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| Anexo 2 | 200.44 KB | Adobe PDF |
Abstract(s)
Introdução: A Artrite Reumatoide (AR) e a Fibromialgia (FM) são doenças músculo-esqueléticas e estão entre as causas mais comuns de dor crónica e incapacidade. Apresentam etiopatogenia, clínica, orientação terapêutica e evolução díspares, mas ambas condicionam limitações nas atividades da vida diária e profissionais, deterioração da qualidade de vida e da autoperceção da saúde global, podendo associar-se a perturbações psicológicas que vão modular o quadro evolutivo. É portanto fundamental, avaliar estes doentes integralmente e não apenas do ponto de vista clínico e analítico. Assim, procedeu-se a uma avaliação clínica e psicológica de uma amostra de doentes com AR e FM, comparando-os, e estabelecendo-se as relações consideradas pertinentes entre as variáveis estudadas.
Métodos: De Outubro de 2011 a Março de 2012, foram aplicados 51 questionários a doentes com AR e FM. Recolheu-se informação sociodemográfica e aplicaram-se instrumentos de avaliação da incapacidade funcional (HAQ), qualidade de vida (SF-36), autoperceção da dor e avaliação global da doença pelo doente por Escala Visual Analógica, atividade da doença (DAS-28 4V- apenas na AR), e de perturbações psicológicas de ansiedade, depressão e stress (EADS-21). Foram solicitadas análises para excluir patologias concomitantes, passíveis de enviesar os resultados dos instrumentos, e ainda doseado o anti-CCP nas doentes com AR.
Resultados: As pacientes com FM apresentam maior autoperceção da dor, ansiedade, depressão e stress, e menor qualidade de vida (exceto na função física), comparativamente às doentes com AR. Não há diferenças estatisticamente significativas quanto à incapacidade funcional.
Nos dois grupos de doentes, maior ansiedade, depressão e stress correlacionam-se com maior incapacidade funcional e autoperceção da dor, e com menor qualidade de vida na maioria das suas dimensões.
Maior autoperceção da dor correlaciona-se com maior incapacidade funcional. Por sua vez, maior incapacidade funcional e autoperceção da dor correlacionam-se com menor qualidade de vida, na maioria das suas dimensões.
Nas doentes com AR, maior atividade da doença correlaciona-se com menor qualidade de vida apenas em termos de função física. Não há correlação da atividade da doença com as perturbações psicológicas e a incapacidade funcional. Doentes com anti-CCP positivo apresentam maior incapacidade funcional.
Conclusão: É fundamental uma avaliação holística e uma abordagem terapêutica multidisciplinar das doentes com FM e AR, de modo a assegurar cuidados de saúde abrangentes. É de salientar a importância de usar instrumentos de avaliação das perturbações psicológicas, da qualidade de vida, da auto-percepção da dor, da incapacidade funcional, e ainda da atividade da doença em doentes com AR, porque permitem compreender a perceção do doente sobre a sua doença e implementar estratégias terapêuticas mais adequadas.
