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Eficácia de técnicas invasivas na dor, ansiedade, depressão e qualidade de vida
Advisor(s)
Abstract(s)
A dor crónica, tem-se revelado, nos dias de hoje, um problema de saúde pública
que atinge cada vez mais pessoas, afectando todas as áreas do seu dia a dia, podendo
causar sintomatologia ansiosa e/ ou depressiva, bem como deterioração da qualidade de
vida (QDV).
Neste sentido, os objetivos principais da presente dissertação de mestrado são:
sistematizar o conhecimento acerca das repercussões que as técnicas invasivas para o
tratamento da dor crónica podem ter na ansiedade, depressão e QDV; e analisar as
repercussões que as técnicas: microcompressão do balão do gânglio do trigémeo
(MCBGT), epiduroscopia e neuromodulação (estimulação cerebral profunda (DBS) e
neuroestimulação medular (NEE)), têm na dor, afeto negativo e QDV.
Em relação ao primeiro obejtivo, realizou-se uma revisão sistemática baseada no
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)
(Liberati et al., 2009), com recurso à base de dados Pubmed, tendo a pesquisa sido feita
até ao dia 19 de Setembro de 2017 inclusive.
Para a concretização do segundo obejtivo, recorreu-se a quatro amostras de
conveniência: a amostra correspondente à MCBGT constituída por 8 adultos (6
mulheres e 2 homens), com idades entre os 41 e 81 anos (M=64,8; DP=12,4); outra
amostra submetida a epiduroscopia que engloba 21 adultos (10 mulheres e 11 homens),
com idades entre os 37 e 61 (M=49,6; DP=7,4); a amostra submetida à DBS composta
por 19 adultos (4 mulheres e 15 homens), de idades entre os 42 e 78 anos ((M=59,8;
DP=9,2); e por fim, a amostra submetida à NEE que contou com 18 adultos (8 mulheres
e 10 homens), com idades entre os 33-74 anos (M=48,5; DP=9,4). Todos os adultos
mantinham acompanhamento na Unidade de Dor Crónica do Hospital de São João do
Porto, mais precisamente, na Consulta de Dor Crónica, até o dia 31 de Maio de 2017,
pelo que se utilizaram os seguintes instrumentos de avaliação: Ficha de Dados
Sociodemográficos e Clínicos, Inventário Resumido da Dor (BPI), SF-36 e Escala
Hospitalar de Ansiedade e Depressão (HADS).
Do ponto de vista teórico, o presente estudo revela-se um contributo para o
estado atual do conhecimento sobre as repercussões do tratamento da dor, com recurso
às quatro técnicas em análise.
Do ponto de vista prático, esta investigação sugere que as todas as técnicas são,
globalmente, eficazes ao nível do alívio da dor e QDV. Em relação à ansiedade e depressão, três das técnicas (MCBGT, à DBS e à NEE) revelaram um efeito
considerável sobre tais variáveis, contrariamente à epiduroscopia.
Em suma, apesar do tratamento da dor crónica, com recurso à técnicas em
estudo, revelar efeitos positivos nas variáveis psicológicas, torna-se necessário mais
investigações neste âmbito para reforçar tais resultados.
