Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20240004-en
Brazilian Journal of Pain
Artigo Original

Impact of the COVID-19 pandemic on the perception of treatment and chronic musculoskeletal pain in users of a family health unit: qualitative study

Impacto da pandemia da COVID-19 na percepção do tratamento e da dor musculoesquelética crônica em usuários de uma unidade de saúde da família: estudo qualitativo

Maria de Paula Faria; Letícia Jonas de Freitas; Paula Nunes Cordeiro Soares; Anamaria Siriani de Oliveira; Tainan de Castro Silva

Downloads: 0
Views: 37

Abstract

BACKGROUND AND OBJECTIVES: Chronic pain has a high demand for health care due to its multifactorial cause. The COVID-19 pandemic represented a scenario of social stress, in which there was a reduction in care for chronic non-communicable diseases, including cases of chronic pain. The aim of this study was to understand the impacts of the pandemic on this population, considering the perception of pain, experience with care and mental health.
METHODS: This is an exploratory case study using a qualitative methodology. An intentional sample of six patients diagnosed with chronic musculoskeletal pain, of both genders and aged between 30 and 70 was used. The individuals underwent a semi-structured interview, in which the data was analyzed by thematic analysis and coding.
RESULTS: After the analysis, three themes emerged: 1) Multidimensional impact of pain and coping strategies; 2) Characteristics of the health service and individual-centered care; 3) Influence of pain on quality of life and perspective of future life. The impact of health care was a factor of anxiety and uncertainty about pain. It had repercussions on new coping strategies, such as telehealth. In this context, Primary Health Care was a scenario capable of managing the short- and long-term quality of life of individuals with chronic pain.
CONCLUSION: This study contributed to understanding the impact of the COVID-19 pandemic on individuals with chronic pain, which represents a challenge to current care.

Keywords

Chronic pain, COVID-19, Musculoskeletal pain, Primary health care

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor crônica apresenta alta demanda de assistência à saúde, devido a sua causa multifatorial. A pandemia da COVID-19 representou um cenário de estresse social, em que houve redução de atendimentos às doenças crônicas não transmissíveis, incluindo os casos de dores crônicas. O objetivo deste estudo foi compreender os impactos da pandemia para este público, considerando a percepção da dor, experiência com assistência e saúde mental. 
MÉTODOS: Trata-se de um estudo de caso exploratório de metodologia qualitativa. Foi utilizada uma amostra intencional de seis pacientes com diagnóstico de dor musculoesquelética crônica, de ambos os sexos e com idade entre 30 e 70 anos. Os indivíduos passaram por uma entrevista semiestruturada, na qual os dados foram analisados por análise temática e codificação. 
RESULTADOS: Após a análise, emergiram três temas: 1) Impacto multidimensional da dor e estratégias de enfrentamento; 2) Características do serviço de saúde e atenção centrada no indivíduo; 3) Influência da dor na qualidade de vida e na perspectiva de vida futura. O impacto na assistência à saúde foi um fator de ansiedade e incertezas sobre a dor. Isso repercutiu em novas estratégias de enfrentamento, como os teleatendimentos. Nesse contexto, a Atenção Primária à Saúde foi o cenário capaz de gerenciar a qualidade de vida a curto e a longo prazo dos indivíduos com dor crônica. 
CONCLUSÃO: Este estudo contribuiu para a compreensão do impacto da pandemia da COVID-19 em indivíduos com dor crônica, o qual representa desafios à assistência atual.

Palavras-chave

Atenção primária à saúde, COVID-19, Dor crônica, Dor musculoesquelética

Referências

1 Leadley RM, Armstrong N, Lee YC, Allen A, Kleijnen J. Chronic diseases in the European Union: the prevalence and health cost implications of chronic pain. J Pain Palliat Care Pharmacother. 2012;26(4):310-25.

2 Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, Keefe FJ, Mogil JS, Ringkamp M, Sluka KA, Song XJ, Stevens B, Sullivan MD, Tutelman PR, Ushida T, Vader K. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.

