Marcos Henrique Foss

Uso de questionários para avaliar a multidimensionalidade e a qualidade de vida do fibromiálgico

Fibromyalgia syndrome (FMS) is a painful condition of unknown etiology, highly prevalent, and associated with other conditions, which causes great impact on daily life and quality of life. OBJECTIVE: To assess, due to the multifactorial character of the FMS, the discriminating power of instruments used to identify good indicators of self-assessment and self-knowledge. PATIENTS AND METHODS: This is a descriptive, exploratory, comparative, cross-sectional study with quantitative approach, and sample comprising a treatment group (T), diagnosed with FMS (n = 63) and a control group (C), undergoing interconsultation at the Pain Outpatient Clinic (n = 75). The following instruments were used: Fibromyalgia Impact Questionnaire (FIQ); visual analogue scale (VAS); McGill Pain Questionnaire; and the Post-Sleep Inventory (PSI). To evaluate the quality of life, Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) was used. RESULTS: In the two groups, female gender predominated. The mean age of the sample was 42.3 ± 4.3 years, 45% were married, and the average schooling was 8 ± 3.5 years. The mean duration of pain was 3.2 years, and a mean time of two years were required for the clinical diagnosis of FMS in group T. Group T had higher levels of pain, anxiety, and depression, worse quality of sleep, less flexibility, and worse quality of life, although some of these symptoms were also present in group C. CONCLUSIONS: All instruments had good discriminating power (P < 0.05), especially FIQ, VAS and PSI, whose areas under the ROC curve were greater

Perfil sócio-demográfico e clínico de uma coorte de pacientes encaminhados a uma Clinica de Dor

BACKGROUND AND OBJECTIVES: There is little information in Brazil about the profile of Pain Clinic users and the impact of this demand on health services. This study aimed at identifying the profile of patients referred to a Pain Clinic using socio-demographic and clinical variables obtained by specific screening, correlating such variables to pain duration and intensity. METHOD: This is a cohort descriptive, transversal and exploratory study with 128 individuals seen by an outpatient setting specialized in pain management. Independent variables included age, gender, marital status, labor status, education, religiousness, ethnicity, clinic referring patients, original diagnosis, Pain Clinic diagnosis, pain duration and type. Evaluation tools were an electronic card and the physical evaluation performed by a pain specialist. Data were collected at first visit before the interaction with any health care provider. RESULTS: Pain was more prevalent among females (58.5%), married (66.4%), inactive (62.5%) and in those with mean school attendance of 6.8 ± 3.5 years. Most have religious beliefs (93.7%). Mean pain duration was 32.6 ± 21.9 months. There has been positive correlation between pain intensity and longer duration among females and educational level lower than 5 years. (p < 0.05). CONCLUSION: Chronic pain patients previously under the care of a different specialty and referred to a Pain Clinic supply data which may contribute to control pain with more effective therapeutic approaches, by the interaction of the knowledge of different professionals.

Melhora da qualidade de vida de pacientes com dor neuropática utilizando de monitorização ambulatorial contínua

JUSTIFICATIVA E OBJETIVOS: O manuseio da dor de paciente com dor cronica exige uma abordagem multifuncional, que implica fisica, psicologica, social e ocupacional. O entendimento da fisiopatologia da dor e sua avaliacao precisam otimizar o tratamento. O objetivo deste estudo foi avaliar de forma abrangente os mais fortes preditores de qualidade de vida atraves de registros semanais realizados em regime ambulatorial e domiciliar verificando atividades de vida pratica e diaria. METODO: Foram aplicados os instrumentos: Inventario de Dor de Wisconsin, Grafico de Humor, Questionario de Dor McGill, Protocolo Pos-Sono e Questionario generico de qualidade de vida (Whoqol-bref). RESULTADOS: A atividade fisica, o desempenho ocupacional e o padrao de sono prenunciaram melhor qualidade de vida. A sensibilidade a dor, evitar o medo, e dependencia de outra pessoa sao responsaveis por quantidade significativa da variacao nas atividades propostas. Estes achados sugerem que as fontes externas de reforco e orientacao podem servir para influenciar o comportamento fisico e social alem de pistas internas, tais como evitar o medo ou a dor. CONCLUSAO: A dor cronica neuropatica deve ser avaliada em suas particularidades de apresentacao clinica, comportamental e aspectos sociais, ja que tais elementos sao fundamentais para uma boa evolucao.

