ABSTRACT
Objective:To investigate the current situation of early postoperative pain beliefs in patients with mixed hemorrhoids and its influencing factors, and to provide a basis for formulating targeted intervention measures.Methods:Totally 242 postoperative patients with mixed hemorrhoids who were treated in Guilin Integrated Traditional Chinese and Western Medicine were selected by convenience sampling method from January 2020 to January 2021 as the research object. The general information questionnaire, Pain Belief and Perception Scale, Visual Analogue Scale, Positive and Negative Emotion Scale were used to investigate. Multiple linear regression was used to analyze the factors influencing of early postoperative pain beliefs in patients with mixed hemorrhoids.Results:The total score of early postoperative pain belief in patients with mixed hemorrhoids was -21-30 (5.32 ± 2.57) points; the results of multiple linear regression analysis showed that age, education level, anal visual analogue score, and negative emotion scores were main factors affecting their pain beliefs ( r=0.736, P<0.05). Conclusions:Patients with mixed hemorrhoids have negative pain beliefs in the early postoperative period. Patients with advanced age, primary/junior high school, high anal pain intensity, and high negative emotion scores are more likely to have negative pain beliefs. Nursing staff should promptly formulate targeted intervention measures according to the main influencing factors in order to reduce the occurrence of negative beliefs about pain.
ABSTRACT
Os objetivos deste estudo foram identificar a prevalência de adesão plena, parcial e não adesão ao tratamento em doentes com dor crônica ao longo de seis meses; caracterizar os motivos da adesão e buscar relações entre adesão e variáveis demográficas, psicossocioculturais, de características de dor e do tratamento. Trinta docentes do Ambulatório de Dor do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram avaliados em cinco entrevistas ao longo de seis meses. Os instrumentos utilizados foram: identificação e caracterização da dor, descrição do tratamento medicamentoso, Escala de Locus de Controle da Saúde, Inventário de Depressão de Beck e Inventário de Atitudes frente à Dor-versão breve. Os doentes foram classificados quanto à adesão em plenamente aderentes (cumprimento total da prescrição medicamentosa), parcialmente aderentes (cumprimento parcial da prescrição medicamentosa) e não aderentes (não cumprimento da prescrição). Foram feitos testes estatísticos para verificar a presença de relações entre as variáveis e, em todos os testes, foi utilizado o nível de significância de 5%. O índice de não adesão e adesão parcial foi alto, entre 40,0% e 56,7%, e não houve variação significativa ao longo de seis meses. O Índice de Acerto de Ingestão Medicamentosa foi entre 57,2% e 69%, e também não houve variação. A principal razão para adesão plena foi "o remédio melhora a dor" (54,0% a 63,9%), para a adesão parcial foi "sente-se mal, tem efeitos colaterais" (55,6% a 66,6%), e para a não adesão foram "indisponibilidade na farmácia do hospital" (23,1% a 28,9%), "sente-se mal, tem efeitos colaterais" (25%) e "dinheiro insuficiente para a compra" (15,4% a 23,7%). A depressão e o locus de controle da saúde não variaram em seis meses. As atitudes frente à dor, com exceção do domínio cura médica, também não variaram ao longo de seis meses. Não se observaram relações estatisticamente ) significativas entre adesão e idade, estado civil, escolaridade, renda, características de dor, número de comprimidos, número de tomadas, uso de automedicação, presença de depressão, dimensões externalidade outros poderosos e acaso do locus de controle da saúde, e domínios controle, emoção, medicação e cura médica do Inventário de Atitudes frente à Dor. Observaram-se relações estatisticamente significativas entre adesão e presença de efeitos colaterais, dimensão internalidade e índice de Internalidade Total do locus de controle da saúde e domínios incapacidade, dano físico e solicitude do Inventário de Atitudes frente à Dor.
The aims of this study were identifying the prevalence of total compliance, partial compliance and non-compliance with the treatment of patients with chronic pain in the lenght of six months; characterising their reason for compliance and looking for relationship between compliance and demographic, psycho-social-cultural, characteristics of pain and treatment variables. Thirty out-patient in the Pain Clinic of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo were evaluated in five interviews in a period of six months. The instruments used were: identification and characterisation of pain, description of medical treatment, Multidimensional Health Locus of Control Scale, Beck Depression Inventory and Survey of Pain Attitudes-brief version. Patients were classified according to compliance as totally compliant (closely following the medical prescription), partially compliant (partially following the medical prescripton) and non-compliant (not following the medical prescription). Statistical tests were carried out to verify the presence of relationship among variables and, in every test, the significance level of 5% was used. The incidence of non-compliance and partial compliance was high, varying between 40,0% and 56,7%, and there was no significant variation during the six months. The Indexes of Right Ingestion of Medication was between 57,2% and 69% and, here too, there was not variation. The main reason for total compliance was "the medication eases the pain" (54,0% to 63,9%), for partial compliance was "felling bad, presence of side effects" (55,6% to 66,6%), and for non-compliance were "medicine unavailable in the hospital pharmacy" (23,1% to 28,9%)," feeling bad, having side effects" (25%) and "can not afford to buy the medicine prescribed" (15,4% to 23,7%). The depression and the health locus of control did not change in six months. Attitudes towards pain, with exception of cure dimension, did not change during six months. No significant statistic relationships were observed between compliance and age, marital status, education background, income group, characteristics of pain, number of pills taken, frequency of ingestion of medicine, use of self-medication, occurence of depression, powerful others and chance externality dimensions of health locus of control and control, emotion, medication and cure domains of the Survey of Pain Attitudes. Significant statistical relationships were observed between compliance and presence of side effects, internality dimension and total internal indexes of health locus of control besides disability, harm and solicitude domains in Survey of Pain Attitudes.