3 Perrot S, Cohen M, Barke A, Korwisi B, Rief W, Treede RD; IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic secondary musculoskeletal pain. Pain. 2019;160(1):77-82.

4 Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA, Kaasa S, Kosek E, Lavand’homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, Wang SJ. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-7.

5 Vargas C, Bilbeny N, Balmaceda C, Rodríguez M F, Zitko P, Rojas R, Eberhard ME, Ahumada M, Espinoza MA. Costs and consequences of chronic pain due to musculoskeletal disorders from a health system perspective in Chile. Pain Rep. 2018;3(5):e656.

6 Clauw DJ, Häuser W, Cohen S P, Fitzcharles MA. Considering the potential for an increase in chronic pain after the COVID-19 pandemic. Pain. 2020;161(8):1694-7.

7 Aguiar D P, Souza C P, Barbosa WJ, Santos-Júnior F F, Oliveira AS. Prevalence of chronic pain in Brazil: systematic review. BrJP. 2021;4(3):257-67.

8 Carter JJ, Watson AC, Sminkey PV. Pain management: screening and assessment of pain as part of a comprehensive case management process. Prof Case Manag. 2014;19(3):126-34; quiz 135-6.

9 Tseli E, LoMartire R, Vixner L, Grooten WJA, Gerdle B, Äng BO. What is the effectiveness of different duration interdisciplinary treatment programs in patients with chronic pain? A large-scale longitudinal register study. J Clin Med. 2020;9(9):2788.

10 Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, van Tulder MW. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015;18;350:h444.

11 Guimarães BEB, Branco ABAC. Trabalho em equipe na atenção básica à saúde: pesquisa bibliográfica. Rev Psicol Saúde. 2020;12(1):143-55.

12 Brasil. Protocolo Clínico e Diretrizes Terapêuticas: Dor Crônica. Portaria SAS/MS nº 1.083, de 02 de outubro de 2012. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/sas/2012/prt1083_02_10_2012.html.

13 Nicholas M, Vlaeyen JWS, Rief W, Barke A, Aziz Q, Benoliel R, Cohen M, Evers S, Giamberardino MA, Goebel A, Korwisi B, Perrot S, Svensson P, Wang SJ, Treede RD; IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic primary pain. Pain. 2019;160(1):28-37.

14 Facchini LA, Tomasi E, Dilélio AS. Qualidade da Atenção Primária à Saúde no Brasil: avanços, desafios e perspectivas. Saúde Debate. 2018;42(spe1):208-23.

15 Alves MLF, Guedes HM, Martins JCA, Chianca TCM. Reference and counter reference network for emergency care assistance in a municipality in the countryside of Minas Gerais, Brazil. Rev Médica Minas Gerais. 2015;25(4):469-75.

16 Fortes S. Queixas somáticas sem explicação médica. In: DUNCAN BB . Medicina ambulatorial: condutas de atenção primária baseadas em evidências. 4ª. Porto Alegre, Artmed, 2022.

17 Karos K, McParland JL, Bunzli S, Devan H, Hirsh A, Kapos F P, Keogh E, Moore D, Tracy LM, Ashton-James CE. The social threats of COVID-19 for people with chronic pain. Pain. 2020;161(10):2229-35.

18 Shanthanna H, Strand NH, Provenzano DA, Lobo CA, Eldabe S, Bhatia A, Wegener J, Curtis K, Cohen S P, Narouze S. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia. 2020;75(7):935-44.

19 Morin CM, Bjorvatn B, Chung F, Holzinger B, Partinen M, Penzel T, Ivers H, Wing YK, Chan NY, Merikanto I, Mota-Rolim S, Macêdo T, De Gennaro L, Léger D, Dauvilliers Y, Plazzi G, Nadorff MR, Bolstad CJ, Sieminski M, Benedict C, Cedernaes J, Inoue Y, Han F, Espie CA. Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study. Sleep Med. 2021;87(1):38-45.

