Dor, depressão e conceitos culturais

Pimenta, Cibele Andrucioli de Mattos; Koizumi, Maria Sumie; Teixeira, Manoel Jacobsen

doi:10.1590/S0004-282X1997000300004

Resumos

A influência de fatores pessoais, culturais e afetivos e das caracterísrticas das neoplasias na ocorrência e expressão do sintoma álgico de 92 doentes com doença oncológica avançada foi avaliada através de escalas e inventários adaptados para a língua portuguesa. Havia dor, em geral moderada ou intensa, durante a semana anterior à entrevista em 62,0% dos casos. A duração média do quadro álgico foi 10 meses. Havia maior proporção de doentes com neoplasia do segmento cabeça e pescoço no grupo com dor, do que sem dor. Concepções culturais errôneas sobre o controle da dor no câncer e de que doentes recebiam remédios em demasia se correlacionaram à dor de maior intensidade (p<0,05). Os indivíduos com dor apresentaram escores de depressão significativamente mais elevados (p<0,05). Doentes com mais altos escores de depressão tiveram experiência dor de maior intensidade (p<0,05).

dor crônica; dor oncológica; depressão; aspectos culturais

The influence of personal, cultural and affective factors and of the characteristics of the neoplasic diseases in the occurrence of pain and pain intensity in 92 patients presenting advanced cancer was evaluated. Pain usually moderate or severe during past week before the interview occurred in 62.0% of the patients. The duration of pain symptomatology lasted 10 months as an average. There was a higher proportion of patients with head and neck tumors in the group with pain than without pain. Cultural misconceptions about cancer pain control and the idea that doctors prescribe excessive amount of analgesics were correlated with higher intensities of pain (p<0.05). Patients with pain presented higher depression scores than patients without pain (p<0.05) Higher pain scores were correlated with higher depressive scores (p<0.05).

cancer pain; chronic pain; depression; misconceptions

Dor, depressão e conceitos culturais

Depression and misconceptions: correlationship with oncological pain expression

Cibele Andrucioli de Mattos Pimenta^I; Maria Sumie Koizumi^II; Manoel Jacobsen Teixeira^III

^IEnfermeira, Professor Doutor do Departamento de Enfermagem Médico-Cirúrgica da Escola de Enfermagem da Universidade de São Paulo (USP), Coordenadora de Enfermagem da Liga de Dor do Hospital das Clínicas da Faculdade de Medicina da USP (HC-FMUSP)

^IIEnfermeira, Professor Titular do Departamento de Enfermagem Médico-Cirúrgica da USP

^IIINeurocirurgião, Professor Doutor do Departamento de Neurologia da FMUSP. Chefe do Ambulatório

RESUMO

A influência de fatores pessoais, culturais e afetivos e das caracterísrticas das neoplasias na ocorrência e expressão do sintoma álgico de 92 doentes com doença oncológica avançada foi avaliada através de escalas e inventários adaptados para a língua portuguesa. Havia dor, em geral moderada ou intensa, durante a semana anterior à entrevista em 62,0% dos casos. A duração média do quadro álgico foi 10 meses. Havia maior proporção de doentes com neoplasia do segmento cabeça e pescoço no grupo com dor, do que sem dor. Concepções culturais errôneas sobre o controle da dor no câncer e de que doentes recebiam remédios em demasia se correlacionaram à dor de maior intensidade (p<0,05). Os indivíduos com dor apresentaram escores de depressão significativamente mais elevados (p<0,05). Doentes com mais altos escores de depressão tiveram experiência dor de maior intensidade (p<0,05).

Palavras chave: dor crônica, dor oncológica, depressão, aspectos culturais.

ABSTRACT

The influence of personal, cultural and affective factors and of the characteristics of the neoplasic diseases in the occurrence of pain and pain intensity in 92 patients presenting advanced cancer was evaluated. Pain usually moderate or severe during past week before the interview occurred in 62.0% of the patients. The duration of pain symptomatology lasted 10 months as an average. There was a higher proportion of patients with head and neck tumors in the group with pain than without pain. Cultural misconceptions about cancer pain control and the idea that doctors prescribe excessive amount of analgesics were correlated with higher intensities of pain (p<0.05). Patients with pain presented higher depression scores than patients without pain (p<0.05) Higher pain scores were correlated with higher depressive scores (p<0.05).

Key words: cancer pain, chronic pain, depression, misconceptions.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 17-março-1997.

Dr. Manoel Jacobsen Teixeira - Rua General Mena Barreto 755 - 01433-010 São Paulo SP - Brasil.