Impacto da terapia manual visceral na melhora da qualidade de vida de pacientes com dor abdominal crônica

JUSTIFICATIVA E OBJETIVOS: A dor abdominal secundaria a constipacao intestinal cronica funcional (CICF) afeta uma proporcao substancial de pessoas, especialmente mulheres. O objetivo deste estudo foi avaliar a eficacia da terapia manual visceral (TMV) em pacientes que pertencem a uma Clinica de Dor, a fim de comprovar essa intervencao na melhora da constipacao e no aumento da mobilidade lombar, e na consequente melhora da qualidade de vida (QV). METODO: Trata-se de um ensaio clinico, com amostra de conveniencia de 20 pacientes com queixa de alteracao na funcao intestinal e restricao da mobilidade vertebral lombar. Foram analisadas as caracteristicas biossociodemograficas e utilizados o formulario Criterio de Roma III, os testes de Schober e do terceiro dedo ao chao e o questionario generico de QV SF-36, para avaliacao da constipacao, da mobilidade lombar e da QV, respectivamente, antes e apos receber a terapia manual visceral (TMV). RESULTADOS: Pacientes, principalmente do sexo feminino, media de idade de 38,42, ± 19,23 apresentaram melhora significativa entre a avaliacao e a reavaliacao em quatro dominios do SF-36 (capacidade funcional, dor, estado geral de saude e vitalidade - p < 0,05) e melhora da constipacao intestinal e da mobilidade lombar. CONCLUSAO: A TMV proposta e aplicada nos individuos com dor abdominal cronica secundaria a CICF deste estudo foi capaz de melhorar a constipacao intestinal e a mobilidade lombar, bem como a QV dos participantes.

Alterações posturais em cirurgiões provocadas pela atividade profissional

BACKGROUND: Any deviation from the standard posture is considered a postural alteration; although this is not necessarily considered a disease, it may substantially affect the quality of life of surgeons. The aim of this study was to evaluate backbone alignment and posture in surgeons and physicians in order to identify and quantify the positioning of body segments and investigate possible postural alterations. METHODS: Thirty subjects participated in the study group (CI) and corresponded to the following inclusion criteria: physician, aged 30-60 years, with at least 2 years of surgical practice and performing 4 weekly surgeries lasting 2 h each. The comparative group (CL) included 32 clinical physicians, in the same age range as the CI group. The control group (CO) included 33 non-physicians in the same age range as the CL and CI groups, who satisfied the following exclusion criteria: chronic muscle-skeletal pain or acute intense pain, diagnosis of or sequelae from orthopedic, rheumatologic, or respiratory disease, or prosthetic use. RESULTS: We observed a high incidence of postural changes in the CI group, including varus thrust, hyperextension, lumbar hyperlordosis, and more foot support in the heel, and other misalignments. The results indicate that the activities of surgeons may be considered as a risk for the musculoskeletal system. Because the specialty of plastic surgery is particularly surgical, the risk is even higher in these surgeons. CONCLUSIONS: Surgical activity provokes progressive postural changes in surgeons and may reduce useful time in the profession and hinder the quality of life.

IMPACTO FUNCIONAL NA QUALIDADE DE VIDA DE INDIVÍDUOS COM SÍNDROME DOLOROSA PÓS-LAMINECTOMIA

Introduction: Post- laminectomy syndrome (FBSS) or pain after surgical proceedings of the lumbar column cause a significant impact in the individual and in the society. It is often under treated. Objective: Evaluate the function, quality of life, fear of movement, and anxiety and depression symptoms in these patients. Patients and Method: This is a descriptive, exploratory, cross-sectional study using a quantitative approach with post laminectomy patients (n = 18) attended at a Pain Clinic. The instruments used were the Roland-Morris Questionnaire, the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI). To assess the quality of life, we used the Whoqol-bref (a short version) and the Tampa Scale for kinesiophobia (KTS) for measure fear of movement. Results: The sample was predominantly female with a mean age of 42.3 ± 5.8 years, 43% married and mean schooling of 7 ± 4.5 years. It was reported an average time of pain of 8 ± 6.8 months, as well as high levels of anxiety, depression, and kinesiophobia. Conclusion: This study demonstrates the great inconvenience that this syndrome causes in patients. It provokes disability, pain, poor quality of life, and it impairs emotional and physical situations as well. This study depicts the great inconvenience that this syndrome causes in patients. It provokes disability, pain, poor quality of life, and it impairs emotional and physical situations as well. There is the need to make changes in the treatment of this particularly vulnerable population. Descriptors: Laminectomy; Quality of life; Chronic Pain.