Terapia cognitivo comportamental em grupo para pacientes com dor crônica

Abstract

The assessment and management of chronic pain are an important focus of attention, since these are pointed out as a major cause of disability and demand for health care.Objective: To evaluate the self-efficacy and indicators of anxiety and depression in patients diagnosed with chronic pain in two forms of treatment: a) structured program of Cognitive-Behavioral Therapy in group; B) control group who undergone the usual treatment of the institution.Materials and Methods: Adult patients of both genders at the beginning of care in the Pain Clinics. Those who met the inclusion criteria and agreed to participate in the study were randomized to allocation in the Experimental Group (EG) or Control Group (CG). All participants were evaluated in three moments: initial evaluation, reassessment and follow-up. They answered the following instruments: Questionnaire on clinical and sociodemographic data; Self-Efficacy Scale for Chronic Pain; Hospital Anxiety and Depression Scale; Numeric Pain Rating Scale; Inventory of Attitudes and Beliefs Facing Chronic Pain. The experimental group received, besides the habitual treatment provided by the institution, 10 sessions of Cognitive-Behavioral intervention in group. The control group received the usual treatment provided by the Pain Clinics. Results:A total of 114 adult patients undergoing chronic pain treatment participated in the first part of this study. Data pointed out high indicators of anxiety (53%) and depression (55%), in addition to low self-efficacy (63%). Low self-efficacy was associated with beliefs and dysfunctional attitudes towards pain and to higher indicators of anxiety and depression were observed. In the second part of the study, all participants were randomized into two groups: Experimental Group (EG) and Control Group (CG) . Fifty-seven patients participated in all the stages of this part of the study, 31 in EG and 26 in CG. Comparing the two groups according to the follow-up, the results showed that the experimental group had significantly higher self-efficacy scores (p <0.026) and. significantly lower anxiety scores (p < 0 , 01) and depression (p <0.023).Conclusion: In this study, the cognitive-behavioral therapy in group has improved important benefits for patients with chronic pain, playing on their beliefs and attitudes toward pain, anxiety management and reduction on depression indicators.