Introduction: Rheumatoid arthritis (RA) and Fibromyalgia (FM) are musculoskeletal diseases and they are among the most common causes of chronic pain and incapacity. They present variable etiology, signs and symptoms, treatment and evolution, but both cause limitations on daily and professional activities, deterioration of the quality of life, of self-perception of general health, which might be associated with psychological problems that might affect the course of the disease. For this reason, it is crucial to evaluate these patients integrally, and not only clinically or analytically. Thus, a clinical and psychological evaluation was performed on a sample of patients with RA and FM, comparing them and establishing correlations between the several variables studied. Method: Between October 2011 and March 2012, 51 questionnaires were applied to patients with RA and FM. Social-demographic data was obtained, and tools for the evaluation of the functional incapacity (HAQ), quality of life (SF-36), self-perception of pain and global evaluation of the disease by the patient using Visual Analogue Scale, activity of the disease (DAS-28 4V – only in RA) and psychological disorders of anxiety, depression and stress (DASS21) were applied. Blood tests were requested to exclude other present pathologies in these patients, that could bias the results of the tools, and the anti-CCP was measured in the patients with RA. Results: The patients with FM present increased self-perception of pain, anxiety, depression and stress, and less quality of life (except in the physical function), when compared with the RA patients. There is no statistically significant difference between the two groups regarding the functional incapacity. In the two groups of patients, more anxiety, depression and stress correlate with an increased functional incapacity and self-perception of pain, and with less quality of life in most of its dimensions. An increased self-perception of pain correlates with an increased functional incapacity. On the other hand, an increased functional incapacity and self-perception of pain correlate with less quality of life in most of its dimensions. In the patients with RA, an increased activity of the disease correlates with less quality of life only in terms of physical function. There is no correlation of the activity of the disease with psychological disorders or functional incapacity. Patients with a positive anti-CCP present an increased functional incapacity. Conclusions: It is crucial to perform a holistic evaluation and a multidisciplinary therapeutic approach on patients with FM and RA, in order to assure an integrated health care to these patients. The importance of using evaluation tools of the psychological disorders, of the quality of life, of the self-perception of pain, of functional incapacity, and also of the activity of the disease in patients with RA should be noted, because they allow understanding patient’s perception about his disease and implement more adequate therapeutic strategies.
Introduction: Rheumatoid arthritis (RA) and Fibromyalgia (FM) are musculoskeletal diseases and they are among the most common causes of chronic pain and incapacity. They present variable etiology, signs and symptoms, treatment and evolution, but both cause limitations on daily and professional activities, deterioration of the quality of life, of self-perception of general health, which might be associated with psychological problems that might affect the course of the disease. For this reason, it is crucial to evaluate these patients integrally, and not only clinically or analytically. Thus, a clinical and psychological evaluation was performed on a sample of patients with RA and FM, comparing them and establishing correlations between the several variables studied. Method: Between October 2011 and March 2012, 51 questionnaires were applied to patients with RA and FM. Social-demographic data was obtained, and tools for the evaluation of the functional incapacity (HAQ), quality of life (SF-36), self-perception of pain and global evaluation of the disease by the patient using Visual Analogue Scale, activity of the disease (DAS-28 4V – only in RA) and psychological disorders of anxiety, depression and stress (DASS21) were applied. Blood tests were requested to exclude other present pathologies in these patients, that could bias the results of the tools, and the anti-CCP was measured in the patients with RA. Results: The patients with FM present increased self-perception of pain, anxiety, depression and stress, and less quality of life (except in the physical function), when compared with the RA patients. There is no statistically significant difference between the two groups regarding the functional incapacity. In the two groups of patients, more anxiety, depression and stress correlate with an increased functional incapacity and self-perception of pain, and with less quality of life in most of its dimensions. An increased self-perception of pain correlates with an increased functional incapacity. On the other hand, an increased functional incapacity and self-perception of pain correlate with less quality of life in most of its dimensions. In the patients with RA, an increased activity of the disease correlates with less quality of life only in terms of physical function. There is no correlation of the activity of the disease with psychological disorders or functional incapacity. Patients with a positive anti-CCP present an increased functional incapacity. Conclusions: It is crucial to perform a holistic evaluation and a multidisciplinary therapeutic approach on patients with FM and RA, in order to assure an integrated health care to these patients. The importance of using evaluation tools of the psychological disorders, of the quality of life, of the self-perception of pain, of functional incapacity, and also of the activity of the disease in patients with RA should be noted, because they allow understanding patient’s perception about his disease and implement more adequate therapeutic strategies.
Description
Keywords
Artrite reumatóide - Avaliação clínica Artrite reumatóide - Qualidade de vida Fibromialgia - Avaliação clínica Fibromialgia - Qualidade de vida
Pedagogical Context
Citation
Publisher
Universidade da Beira Interior