Function, activity and participation in perception of patients with chronic low back pain: a focus group

Main Article Content

Sheila Aparecida da Silva
http://orcid.org/0000-0001-5971-7944
Victor Silva Alves
http://orcid.org/0000-0002-9377-2434
Lara Andrade Souza
http://orcid.org/0000-0003-4235-1215
Marina Andrade Donzeli
http://orcid.org/0000-0002-8986-079X
Dernival Bertoncello
http://orcid.org/0000-0002-4432-4651

Abstract

Objective: Identify the perception of chronic low back pain (LBP) in users of a physical therapy rehabilitation unit in a city in Minas Gerais, Brazil. Methods: This is a descriptive and qualitative exploratory research. Focus groups were held with users of the health service of both genres, above 18 years old, with a medical diagnosis of chronic LBP, and in physical rehabilitation. The guiding units were talking about pain and previous pain relief treatments, programmed by a semi-structured script. The units that emerged were the speech of health professionals and the speech of co-workers and family members. The statements were recorded, transcribed and analyzed using the Elaboration Technique and Analysis of Units of Meaning. The Oswestry Disability Index (ODI) pain score and the complete ODI were used to assess pain and functionality. Results: 14 patients (mean age 52 ± 3 years), mostly women, reported chronic LBP on average for 5 ± 5 years. The mean value of the pain score was 1.37 ± 1.72 and the mean disability was 21.96% (95% CI 15.43 - 28.50%). The reports on pain were: ‘a nuisance’, ‘a disease’, ‘disability’, treated with medication and physiotherapy; health professionals demonstrate ‘neglect’, ‘aggression’ or ‘ban’; while family and co-workers demonstrate ‘contempt’, ‘retaliation’ or ‘support’. Conclusion: The perception of chronic LBP is equivalent to distress, discomfort, illness, restrictions, aggression, neglect, contempt, reprisal or support to a mix of physical and psychological sensations.



Article Details

How to Cite
1.
Silva SA da, Alves VS, Souza LA, Donzeli MA, Bertoncello D. Function, activity and participation in perception of patients with chronic low back pain: a focus group. HSJ [Internet]. 2020May22 [cited 2024May15];10(3):15-1. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/907
Section
ORIGINAL ARTICLE
Author Biographies

Sheila Aparecida da Silva, Fisioterapeuta da Prefeitura de Uberaba, MG

Mestre em Educação Física (UFTM), Fisioterapeuta da Prefeitura de Uberaba, MG.

Victor Silva Alves, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP

Fisioterapeuta, Especialista em Fisioterapia do Esporte (UNIFESP).

Lara Andrade Souza, Programa de Pós-Graduação em Atenção à Saúde, UFTM

Fisioterapeuta, Mestre em Educação Física (UFTM), Doutoranda em Atenção à Saúde (UFTM)

Marina Andrade Donzeli, Programa de Atenção à Saúde, UFTM

Fisioterapeuta, Mestre em Educação Física (UFTM), Doutoranda em Atenção à Saúde (UFTM)

Dernival Bertoncello, Departamento de Fisioterapia Aplicada, Universidade Federal do Triângulo Mineiro

Fisioterapeuta (UFSCar), Doutor em Ciências Fisiológicas (UFSCar/UNESP), Professor Associado do Departamento de Fisioterapia Aplicada - UFTM, Docente do Programa de Pós-Graduação em Educação Física (UFTM) e do Programa de Pós-Graduação em Fisioterapia (UFTM/UFU)

