Influência da dor crônica na qualidade de vida em idosos

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Abstract

JUSTIFICATIVA E OBJETIVOS: A dor crônica é um dos problemas mais importantes, que dificultam consideravelmente a autonomia do idoso no desempenho de suas funções diárias, afetando sua qualidade de vida (QV). Os objetivos deste estudo foram avaliar a influência da dor crônica na QV dos idosos, usando a escala analógica visual (EAV) da dor e o questionário World Health Organization Quality of Life (WHOQOL-bref), observando suas repercussões nos quatro domínios: físico, psicológico, relações sociais e meio ambiente. MÉTODO: Realizou-se este estudo transversal descritivo, exploratório com uma amostragem de conveniência composta por 50 idosos, com diagnóstico clínico de dor crônica e idade igual ou superior a 60 anos. Foi utilizado como Instrumento de Avaliação, o questionário WHOQOL-bref e a EAV de Dor. RESULTADOS: Foram identificados 34% com distúrbios da coluna; 22% com artrite reumatoide, 18% com osteoporose, 14% com artrose e 12% com tendinopatias. Pela EAV foi identificado padrão de dor moderada. Houve uma influência negativa da dor crônica na QV dos idosos no domínio físico e nas relações sociais em relação aos voluntários controles. CONCLUSÃO: Este estudo evidenciou a presença de dor moderada avaliada pela escala unidimensional, com influências negativas na QV dos idosos, e os profissionais de saúde devem estar sempre atentos e utilizar métodos avaliativos que possam identificar a magnitude do quadro álgico, uma vez que muitas vezes o idoso não saber expressar adequadamente sua dor, para oferecer ao idoso todo o suporte de saúde necessário.

Translated abstract

BACKGROUND AND OBJECTIVES: Chronic pain is one of the most important problems considerably impairing autonomy of the elderly to perform their daily functions, highly impairing their quality of life (QL). This study aimed at evaluating the influence of chronic pain on the QL of the elderly, using the pain visual analog scale (VAS) and the World Health Organization Quality of Life (WHOQOL-bref) questionnaire, observing its repercussions on four domains: physical, psychological, social relations and environment. METHOD: This was a transversal, descriptive, exploratory study with a convenience sample of 50 elderly people with clinical diagnosis of chronic pain, aged 60 years or above. Evaluation tools were the WHOQOL-bref questionnaire and the pain VAS. RESULTS: We identified 34% with spinal disorders; 22% with rheumatoid arthritis, 18% with osteoporosis, 14% with arthritis and 12% with tendon injuries. Pain was moderate according to the VAS. There has been a negative influence of chronic pain on the QL of the elderly in the physical domain and in social relations as compared to control voluntary people. CONCLUSION: This study has shown the presence of moderate pain evaluated by the one-dimension scale, with negative influence on the QL of the elderly, and health professionals should be always attentive and should use evaluation methods which may identify the magnitude of pain, since very often the elderly do not know how to adequately explain their pain, to be able to offer the elderly all needed health support.

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Most cited references 13

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Age-related differences in the qualities but not the intensity of chronic pain.

Lucia Gagliese, Ronald Melzack (2003)

Age differences in the experience of chronic pain remain unclear. A serious barrier to progress in the field of pain and aging arises from the lack of data regarding the psychometric properties of pain scales for use with the elderly. The present study was designed to assess age differences in pain intensity and quality and to compare the psychometric properties of the McGill Pain Questionnaire (MPQ) in young and elderly chronic pain patients. Young (n=139, mean age=42.93+/-9.41 years) and elderly (n=139, mean age=70.12+/-7.51 years) pain center patients, matched on primary diagnosis or pain location, duration, and sex, completed the MPQ, numeric ratings (0-10) of pain intensity, a Pain Map, and the Hospital Anxiety and Depression Scale (HADS). A Pain Management Index (PMI) score was calculated for each patient. Age differences on the measure of pain qualities were found. The elderly group had significantly lower MPQ total and sensory scores and chose fewer words than the young group. However, there were no significant differences between the groups on numeric ratings of highest, usual, and lowest pain intensity. Similarly, there were no age differences on PMI, Pain Map, or the HADS Depression or Anxiety Subscales. Finally, the latent structure, internal consistency, and pattern of subscale correlations of the MPQ were very similar in the young and elderly groups. Possible explanations for the discrepancy in the pattern of age differences on measures of pain intensity and quality are explored. The implications of this pattern of age differences for basic pain mechanisms and pain management should be given serious empirical attention.