Assessment of pain and associated factors in people living with HIV/AIDS

Pereira, Aliny Cristini; Bradbury, Fernanda; Rossetti, Estefani Serafim; Hortense, Priscilla

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Brasil

Revista Latino-Americana de Enfermagem

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Brasil

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Original Article • Rev Lat Am Enfermagem 27 • 2019 • https://doi.org/10.1590/1518-8345.2803.3155 copy

Assessment of pain and associated factors in people living with HIV/AIDS^* * Paper extracted from master's thesis “Prevalência, fatores associados à dor e qualidade de vida relacionada à saúde em pessoas que vivem com HIV/aids”, presented to Universidade Federal de São Carlos, São Carlos, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to evaluate pain in people living with human immunodeficiency virus/acquired immunodeficiency syndrome and to relate it to sociodemographic and clinical factors, depressive symptoms and health-related quality of life.

Method:

descriptive, analytical, observational, cross-sectional and quantitative study. Three hundred and two (302) people assisted at a specialized care service participated in the study. Instruments were used to evaluate sociodemographic and clinical data, depressive symptoms, and health-related quality of life. Descriptive, bivariate analysis and multiple logistic regression were used.

Results:

the incidence of pain of mild intensity was 59.27%, recurrent in the head, with interference in mood, mostly affecting females and individuals with no schooling/low schooling. Women were more likely to have moderate or severe pain. People aged 49 to 59 years had greater pain intensity than people aged 18 to 29 years. The variables depressive symptoms and pain were directly proportional. The higher the health-related quality of life and schooling, the lower was the possibility of presence of pain.

Conclusion:

presence of pain is of concern and has association with female sex, lack of schooling/low schooling, worse level of health-related quality of life and presence of depressive symptoms.

Descriptors:
HIV; Acquired Immunodeficiency Syndrome; Pain; Pain Measurement; Quality of Life; Depression

Variables	Categories	Pain				Total	p-value^* * p-value = Probability of significance;
		No		Yes
		n	%	n	%
Sex	Female	31	29.52%	74	70.48%	105	0.0038^† † p-value < 0.05; ^‡ ‡ Chi-square test;
Sex	Male	92	46.70%	105	53.30%	197	0.0038^† † p-value < 0.05; ^‡ ‡ Chi-square test;
Age group (years)	18-≤29	38	45.78%	45	54.21%	83	0.5007^‡ ‡ Chi-square test;
	30-≤39	47	39.83%	71	60.16%	118
	40-≤49	29	40.27%	43	59.72%	72
	50-≤59	9	31.03%	20	68.96%	29
Skin color	White	55	45.83%	65	54.17%	120	0.2954^‡ ‡ Chi-square test;
	Brown	48	40.34%	71	59.66%	119
	Black	14	29.79%	33	70.21%	47
	Others	6	37.50%	10	62.50%	16
Marital status	Married	26	45.61%	31	54.39%	57	0.2635^§ § Fisher test;
	Divorced	14	46.67%	16	53.33%	30
	Single	70	42.17%	96	57.83%	166
	Widowed	2	25.00%	6	75.00%	8
	Lives with companion	11	26.83%	30	73.17%	41
Family income	Less than one minimum wage	22	40.74%	32	59.26%	54	0.1327^‡ ‡ Chi-square test;
	One minimum wage	39	33.62%	77	66.38%	116
	Two minimum wages	30	42.86%	40	57.14%	70
	More than two minimum wages	32	51.61%	30	48.39%	62
Schooling	No schooling /low schooling	17	35.42%	31	64.58%	48	0.0001^† † p-value < 0.05; ^§ § Fisher test;
	Complete elementary education	19	52.78%	17	47.22%	36
	Incomplete high school	11	16.92%	54	83.08%	65
	Complete high school	45	45.45%	54	54.55%	99
	Incomplete higher education	16	55.17%	13	44.83%	29
	Complete higher education/Postgraduation	15	60.00%	10	40.00%	25
Occupation	Recipient of INSS benefit^¶ ¶ INSS - National Social Security Institute; due to HIV^ HIV = Human Immunodeficiency Virus	7	36.84%	12	63.16%	19	0.5215^§ § Fisher test;
	Retired	2	22.22%	7	77.78%	9
	Unemployed	36	46.15%	42	53.85%	78
	Employed	78	39.80%	118	60.20%	196