1. Ahles TA, Ruckdeschel JC, Blanchard E.B. Cancer-related pain: prevalence in an out patient setting as a function of stage of disease and type of cancer. J Psychosom Res 1984;28:115-149.
2. Ahles TA. The multidimension nature of cancer-related pain. Pain 1983;17:277-288.
3. Beck AT. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571.
4. Beck AT. Terapia cognitiva da depressão. Rio de Janeiro: Zahar, 1982:385-387.
5. Bond MR. Cancer pain: psychological substrates and therapy. In Fields HL, Dubner R, Cervero F (eds). Advances in pain research and therapy. Proceeding of the Fourth World Congress on Pain. New York: Raven Press, 1985;9:559-567.
6. Bond MR, Pilowsky I. Subjective assessment of pain and its relationship to the administration of analgesics in patients with advanced cancer. J Psychosom Res 1966;10:203-208.
7. Bonica JJ. Treatment of cancer pain: current status and future needs. In Fields HL, Dubner R, Cervero F (eds). Advances in pain research and therapy. Proceeding of the Fourth World Congress on Pain. New York: Raven Press, 1985;9:589-615.
8. Buckerg J, Penman D, Holland JC. Depression in hospitalized cancer patients. Psychosom Med 1984;46:199-212.
9. Clark DC, Cavanaugh S A, Gibbons RD. The core symptoms of depression in medical and psychiatric patients. J Nerv Ment Dis 1983;171:705-713.
10. Cleeland CS. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 1994;330:592-596.
11. Daut RL, Cleeland CS The prevalence and severity of cancer pain. Cancer 1982;50:1913-1918.
12. Del Porto J A. Aspectos gerais das escalas para avaliação de depressão. São Paulo: Centro de Pesquisa em Psicobiologia Clínica. 1989;93-105.
13. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale MA, Henrichs M, Carnicke CLM. The prevalence of psychiatric disorders among cancer patients. JAMA 1983;249:751-757.
14. Ferrell BR. Family factors influencing cancer pain management. Postgrad Med J 1991;67 (Suppl 2):564-569.
15. Ferrell B, Rhiner R. Development and evaluation of the family pain questionnaire. J Psychosoc One 1993;10:21-35.
16. Ferrell BR, Schneider C. Experience and management of cancer pain at home. Cancer Nurs 1988; 11:84-90.
17. Foley KM. Supportive care and the quality of life of cancer patient. In Devitta VT (ed). Cancer: principles & practice of oncology. Ed 4. Philadelphia: Lippincott, 1993:2417-2418.
18. Hiraga K, Mizuguchi T, Takeda F. The incidence of cancer pain and improvement of pain management in Japan, Postgrad Med 1991;67(Suppl 2):14-25.
19. Huskisson EC. Measurement of pain. Lancet 1974;2:1127-1131.
20. Jones WL, Rimer BK, Levy MH, Kinman MA. Cancer patient knowledge, beliefs, and behavior regarding pain control regimens: implications for education programs. Patient Counseling Health 1984;5:159-164.
21. Levin DN, Cleeland CS, Dar R. Public attitudes toward cancer pain. Cancer 1985;56:2337-2339.
22. Martelete M. O tratamento da dor no câncer. In Schwartsmann G (ed). Oncologia clínica: princípios e prática. Porto Alegre: Artes Médicas, 1991:488-493.
23. Maurice, J. Cancer will 'overwhelm' the Third World. New Scientist 1991; 132:139.
24. Pimenta CAM, Teixeira MJ, Correa CF, Fukuda CL. Analgesia peridural: experiência do Ambulatório de Dor do Hospital das Clínicas da Faculdade de Medicina da USP. Rev Bras Cancerol 1993;39:191-196.
25. Portenoy RK, Miranski J, Thaler HT, Hornung J, Bianchi CBA, Kong IC, Felhamer E, Lewis F, Matamoros I, Sugar MZ, Olivieri AP, Kemeny NE, Foley KM. Pain in ambulatory patients with lung or colon cancer: prevalence, characteristics, and effects, Cancer 1992;70:1616-1624.
26. Siegel S. Estatística não paramétrica. São Paulo: McGraw-Hill, 1975.
²⁷
Sociedade Brasileira de Psiquiatria Clínica. Depressão em atenção primária:detecção, diagnóstico e tratamento. Ribeirão Preto, 1994.
28. Spiegel D, Bloom JR. Pain in metastatic breast cancer. Cancer 1983;52:341-345.
29. Teixeira MJ. Tratamento neurocirúrgico da dor. In Raia AA, Zerbini EJ (eds). Clínica Cirúrgica Alípio Corrêa Neto. Ed 4. São Paulo: Sarvier, 1988;2:541-572.
30. Ward NG. Pain and depression In Bonica JJ (ed) The management of pain. Ed 2. Philadelphia: Lea & Febeger, 1990:310-319.

Datas de Publicação

Publicação nesta coleção
18 Out 2010
Data do Fascículo
Set 1997

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Ahles TA, Ruckdeschel JC, Blanchard E.B. Cancer-related pain: prevalence in an out patient setting as a function of stage of disease and type of cancer. J Psychosom Res 1984;28:115-149.

[2] 2. Ahles TA. The multidimension nature of cancer-related pain. Pain 1983;17:277-288.

