Resiliência e dor em pacientes com fibromialgia: um estudo observacional transversal
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Data
2022-02-22
Autores
Teixeira, Lívia Agostinho
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A fibromialgia é uma síndrome multifatorial e uma das condições de dor crônica mais comuns no mundo, com poucas opções de tratamento eficazes disponíveis. No contexto da dor, a resiliência pode ser definida como ‘a habilidade de se recuperar e sustentar uma vida plena, mesmo na presença da dor’. A relação entre resiliência, dor e funcionalidade em pacientes com fibromialgia não é bem estabelecida. O objetivo da pesquisa é investigar essa relação e identificar possíveis variáveis envolvidas. Uma amostra transversal de 2176 pacientes com fibromialgia foi avaliada em uma pesquisa online utilizando a Escala de Resiliência de Connor-Davidson para o Brasil, o Inventário Breve de Dor e um questionário sociodemográfico. A associação entre resiliência, dor e funcionalidade foi avaliada em regressões lineares multivariáveis. A resiliência não foi associada diretamente aos escores médios de dor (β: -0,003, IC 95%: -0,17 a 0,17, p=0,97), mas diminuiu significativamente o efeito da dor média sobre seu grau de interferência na vida dos participantes, principalmente na dor de fraca intensidade. Para esse grupo, a resiliência moderada a alta foi associada a -2,3 pontos de interferência da dor em comparação com resiliência baixa, enquanto, para pessoas com dor moderada a intensa, a diminuição foi de 0,5 (IC 95% 0,2 a 0,8, p<0,001) e 0,2 (IC 95%: 0,2 a 0,4, p=0,03), respectivamente. Os resultados lançam luz sobre a complexidade das relações entre resiliência, dor e funcionalidade, e podem sinalizar a relevância e os limites da resiliência no tratamento da dor crônica, além de evidenciar o impacto da fibromialgia na vida dos pacientes. Estudos futuros que avaliem intervenções psicológicas na fibromialgia devem considerar essas interações.
Fibromyalgia is a multifactorial syndrome and one of the most common chronic pain conditions in the world, with few effective treatment options available. In pain context, resilience can be defined as ‘the ability to restore and sustain living a fulfilling life in the presence of pain’. The relationship between resilience, pain and functionality in fibromyalgia is not well understood. We aim to investigate these associations, and other variables as social factors and physical activity. A cross-sectional sample of 2176 fibromyalgia patients was assessed by web survey through Connor-Davidson Resilience Scale, Brief Pain Inventory and health data. The association between resilience, average pain, and functionality was evaluated through multivariable linear regression. The median pain score was 7 (IIQ: 6-8) on an 11-point scale, and moderate to intense in 97.3% of respondents. Resilience was not directly associated with average pain scores (β:-0.003, 95%CI -0.17 to 0.17, p=0.97), but it significantly decreased the effect of pain on its degree of interference in participants' lives, especially when the pain was mild. For people with mild pain, moderate to high resilience was associated with -2.3 points pain interference compared to low resilience, while for people with moderate to severe pain the decrease was 0.5 (95% CI 0.2 to 0.8, p<0.001) and 0.2 (95% CI: 0.2 to 0.4, p=0.03), respectively. These results shed light on the complex interrelationships between resilience, pain, and functionality, and may signal both the relevance and the limits of resilience in the management of fibromyalgia, besides highlighting its impact in patients' lives. Future studies evaluating psychological interventions for the management of fibromyalgia should consider these interactions.
Fibromyalgia is a multifactorial syndrome and one of the most common chronic pain conditions in the world, with few effective treatment options available. In pain context, resilience can be defined as ‘the ability to restore and sustain living a fulfilling life in the presence of pain’. The relationship between resilience, pain and functionality in fibromyalgia is not well understood. We aim to investigate these associations, and other variables as social factors and physical activity. A cross-sectional sample of 2176 fibromyalgia patients was assessed by web survey through Connor-Davidson Resilience Scale, Brief Pain Inventory and health data. The association between resilience, average pain, and functionality was evaluated through multivariable linear regression. The median pain score was 7 (IIQ: 6-8) on an 11-point scale, and moderate to intense in 97.3% of respondents. Resilience was not directly associated with average pain scores (β:-0.003, 95%CI -0.17 to 0.17, p=0.97), but it significantly decreased the effect of pain on its degree of interference in participants' lives, especially when the pain was mild. For people with mild pain, moderate to high resilience was associated with -2.3 points pain interference compared to low resilience, while for people with moderate to severe pain the decrease was 0.5 (95% CI 0.2 to 0.8, p<0.001) and 0.2 (95% CI: 0.2 to 0.4, p=0.03), respectively. These results shed light on the complex interrelationships between resilience, pain, and functionality, and may signal both the relevance and the limits of resilience in the management of fibromyalgia, besides highlighting its impact in patients' lives. Future studies evaluating psychological interventions for the management of fibromyalgia should consider these interactions.
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Palavras-chave
Resiliência (Traço da personalidade), Fibromialgia, Dor, Fibromyalgia, Resilience (Personality trait), Dor crônica, Doença crõnica, Resiliência psicológica