References

1. Kreling MCGD, Cruz DALM, Pimenta CAM. Prevalence of chronic pain in adult workers. Rev Bras Enferm. 2006;59(4):509–13. doi: 10.1590/S0034-71672006000400007
2. Aziz Q, Barke A, Bennett MI, Benoliel R, Cohen M, Evers S, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003–7. doi: 10.1097/j.pain.0000000000000160
3. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356–67. doi: 10.1016/S0140-6736(18)30480-X
4. Buchbinder R, van Tulder M, Öberg B, Costa LM, Woolf A, Schoene M, et al. Low back pain: a call for action. Lancet. 2018;391(10137):2384–8. doi: 10.1016/s0140-6736(18)30488-4
5. Korelo RIG, Ragasson CAP, Lerner CE, Morais JC, Cossa JBN, Krauczuk C. Efeito de um programa cinesioterapêutico de grupo, aliado à escola de postura, na lombalgia crônica. Fisioter em Mov [Internet]. 2013 [cited 2020 May 10];26(2):389–94. Avaiable from: www.scielo.br/pdf/fm/v26n2/16.pdf
6. Brasil. Ministério do Planejamento, Orçamento e Gestão. Instituto Brasileiro de Geografia e Estatística (IBGE) [Internet]. Pesquisa Nacional de Saúde 2013: Acesso e utilização dos serviços de saúde, acidentes e violências. Rio de Janeiro: IBGE; 2015 [cited 2020 May 10]. Avaiable from: biblioteca.ibge.gov.br/visualizacao/livros/liv94074.pdf
7. Carvalho RC, Maglioni CB, Machado GB, Araújo JE, Silva JRT, Silva ML. Prevalence and characteristics of chronic pain in Brazil: a national internet-based survey study. Brazilian J Pain. 2018;1(4):331–8. doi: 10.5935/2595-0118.20180063
8. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. doi: 10.7326/M16-2367
9. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4: European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):s192–s300. doi: 10.1007/s00586-006-1072-1
10. Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J [Internet]. 2014 [cited 2020 May 10];14(1):101–7. Avaiable from: www.ochsnerjournal.org/content/ochjnl/14/1/101.full.pdf
11. Desconsi MB, Bartz PT, Fiegenbaum TR, Candotti CT, Vieira A. Tratamento de pacientes com dor lombar crônica inespecífica por fisioterapeutas: um estudo transversal. Fisioter Pesqui. 2019;26(1):15–21. doi: 10.1590/1809-2950/17003626012019
12. Kitzinger J. Grupos focais. In: Pesquisa qualitativa na atenção à saúde. 3o ed. Porto Alegre: Artmed; 2009.
13. Nogueira-Martins MCF, Bógus CM. Considerações sobre a metodologia qualitativa como recurso para o estudo das ações de humanização em saúde. Saúde Soc. 2004;13(3):44–57. doi: 10.1590/S0104-12902004000300006
14. Minayo MC de S. O desafio do conhecimento: pesquisa qualitativa em Saúde. 9o ed. São Paulo: Hucitec; 2006. 406 p.
15. Gatti BA. Grupo focal na pesquisa em ciências sociais e humanas. 1o ed. Brasília: Líber livro; 2005.
16. Vigatto R, Alexandre NM, Correa Filho HR. Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity. Spine (Phila Pa 1976). 2007;32(4):481-6. doi: 10.1097/01.brs.0000255075.11496.47
17. Falavigna A, Teles AR, Braga GL, Barazzeti DO, Lazzaretti L, Tregnago AC. Instrumentos de avaliação clínica e funcional em cirurgia da coluna vertebral. Coluna/Columna. 2011;10(1)62-7. doi: 10.1590/S1808-18512011000100012
18. Moreira WW, Simões R, Porto E. Análise de conteúdo: técnica de elaboração e análise de unidades de significado. R Bras Ci Mov [Internet]. 2005 [cited 2020 May 10];13(4):107-114. Avaiable from: portalrevistas.ucb.br/index.php/RBCM/article/view/665/676
19. Verbeek J, Sengers MJ, Riemens L HJ. Patient expectations of treatment for back pain: a systematic review of qualitative and quantitative studies. Spine (Phila Pa 1976). 2004;29(20):2309–18. doi: 10.1097/01.brs.0000142007.38256.7f