Nowadays, Chronic pain has revealed itself to be a public health issue affecting increasingly more people, influencing every area of their daily life, possibly causing anxious and/or depressive symptomatology, as well as the deterioration of their quality of life (QOF). On that subject, the main goals of this masters dissertation are: To systematize the knowledge around the repercussions that invasive techniques as treatment for chronic pain may have on anxiety, depression and QOF; Analyze the impact that techniques such as: Micro Compression of the Trigeminal Ganglion Balloon (MCBGT), Epiduroscopy and Neuromodulation (Deep brain stimulation (DBS) and Medullary Neurostimulation (NEE)), have in pain, negative affect and QOF. Regarding the first goal, a systematic review, based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) (Liberati et al., 2009), was made, using the PUBMED database. The research was done until, and including, the 19th of September 2017. As for the accomplishment of the second goal, four samples of convenience were used: One sample corresponding to MCBGT, composed of 8 adults (6 women and 2 men), with ages ranging between 41 and 81 (M=64,8; DP=12,4); Another sample, submitted to Epiduroscopy, including 21 adults (10 women and 11 men), ages ranging between 37 and 61 (M=49,6; DP=7,4); The third sample, submitted to DBS, was composed of 19 adults (4 women and 15 men), ages ranging between 42 and 78 (M=59,8; DP=9,2). Finally, the last sample, submitted to NEE, composed of 18 adults (8 women and 10 men), with ages ranging between 33 and 74 (M=48,5; DP=9,4). All adults were supervised at the Chronic Pain Unit at Hospital São João do Porto, specifically at the Chronic Pain examination, until the 31st of May 2017, using the following evaluation tools: Clinical and Socio-demographic data sheet, Brief Pain Inventory (BPI), SF-36 and Hospital Anxiety and Depression Scale (HADS). From the theoretical point of view, the present study proves to be a valuable contribution to the current state of the knowledge concerning the backlash of pain treatment when using the four techniques in review. From the practical point of view, this investigation suggests that all these techniques are efficient at mitigating pain and increasing QOL. Regarding anxiety and depression, three of the techniques (MCBGT, DBS and NEE) revealed a considerable effect on those variables, as opposed to Epiduroscopy. In summary, although the treatment of chronic pain using the aforementioned techniques has revelead positive effects on the psychological variables, further investigations are required on this matter to reinforce those results.
Nowadays, Chronic pain has revealed itself to be a public health issue affecting increasingly more people, influencing every area of their daily life, possibly causing anxious and/or depressive symptomatology, as well as the deterioration of their quality of life (QOF). On that subject, the main goals of this masters dissertation are: To systematize the knowledge around the repercussions that invasive techniques as treatment for chronic pain may have on anxiety, depression and QOF; Analyze the impact that techniques such as: Micro Compression of the Trigeminal Ganglion Balloon (MCBGT), Epiduroscopy and Neuromodulation (Deep brain stimulation (DBS) and Medullary Neurostimulation (NEE)), have in pain, negative affect and QOF. Regarding the first goal, a systematic review, based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) (Liberati et al., 2009), was made, using the PUBMED database. The research was done until, and including, the 19th of September 2017. As for the accomplishment of the second goal, four samples of convenience were used: One sample corresponding to MCBGT, composed of 8 adults (6 women and 2 men), with ages ranging between 41 and 81 (M=64,8; DP=12,4); Another sample, submitted to Epiduroscopy, including 21 adults (10 women and 11 men), ages ranging between 37 and 61 (M=49,6; DP=7,4); The third sample, submitted to DBS, was composed of 19 adults (4 women and 15 men), ages ranging between 42 and 78 (M=59,8; DP=9,2). Finally, the last sample, submitted to NEE, composed of 18 adults (8 women and 10 men), with ages ranging between 33 and 74 (M=48,5; DP=9,4). All adults were supervised at the Chronic Pain Unit at Hospital São João do Porto, specifically at the Chronic Pain examination, until the 31st of May 2017, using the following evaluation tools: Clinical and Socio-demographic data sheet, Brief Pain Inventory (BPI), SF-36 and Hospital Anxiety and Depression Scale (HADS). From the theoretical point of view, the present study proves to be a valuable contribution to the current state of the knowledge concerning the backlash of pain treatment when using the four techniques in review. From the practical point of view, this investigation suggests that all these techniques are efficient at mitigating pain and increasing QOL. Regarding anxiety and depression, three of the techniques (MCBGT, DBS and NEE) revealed a considerable effect on those variables, as opposed to Epiduroscopy. In summary, although the treatment of chronic pain using the aforementioned techniques has revelead positive effects on the psychological variables, further investigations are required on this matter to reinforce those results.
Description
Keywords
Dor crónica Técnicas Invasivas Ansiedade Depressão Qualidade de vida Chronic pain Invasive techniques Anxiety Depression Quality of Life