Estilo de vida e qualidade de vida de pacientes com dor crônica neuropática

Abstract

Neuropathic pain is a complex, different entity, a pain state, a syndrome,in which nociception mechanisms are potentiated, generating extremely unpleasant symptoms, such as spontaneous pain (without noxious stimulus), tactile and dynamic allodynia, hyperalgesia. It is often refractory to existing therapies, its treatment is frustrating. This pain is considered the pain that most impairs the patient's quality of life, therefore being a public health problem. Strategies for prevention and control of this pain must take into account the biological, psychological, and sociodemographic determinants, as well as the patients' lifestyle. Studies on this subject are scarce. Objective: To evaluate the lifestyle and quality of life of patients with chronic neuropathic pain.Casuistics andMethod: This is an exploratory, descriptive, cross-sectional, quantitative study, in which the "Fantastic Lifestyle" questionnaire was applied in a Pain outpatient clinic to analyze the patient's lifestyle and quality of life through the WHOQOL-bref generic quality of life questionnaire. The Morisky-Green Test was used to assess whether the patient was compliant with the drug treatment, and the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANNS) was used to test neuropathic pain. Results: Sixty-two patients with chronic pain who underwent follow-up at the outpatient clinic of the Pain clinic of the Hospital de Base de São José do Rio Preto participated in the study. The age of the 62 patients ranged between 30 and 80 years, with the majority being female (60%). Regarding marital status, 64% (n=40) were married, 80% (n=50) with children and, as for education, the highest percentage of patients 47% (n=29) is trained in elementary school and, the great part in a condition of absence from work 52% (n=32). As for the quality of life evaluated by the WHOQOL-bref questionnaire, all domains were negatively affected (≤50) expressing greater impact in the physical, daily activities and ability to work. The domain of social relationships guided the subdomain of personal relationships as the smallest, and the domain of the environment negatively compromised recreation/leisure and transportation. Regarding lifestyle, the “Fantastic Lifestyle” questionnaire identified a “regular” lifestyle in most patients (n=38), with activity and nutrition components negatively perceived. The results referring to the Morisky-Green test for medication adherence observed that 23 (37%) patients had low adherence. The LANNS scale (The Leeds assessment of neuropathic symptoms and signs pain scale) indicated 48 (77%) patients with neuropathic mechanisms contributing to the reported pain. When the lifestyle components were correlated with quality of life; a strong positive correlation was presented, pointing out that the low level of activity and the amount of alcohol ingested are associated with worse quality of life in the physical domains, social relationships and environment. Conclusion: Patients with chronic neuropathic pain inthis study showed that the level of activity and the presence of alcoholhave impairedtheir lifestyle and produced a worse quality of life in the physical, social and environmental domains. Considering these results, this research has concluded that the quality of life of patients with chronic neuropathic pain must be valued, facing a comprehensive care, assessing pain as a conditioner of QL and contemplating the lifestyle of each population, since this will provide scientific knowledge so that the actions can be efficiently directed.