Chronic Pain - Perceptions, Limitations and Implications. A Social Perspective

Biomedical and Biopharmaceutical Research Health and Society | Saúde e Sociedade Biomed Biopharm Res. , 2013; (10) 1: 9-18 DOI: 10.19277/bbr.10.1.47 Jornal de Investigação Biomédica e Biofarmacêutica Chronic Pain - Perceptions, Limitations and Implications. A Social Perspective Dor Crónica - Percepções, Limitações e Implicações. Uma Perpectiva Social 1 2 Maria Carolina Monteiro *, Paulo Reis-Pina 1 Instituto da Segurança Social, IP Lisboa 2 Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE. , Lisboa Email: *This work was developed as part of the Master in Continuous Care (Universidade Lusófona, Lisboa) __________________________________________________________________________________ Abstract Chronic pain (CP) is a complex phenomenon that affects the lives of individuals at the level of well-being, family relationships and social and professional life, causing biological and psychosocial changes, and in most cases, suffering. CP is associated with physical, professional and social limitations, and compromises quality of life (QOL) provoking insecurity which results in considerable social and material losses. In this context a multidimensional pain assessment is fundamental in order to find a swift and appropriate response to the needs of each individual. The evaluation should take into account psychological and social factors in addition to physical factors. pain (CP) is a complex phenomenon that affects the lives of individuals at the level of well-being, family relationships and social and professional life, causing biological and psychosocial changes, and in most cases, suffering. CP is associated with physical, professional and social limitations, and compromises quality of life (QOL) provoking insecurity which results in considerable social and material losses. In this context a multidimensional pain assessment is fundamental in order to find a swift and appropriate response to the needs of each individual. The evaluation should take into account psychological and social factors in addition to physical factors. The authors of this paper reinforce the idea that any evaluation and / or intervention that is made in people with CP must always take into account the internal and external factors of the environment in which the individual belongs, and which influence how they perceive and assess their pain Keywords: Chronic pain; biopsychosocial model; well-being; quality of life, suffering. ___________________________________________________________________________________________________ Resumo A dor crónica (DC) é um fenómeno complexo que interfere na vida dos indivíduos ao nível do bem-estar, nas relações familiares e sociais, e na vida profissional, provocando alterações biológicas, psicossociais e, na maioria das vezes, sofrimento. Associada às limitações físicas, profissionais e sociais, a DC compromete a qualidade de vida (QDV) e promove a insegurança, resultando em perdas materiais e sociais consideráveis. Neste contexto é fundamental uma abordagem multidimensional na avaliação da dor, de modo a encontrar uma resposta célere e adequada às necessidades de cada indivíduo. A avaliação deve ter em conta, além dos factores físicos, os factores psicológicos e os sociais. Os autores, neste artigo, reforçam a ideia que, qualquer avaliação e/ou intervenção que seja feita em pessoas com DC, deve ter sempre em conta os factores internos e externos do meio em que o indivíduo está inserido e que influenciam o modo como este percepciona e avalia a sua dor. Palavras-chave: Dor crónica; modelo biopsicossocial; bem-estar; qualidade de vida, sofrimento. ________________________________________________________________________________________________ Received / Recebido : 02/02/2013 Accepted / Aceite: 11/04/2013 Electronic Edition: http://www.biomedicalandbiopharmaceuticalresearch.com 9 M. Carolina Monteiro & Paulo Reis-Pina Introduction Introdução Pain is a major factor that affects the full experience of a human being, whether in our individuality, in our private life or the socio-economic environment in which we operate. Pain restricts QOL, weakens the capabilities and limits human qualities. Pain constitutes a unique experience as it is subjective and personal. Each individual has their culture on pain which is conditioned by the biological, psychological, social, emotional, cultural and spiritual needs of that person [1]. According to the 'International Association for the Study of Pain' (IASP), pain is a multidimensional unpleasant experience. It involves sensory and emotional components, is usually associated with actual or potential tissue damage, and described according to the lesion [2]. CP is characterized as a persistent or recurrent pain lasting for at least 3-6 months and one which often persists beyond the healing of the injury that caused it, or where there is no [2] apparent injury . This type of pain is usually associated with chronic disease processes that cause continuous or recurrent pain [1] , conditioning limitations and disabilities that are reflected at the level [3] of employment, social life and family . In addition to affecting relationships, personal interaction and even the carrying out of daily life activities, CP most often becomes an increased economic burden which depletes the individual and those around them, both in physical and mental resources [4,5]. In many areas of knowledge there are various definitions for the concept of pain, some of which are more targeted towards healthcare and others more relevant to the psychosocial sphere. In this context, pain may be associated with a set of negative images resulting from either direct or indirect experiences of an individual such as prolonged suffering, the absence of treatment, abuse of and addiction to drugs[3]. This becomes a serious problem for the individual, their family and network of relationships because it limits and governs the behavior and living conditions of those [5, 6] involved . The negative impacts it has on many aspects of life are associated with a significant decline in functionality, social and family relationships and [5, 7, 8] QOL . In short, pain is a subjective sensation caused by physical and / or mental factors. We must pay attention to pain because the anguish and vulnerability that it causes in an individual may jeopardize their integrity [4] . A dor é um dos principais factores que condiciona a vivência plena do ser humano, seja na sua individualidade, na sua vida privada ou no meio sócioeconómico em que está inserido. A dor coarcta a QDV, enfraquece as capacidades e limita as qualidades do ser humano. A dor congrega uma experiência única, subjectiva e intransmissível. Cada indivíduo possui a sua cultura sobre dor, condicionada pelos aspectos biológicos, psicológicos, sociais, emocionais, culturais [1] e espirituais de cada ser Segundo a “International Association for the Study of Pain” (IASP), a dor é uma experiência multidimensional d (...truncated)