Variables	Categories	Pain				Total	p-value^* * p-value = Probability of significance;
		No		Yes
		n	%	n	%
Lymphocytes CD4+ T	<200 cells/mm³	7	33.33%	14	66.67%	21	0.6139^† † Chi-square test;
	201-350 cells/mm³	13	44.83%	16	55.17%	29	0.6139^† † Chi-square test;
	351-500 cells/mm³	21	35.00%	39	65.00%	60
	>500 cells/mm³	82	42.71%	110	57.29%	192
Clinical stage	2^nd phase - asymptomatic	116	41.88%	161	58.12%	277	0.1762^† † Chi-square test;
Clinical stage	4^th phase – aids	7	28.00%	18	72.00%	25	0.1762^† † Chi-square test;
ART^§ § ART = Antiretroviral Therapy	1^st treatment line	81	42.86%	108	57.14%	189	0.7461^‡ ‡ Fisher test;
	2^nd treatment line	35	36.46%	61	63.54%	96
	No treatment	2	33.33%	4	66.67%	6
	Special situations	5	45.45%	6	54.55%	11

		n	%	Mean	SD^* * SD = Standard deviation	Median	Minimum	Maximum
Intensity of pain
	Mild	108	59.88%	3.26	1.05	3.50	1.00	4.75
	Moderate	65	36.72%	6.11	0.86	6.00	5.00	7.75
	Severe	6	03.38%	8.00	0.52	8.12	7.00	8.50
Interference of pain
	General activity	179		6.50	7.57	6.71	0.00	10.00
	Daily Activity	179		7.04	3.25	8.00	0.00	10.00
	Mood	179		7.76	3.13	9.00	0.00	10.00
	Ability to walk	179		5.60	4.01	6.00	0.00	10.00
	Job	179		5.82	4.44	8.00	0.00	10.00
	Relationships with other people	179		5.97	3.89	7.00	0.00	10.00
	Sleep	179		4.69	3.78	4.00	0.00	10.00
	Enjoyment of life	179		5.21	3.45	5.00	0.00	10.00

Variable	Category	OR^* * OR = Odds ratio;	OR^* * OR = Odds ratio; (95% CI^† † 95% CI = 95% confidence interval; )		p-value^‡ ‡ p-value = Probability of significance;
Sex	Female	1.89	1.12	3.20	0.017^§ § Stepwise selection (with alpha of retention in the model of 5%);
Schooling	Complete high school	0.65	0.38	1.12	0.922^§ § Stepwise selection (with alpha of retention in the model of 5%);
	Higher education/postgraduation	0.45	0.23	0.88	0.066^§ § Stepwise selection (with alpha of retention in the model of 5%);
DS^\|\| \|\| DS = Depressive symptoms	Score ≥ 9	2.11	1.27	3.52	0.004^§ § Stepwise selection (with alpha of retention in the model of 5%);

Variable	Category	OR^* * OR = Odds ratio;	OR^* * OR = Odds ratio; (95% CI^† † 95% CI = 95% confidence interval; )		p-value^‡ ‡ p-value = Probability of significance;
Sex	Female	2.07	1.16	3.71	0.014
Age group	> 29 years and <= 49 years	1.29	0.66	2.55	0.189
	> 49 years	3.85	1.40	10.61	0.008
Family income^§ § 1 minimum wage, Brazil, year 2017 - R$ 937.00;	Two minimum wages	0.37	0.17	0.78	0.612
	More than two minimum wages	0.21	0.08	0.57	0.038
PHQ-9^\|\| \|\| PHQ-9 = Patient Health Questionnaire-9	Score ≥ 9	2.48	1.39	4.43	0.002

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[1] Corresponding author: Aliny Cristini Pereira. E-mail: alinycristini@yahoo.com.br