[3] 3. Beck AT. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571.

[4] 4. Beck AT. Terapia cognitiva da depressão. Rio de Janeiro: Zahar, 1982:385-387.

[5] 5. Bond MR. Cancer pain: psychological substrates and therapy. In Fields HL, Dubner R, Cervero F (eds). Advances in pain research and therapy. Proceeding of the Fourth World Congress on Pain. New York: Raven Press, 1985;9:559-567.

[6] 6. Bond MR, Pilowsky I. Subjective assessment of pain and its relationship to the administration of analgesics in patients with advanced cancer. J Psychosom Res 1966;10:203-208.

[7] 7. Bonica JJ. Treatment of cancer pain: current status and future needs. In Fields HL, Dubner R, Cervero F (eds). Advances in pain research and therapy. Proceeding of the Fourth World Congress on Pain. New York: Raven Press, 1985;9:589-615.

[8] 8. Buckerg J, Penman D, Holland JC. Depression in hospitalized cancer patients. Psychosom Med 1984;46:199-212.

[9] 9. Clark DC, Cavanaugh S A, Gibbons RD. The core symptoms of depression in medical and psychiatric patients. J Nerv Ment Dis 1983;171:705-713.

[10] 10. Cleeland CS. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 1994;330:592-596.

[11] 11. Daut RL, Cleeland CS The prevalence and severity of cancer pain. Cancer 1982;50:1913-1918.

[12] 12. Del Porto J A. Aspectos gerais das escalas para avaliação de depressão. São Paulo: Centro de Pesquisa em Psicobiologia Clínica. 1989;93-105.

[13] 13. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale MA, Henrichs M, Carnicke CLM. The prevalence of psychiatric disorders among cancer patients. JAMA 1983;249:751-757.

[14] 14. Ferrell BR. Family factors influencing cancer pain management. Postgrad Med J 1991;67 (Suppl 2):564-569.

[15] 15. Ferrell B, Rhiner R. Development and evaluation of the family pain questionnaire. J Psychosoc One 1993;10:21-35.

[16] 16. Ferrell BR, Schneider C. Experience and management of cancer pain at home. Cancer Nurs 1988; 11:84-90.

[17] 17. Foley KM. Supportive care and the quality of life of cancer patient. In Devitta VT (ed). Cancer: principles & practice of oncology. Ed 4. Philadelphia: Lippincott, 1993:2417-2418.

[18] 18. Hiraga K, Mizuguchi T, Takeda F. The incidence of cancer pain and improvement of pain management in Japan, Postgrad Med 1991;67(Suppl 2):14-25.

[19] 19. Huskisson EC. Measurement of pain. Lancet 1974;2:1127-1131.

[20] 20. Jones WL, Rimer BK, Levy MH, Kinman MA. Cancer patient knowledge, beliefs, and behavior regarding pain control regimens: implications for education programs. Patient Counseling Health 1984;5:159-164.

[21] 21. Levin DN, Cleeland CS, Dar R. Public attitudes toward cancer pain. Cancer 1985;56:2337-2339.

[22] 22. Martelete M. O tratamento da dor no câncer. In Schwartsmann G (ed). Oncologia clínica: princípios e prática. Porto Alegre: Artes Médicas, 1991:488-493.

[23] 23. Maurice, J. Cancer will 'overwhelm' the Third World. New Scientist 1991; 132:139.

[24] 24. Pimenta CAM, Teixeira MJ, Correa CF, Fukuda CL. Analgesia peridural: experiência do Ambulatório de Dor do Hospital das Clínicas da Faculdade de Medicina da USP. Rev Bras Cancerol 1993;39:191-196.

[25] 25. Portenoy RK, Miranski J, Thaler HT, Hornung J, Bianchi CBA, Kong IC, Felhamer E, Lewis F, Matamoros I, Sugar MZ, Olivieri AP, Kemeny NE, Foley KM. Pain in ambulatory patients with lung or colon cancer: prevalence, characteristics, and effects, Cancer 1992;70:1616-1624.

[26] 26. Siegel S. Estatística não paramétrica. São Paulo: McGraw-Hill, 1975.

[27] ²⁷
Sociedade Brasileira de Psiquiatria Clínica. Depressão em atenção primária:detecção, diagnóstico e tratamento. Ribeirão Preto, 1994.

[28] 28. Spiegel D, Bloom JR. Pain in metastatic breast cancer. Cancer 1983;52:341-345.

[29] 29. Teixeira MJ. Tratamento neurocirúrgico da dor. In Raia AA, Zerbini EJ (eds). Clínica Cirúrgica Alípio Corrêa Neto. Ed 4. São Paulo: Sarvier, 1988;2:541-572.

[30] 30. Ward NG. Pain and depression In Bonica JJ (ed) The management of pain. Ed 2. Philadelphia: Lea & Febeger, 1990:310-319.