20 Turk DC, Fillingim RB, Ohrbach R, Patel KV. Assessment of psychosocial and functional impact of chronic pain. J Pain. 2016;17(9 Suppl):T21-49.

21 Hammock AC, Majumdar Das S, Mathew A, Johnson S. An exploratory qualitative study of undergraduate men’s perspectives on sexual violence bystander education. J Am Coll Health. 2022;70(4):1223-30.

22 Knox M. Design-related impacts on end-of-life experience: a brief report of findings from an exploratory qualitative study. Am J Hosp Palliat Care. 2023;40(7):753-60.

23 Trenholm-Jensen EA, Burns L, Trenholm JE, Hand CJ. Beyond tingles: An exploratory qualitative study of the Autonomous Sensory Meridian Response (ASMR). PLoS One. 2022;17(12):e0277962.

24 Christine C, Suto M. Qualitative research for occupational and physical therapists: a practical guide. Blackwell Publishing; 2008.

25 Klem NR, Shields N, Smith A, Bunzli S. Demystifying qualitative research for musculoskeletal practitioners Part 3: phenomeno-what? understanding what the qualitative researchers have done. J Orthop Sports Phys Ther. 2022;52(1):3-7.

26 Gil AC. Métodos e técnicas de pesquisa social. São Paulo: Atlas, 1994;(4)207.

27 Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-57.

28 O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245-51.

29 Cássia R De Oliveira M De. (Entre) Linhas De Uma Pesquisa: o Diário de Campo como dispositivo de (in) formação na/da abordagem (Auto) biográfica. Rev Bras Educ Jovens e Adultos. 2014;2(4):69-87. https://www.revistas.uneb.br/index.php/educajovenseadultos/article/view/1059.

30 Korstjens I, Moser A. Series: Practical guidance to qualitative research. Part 2: context, research questions and designs. Eur J Gen Pract. 2017;23(1):274-9.

31 Braun V, Clarke, V. Using thematic analysis in psychology. Qualitative Res Psychol, 2006;3(2):77-101.

32 Kiger ME, Varpio L. Thematic analysis of qualitative data: AMEE Guide No. 131. Med Teach. 2020;42(8):846-54.

33 Moser A, Korstjens I. Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. Eur J Gen Pract. 2018;24(1):9-18.

34 Mohamed Ali O, Borg Debono V, Anthonypillai J, Hapidou EG. A Qualitative study of the impact of the COVID-19 pandemic on a sample of patients with chronic pain. J Patient Exp. 20227;9:23743735221089698.

35 Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;(4):CD011279.

36 Chatkoff DK, Leonard MT, Najdi RR, Cruga B, Forsythe A, Bourgeau C, Easton H. A Brief survey of the COVID-19 pandemic’s impact on the chronic pain experience. Pain Manag Nurs. 2022;23(1):3-8.

37 Balestra AM, Chalk K, Spies C, Denke C, Krampe H, Tafelski S. Living with chronic pain during the covid-19 pandemic: a qualitative analysis. J Pain Res. 2022;5;15:969-81.

38 Vlaeyen, Johan W. S.; Linton, Steven J. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012;153(6):1144-7.

39 Dassieu L, Pagé MG, Lacasse A, Laflamme M, Perron V, Janelle-Montcalm A, Hudspith M, Moor G, Sutton K, Thompson JM, Choinière M. Chronic pain experience and health inequities during the COVID-19 pandemic in Canada: qualitative findings from the chronic pain & COVID-19 pan-Canadian study. Int J Equity Health. 2021;20(1):147.

40 Garnæs KK, Mørkved S, Tønne T, Furan L, Vasseljen O, Johannessen HH. Mental health among patients with chronic musculoskeletal pain and its relation to number of pain sites and pain intensity, a cross-sectional study among primary health care patients. BMC Musculoskelet Disord. 2022;23(1):1115.
 


Submetido em:
26/04/2023

Aceito em:
22/11/2023

666077f8a953957cce1c2ed3 brjp Articles

BrJP

Share this page
Page Sections