Chronic pain and labor activity
psychosocialcharacteristics of patients at a pain clinic in the inner paulista
Keywords:
Chronic pain, psychosocial aspects, work activityAbstract
Estimative studies indicate that the main global diseases in the year 2030 will be chronic diseases that present pain as symptoms. In this sense, the present study aims to carry out a survey of the psychosocial characteristics and the correlation with the work activity of patients treated at a Pain Clinic. A retrospective study was carried out using archived data from psychological assessments of two hundred and one patients diagnosed with non-cancer chronic pain of varied etiology undergoing treatment at the Pain Clinic of the Hospital de Base de São José do Rio Preto – SP. In total, data from 187 patients were used. Fourteen protocols were excluded due to incomplete data. There was a predominance of female patients (68.4%), married (64.7%), with up to elementary school (65.8%), and with a mean age of 47 years (±12.06), ranging from 18 to 77 years. As for professional activity, 71.1% were inactive, being: n=96 (51.3%) on leave, n=13 (6.95%) unemployed and n=24 (12.8%) retired. Pain intensity was assessed using the Analog Pain Scale that ranged from 1 to 10 points, considering a scale from 0 (no pain) to 10 (unbearable pain), with an average intensity of 7.75 points. The mean duration of pain ranged from six months to forty years, with a mean of 84.1 (±82.02) months, about 7 years. The CPSS data showed that 140 patients (74.9%) had indicators of low self-efficacy regarding symptom control, perceived ability to deal with pain and perform their daily tasks. The Anxiety and Depression Scale (HAD) in this sample showed that about n=138 patients (73.8%) presented indications for a possible diagnosis of anxiety and n=133 patients (71.1%) presented indicators for a possible diagnosis of anxiety. depression. Of these, n=118 (63.1%) had indicators of concomitant anxiety and depression. A relationship was observed between self-efficacy and occupational activity. Comparing the means of self- -efficacy scores between active patients involved in paid and unpaid activities (160.6) and the mean of self-efficacy scores of participants who are professionally inactive - away, retired, unemployed and not involved in unpaid activities (129.2) it was possible to verify a statistically significant difference in self-efficacy indicators (p=0.0007). The data also point to a significant difference between active and inactive in anxiety (p=0.0003) and depression (p=0.0003) scores. Therefore, the Inventory of Attitudes towards Pain (IAD) in this sample resulted in a significant difference in relation to participants involved in occupational activities and those not involved, in the control subscales (p=0.0332) physical harm (p=0.0464) medication (p=0.0018) and disability (p=0.0182). Active patients have a shorter time of living with pain, but without statistical significance. There was also no significant difference between the pain intensity of active patients and those considered inactive. Therefore, in this study, low self-efficacy, dysfunctional beliefs, vulnerability to anxiety and depression were more associated with patients considered inactive.
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