20. Associação Brasileira de Medicina Física e Reabilitação. Lombalgia inespecífica crônica: reabilitação. Rev Assoc Med Bras [Internet]. 2013 [cited 20202 May 10];59(6):536–53. doi: doi.org/10.1016/j.ramb.2013.10.003
21. Franco YR, Liebano RE, Moura KF, Oliveira NTB, Myamoto GC, Santos MO, Cabral CNM. Efficacy of the addition of interferential current to Pilates method in patients with low back pain: a protocol of a randomized controlled trial. BMC Musculoskelet Disord. 2014;15:420. doi: doi.org/10.1186/1471-2474-15-420
22. Toye F, Seers K, Allcock N, Briggs M, Carr E, Andrews J, et al. A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain. Heal Serv Deliv Res. 2013;1(12):1–190. doi: 10.3310/hsdr01120
23. Gomes-Neto M, Lopes JM, Conceição CS, Araujo A, Brasileiro A, Sousa C, et al. Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis. Phys Ther Sport. 2017;23:136–42. doi: 10.1016/j.ptsp.2016.08.004
24. Kisner C, Colby LA, editors. A coluna: intervenção com exercícios para o pescoço e o tronco. In: Exercícios terapêuticos fundamentos e técnicas. 4o ed. Barueri: Manole; 2005. p. 649–76.
25. Delitto A, George SZ, Dillen LV, Whitman JM, Gwendolyn AS, Shekelle P, et al. Low back pain. J Orthop Sport Phys Ther [Internet]. 2012;42(4):A1-57. doi: 10.2519/jospt.2012.42.4.A1
26. Patel VB, Wasserman R, Imani F. Interventional therapies for chronic low back pain: A focused review (efficacy and outcomes). Anesth Pain Med. 2015;5(4):e29716. doi: 10.5812/aapm.29716
27. Garland EL. Pain Processing in the nervous system: A selective review of nociceptive and biobehavioral pathways. Prim Care. 2013;39(3):561–71. doi: 10.1016/j.pop.2012.06.013
28. Ribeiro ACL, Ferla AA. Como médicos se tornaram deuses: reflexões acerca do poder médico na atualidade. Psicol Rev [Internet]. 2016 [cited 2020 May10];22(2):294–314. Avaiable from: pepsic.bvsalud.org/pdf/per/v22n2/v22n2a04.pdf
29. Baptista MKS, Santos RM dos, Duarte SJH, Comassetto I, Trezza MCSF. The patient and the relation between power-knowledge and care by nursing professionals. Esc Anna Nery. 2017;21(4):e20170064. doi: 10.1590/2177-9465-ean-2017-0064
30. Bruns EB, Befus D, Wismer B, Knight K, Adler SR, Leonoudakis-Watts K, et al. Vulnerable patients’ psychosocial experiences in a group-based, integrative pain management program. J Altern Complement Med. 2019;25(7):719–26. doi: 10.1089/acm.2019.0074
31. Shaygan M, Böger A, Kröner-Herwig B. How does reduction in pain lead to reduction in disability in patients with musculoskeletal pain? J Pain Res. 2019;12:1879–90. doi: 10.2147/JPR.S197533
32. Sung PS. Disability and back muscle fatigability changes following two therapeutic exercise interventions in participants with recurrent low back pain. Med Sci Monit. 2013;19:40–8. doi: 10.12659/msm.883735
33. Cho YK, Kim DY, Jung SY, Seong JH. Synergistic effect of a rehabilitation program and treadmill exercise on pain and dysfunction in patients with chronic low back pain. J Phys Ther Sci. 2015;27(4):1187–90. doi: 10.1589/jpts.27.1187
34. Barra LYL. O fisioterapeuta, o paciente e a doença [Dissertação de Mestrado]. São Bernardo do Campo: Universidade Metodista de São Paulo; 2006. Avaiable from: tede.metodista.br/jspui/handle/tede/1328
35. Moser AD, Scharan K. O olhar biopsicossocial na Fisioterapia: ferramentas disponíveis para sua operacionalização. Fisioter em Mov. 2018;31:e003136. doi: 10.1590/1980-5918.031.ed01