

Palavras-chave

Atenção primária a saúde, Catastrofização, Dor crônica, Dor musculoesquelética

Referências

Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.

Silva FE, Dantas FR, Macena RH, Vasconcelos TB. Implementation process of the strategy of surveillance of chronic musculoskeletal pain in basic health care. Case report. Rev Dor. 2016;17(1):69-72.

Marques ES, Meziat Filho NA, Gouvea ME, Ferreira PS, Nogueira LA. Funcionalidade, fatores psicossociais e qualidade de vida em mulheres com predomínio de sensibilização central. BrJP. 2017;18(2):112-8.

Vasconcelos FH, Araújo GC. Prevalência de dor crônica no Brasil: estudo descritivo. BrJP. 2018;1(2):176-9.

Tsuboi Y, Murata S, Naruse F, Ono R. Association between pain-related fear and presenteeism among eldercare workers with low back pain. Eur J Pain. 2019;23(3):495-502.

Souza JB, Grossmann E, Perissinotti DMN, Oliveira Junior JO, Fonseca PRB, Posso IP. Prevalence of chronic pain, treatments, perception, and interference on life activities: Brazilian population-based survey. Pain Res Manag. 2017;2017:1-9.

De Paula Prudente M, Andrade DDBC, Prudente Filho FAA, Prudente EM. Tratamento da dor crônica na atenção primária à saúde. Braz J Develop. 2020;6(7):49945-62.

The International Classification of Functioning, Disability and Health (ICF). 2001.

Semeru GM, Halim MS. Acceptance versus catastrophizing in predicting quality of life in patients with chronic low back pain. Korean J Pain. 2019;32(1):22.

Sehn F, Chachamovich E, Vidor LP, Dall-Agnol L, Custodio de Souza IC, Torre IL. Cross-cultural adaptation and validation of the brazilian portuguese version of the pain catastrophizing scale (BP-PCS). Pain Med. 2012;13(11):1425-35.

Wheeler CHB, Williams ACC, Morley SJ. Meta-analysis of the psychometric properties of the pain catastrophizing scale and associations with participant characteristics. Pain. 2019;160(9):1946-53.

Martinez-Calderon J, Jensen MP, Morales-Asencio JM, Luque-Suarez A. Pain catastrophizing and function in individuals with chronic musculoskeletal pain: a systematic review and meta-analysis. Clin J Pain. 2019;35(3):279-93.

Huskisson EC. Measurement of pain. Lancet. 1974;304(7889):1127-31.

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.

Azevedo L, Pereira A, Dias C, Agualusa L, Lemos L, Romão J. Tradução, adaptação cultural e estudo multicêntrico de validação de instrumentos para rastreio e avaliação do impacto da dor crónica. Rev Dor. 2007;15(1):6-56.

Sardá Junior J, Nicholas MK, Pereira IA, Pimenta CAM, Asghari A, Cruz RM. Validação da escala de pensamentos catastróficos sobre dor. Acta Fisiátrica. 2008;15(1):31-6.

Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7(4):524-32.

Miot HA. Análise de correlação em estudos clínicos e experimentais. J Vasc Brasil. 2018;17(4):275-9.

Ranger TA, Cicuttini FM, Jensen TS, Manniche C, Heritier S, Urquhart DM. Catastrophization, fear of movement, anxiety, and depression are associated with persistent, severe low back pain and disability. Spine J. 2020;20(6):857-65.

Ogunlana MO, Odole AC, Adejumo A, Odunaiya N. Catastrophising, pain, and disability in patients with nonspecific low back pain. Hong Kong Physiother J. 2015;33(2):73-9.

Carvalho RC, Maglioni CB, Machado GB, Araújo JE, Silva JR, Silva ML. Prevalence and characteristics of chronic pain in Brazil: a national internet-based survey study. BrJP. 2018;1(4):331-8.

El-Shormilisy N, Strong J, Meredith PJ. Associations among gender, coping patterns and functioning for individuals with chronic pain: a systematic review. Pain Res Manag. 2015;20(1):48-55.

Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth. 2019;123(2):e273-83.

Mota PHS, Lima TA, Berach FR, Schmitt ACB. Impacto da dor musculoesquelética na incapacidade funcional. Fisioter Pesqui. 2020;27(1):85-92.

Glette M, Landmark T, Jensen MP, Woodhouse A, Butler S, Borchgrevink PC. Catastrophizing, solicitous responses from significant others, and function in individuals with neuropathic pain, osteoarthritis, or spinal pain in the general population. J Pain. 2018;19(9):983-95.

Almeida B, Capela A, Pinto J, Santos V, Silva CG, Rosa MC. Relationship between the perceived social support and catastrophization in individuals with chronic knee pain. BrJP. 2019;2(1):55-60.

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.

Adachi T, Nakae A, Maruo T, Shi K, Maeda L, Saitoh Y. The relationships between pain-catastrophizing subcomponents and multiple pain-related outcomes in Japanese outpatients with chronic pain: a cross-sectional study. Pain Pract. 2019;19(1):27-36.

Mehta S, Rice D, McIntyre A, Getty H, Speechley M, Sequeira K. Identification and characterization of unique subgroups of chronic pain individuals with dispositional personality traits. Pain Res Manag. 2016;2016(5187631):1-7.

Godoi JE, Reis DR, Carvalho JR, Deus JM. Chronic pelvic pain portraits: perceptions and beliefs of 80 women. BrJP. 2019;2(1):8-13.

Bonafé FSS, Campos LA, Marôco J, Campos JADB. Pain catastrophizing: rumination is a discriminating factor among individuals with different pain characteristic. Braz Oral Res. 2019;33:e113.

Esteve R, López-Martínez AE, Ruíz-Párraga GT, Serrano-Ibáñez ER, Ramírez-Maestre C. Pain acceptance and pain-related disability predict healthcare utilization and medication intake in patients with non-specific chronic spinal pain. IJERPH. 2020;17(15):5556.

Submetido em:
18/02/2021

Aceito em:
15/09/2021

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