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Abstract(s)
Introdução: A dor lombar crónica é um problema comum e tem um impacto elevado na vida das pessoas afetadas, com repercussões a nível físico, psicológico, social e económico. O estudo Global Burden of Disease de 2010 revelou que é a principal causa de incapacidade a nível mundial e em Portugal. A dor lombar afeta pessoas de todas as idades e classes socioeconómicas, pelo que deve ser considerada um problema de saúde pública.
Objetivos: Conhecer as características e impacto da dor lombar crónica nos utentes do Centro de Saúde da Covilhã. Avaliar a intensidade da dor, a incapacidade funcional e a gravidade de depressão. Estudar as relações entre estas variáveis.
Material e métodos: Estudo observacional, descritivo e transversal que incidiu sobre os utentes do Centro de Saúde da Covilhã, com idade igual ou superior a 18 anos. Foi utilizada uma amostra não aleatória de utentes consecutivos que recorreram à consulta com queixa de dor lombar crónica, entre junho e dezembro de 2014. Os dados foram recolhidos através de questionário constituído por 4 partes: caracterização sociodemográfica; caracterização da dor lombar (duração, frequência, intensidade, absentismo laboral, medicação analgésica e problemas associadas); Índice de incapacidade de Oswestry (ODI) 2.1a; Questionário sobre a saúde do paciente-9 (PHQ-9) para depressão.
Resultados: Participaram no estudo 21 pessoas de ambos os sexos, com idade média de 57,48 anos. A intensidade média da dor foi 6,13, com mais de metade dos doentes a referirem dor lombar intensa que ocorre diariamente, muitos deles há pelo menos 4 anos. A média do ODI foi 30,87% (incapacidade moderada) e do PHQ-9 foi 8,57 pontos (depressão leve), mas mais de 40% dos indivíduos tiveram um score sugestivo de depressão clinicamente significativa. A intensidade da dor e a incapacidade apresentaram uma correlação linear positiva significativa com a gravidade de depressão. Todas estas variáveis apresentaram scores mais elevados nos indivíduos com outros problemas associados à dor lombar (por exemplo, hérnia discal ou osteoporose).
Discussão: A dor lombar crónica associou-se a incapacidade funcional e depressão. Esta última revelou ser um fator determinante na intensidade da dor e no nível de incapacidade. Estes dados são consistentes com outros estudos realizados na área. Por esta razão, a dor lombar crónica deve ser entendida como um problema biopsicossocial, destacando-se a importância da avaliação dos fatores psicológicos e sociais na abordagem do doente.
Introduction: Chronic low back pain is a common problem with strong impact on the affected people, having implications on the physical, psychological, social and economic level. The ‘Global Burden of Disease Study 2010’ revealed that low back pain is the leading cause of disability both worldwide and in Portugal. This problem affects people of all ages and socio-economic groups, therefore it should be treated as a public health issue. Objectives: To characterize chronic low back pain and its impact on the patients of the primary care clinic of Covilhã. To evaluate the intensity of pain, the functional disability and the depression severity in this patients. To study the relationships between these variables. Material and Methods: Observational, descriptive, cross-sectional study. The target population comprised the patients of the primary care clinic of Covilhã aged above 18 years. It was used a non-random sample of consecutive patients that went to a consultation with complaint of chronic low back pain, between June and December, 2014. Data were collected with a questionnaire divided in four sections: socio-demographic characterization; low back pain characterization (duration, frequency, intensity, work absenteeism, pain medication and associated problems); Oswestry Disability Index (ODI) 2.1a; Patient Health Questionnaire-9 (PHQ-9) for depression. Results: The study included 21 individuals of both sexes, with a mean age of 57,48 years. The average intensity of pain was 6,13. More than a half of the participants referred severe low back pain which occurs daily, many of them for at least 4 years. The mean score of ODI was 30,87% (moderate disability) and of PHQ-9 was 8,57 points (mild depression), but more than 40% of individuals had a PHQ-9 score suggestive of clinically significant depression. Both pain intensity and disability showed a positive linear correlation with the severity of depression. All of these variables showed higher scores in individuals with additional problems associated with low back pain (for instance, herniated disc or osteoporosis). Discussion: This study showed that chronic low back pain and depression are related and that depression is a crucial factor in the intensity of pain and disability level. This finding is consistent with other studies in the field. Therefore, chronic low back pain should be understood as biopsychosocial problem, by including the evaluation of psychological and social factors in the patient management.
Introduction: Chronic low back pain is a common problem with strong impact on the affected people, having implications on the physical, psychological, social and economic level. The ‘Global Burden of Disease Study 2010’ revealed that low back pain is the leading cause of disability both worldwide and in Portugal. This problem affects people of all ages and socio-economic groups, therefore it should be treated as a public health issue. Objectives: To characterize chronic low back pain and its impact on the patients of the primary care clinic of Covilhã. To evaluate the intensity of pain, the functional disability and the depression severity in this patients. To study the relationships between these variables. Material and Methods: Observational, descriptive, cross-sectional study. The target population comprised the patients of the primary care clinic of Covilhã aged above 18 years. It was used a non-random sample of consecutive patients that went to a consultation with complaint of chronic low back pain, between June and December, 2014. Data were collected with a questionnaire divided in four sections: socio-demographic characterization; low back pain characterization (duration, frequency, intensity, work absenteeism, pain medication and associated problems); Oswestry Disability Index (ODI) 2.1a; Patient Health Questionnaire-9 (PHQ-9) for depression. Results: The study included 21 individuals of both sexes, with a mean age of 57,48 years. The average intensity of pain was 6,13. More than a half of the participants referred severe low back pain which occurs daily, many of them for at least 4 years. The mean score of ODI was 30,87% (moderate disability) and of PHQ-9 was 8,57 points (mild depression), but more than 40% of individuals had a PHQ-9 score suggestive of clinically significant depression. Both pain intensity and disability showed a positive linear correlation with the severity of depression. All of these variables showed higher scores in individuals with additional problems associated with low back pain (for instance, herniated disc or osteoporosis). Discussion: This study showed that chronic low back pain and depression are related and that depression is a crucial factor in the intensity of pain and disability level. This finding is consistent with other studies in the field. Therefore, chronic low back pain should be understood as biopsychosocial problem, by including the evaluation of psychological and social factors in the patient management.
Description
Keywords
Cuidados de Saúde Primários Depressão Dor Lombar Crónica Incapacidade Intensidade da Dor