Avaliação da dor crónica: instrumentos multidimensionais, aplicabilidade e praticabilidade
DOI:
https://doi.org/10.32385/rpmgf.v40i5.13966Palabras clave:
Dor crónica, Avaliação da dor, Funcionalidade, Ferramentas de avaliação da dorResumen
Introdução: A dor crónica tem um impacto negativo na condição física e psicológica dos doentes, tendo o potencial para afetar essencialmente qualquer aspeto do quotidiano. Em Portugal, a dor crónica é um grande problema de saúde pública que afeta aproximadamente 36,7% dos adultos. Contudo, a avaliação desta condição ainda se encontra longe do que seria ideal. Um estudo português mostrou que a maioria dos finalistas do curso de medicina e dos internos do ano comum não avalia a dor de forma rotineira. Adicionalmente, as ferramentas de avaliação da dor mais conhecidas são aquelas que se focam apenas na intensidade da dor e, portanto, não têm em conta a sua natureza multidimensional.
Objetivos: Este trabalho tem como objetivo rever diversas ferramentas de avaliação da dor que consideram a sua natureza e o seu impacto na funcionalidade dos doentes. O propósito final é aumentar o conhecimento e visibilidade destes instrumentos.
Métodos: Para discutir a aplicabilidade, praticabilidade e relevância de vários instrumentos de avaliação de dor foram realizados focus groups com participação de um painel de 29 médicos Portugueses especialistas em medicina geral e familiar e em ortopedia. Após a discussão em grupo, cinco questionários foram considerados particularmente relevantes.
Resultados: Foi realizado um levantamento das características, vantagens e desvantagens de cinco ferramentas de avaliação da dor (ACT-UP, CAPA, índice de Bartel, BPI e EQ-5D) e salientada a importância da sua aplicabilidade na prática clínica do médico de família. A avaliação funcional de doentes com dor crónica é essencial para a escolha do tratamento mais adequado; a natureza individual dos doentes fará com que estes sejam afetados de forma diferente por limitações distintas, mesmo que a intensidade de dor seja semelhante.
Conclusão: A implementação do uso destas ferramentas na prática clínica será fundamental para a melhoria da gestão da dor crónica.
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