Implementation process of the strategy of surveillance of chronic musculoskeletal pain in basic health care. Case report

Abstract

BACKGROUND AND OBJECTIVES: Chronic pain is a persistent indicator for the basic health care. It is estimated that between 30 and 40% of Brazilians suffer some chronic pain, including musculoskeletal pain, making necessary the development of strategies to cope with such indicator. In light of the above, this study aimed at reporting the experience of the implementation process of the Strategy of Surveillance of Chronic Musculoskeletal Pain in basic health care of the city of Maracanaú/CE. METHODS: This is a qualitative and interpretative study by means of description of the strategy implementation process stages. RESULTS: The Strategy of Surveillance of Chronic Musculoskeletal Pain flowchart was based on and made up of an open cycle, where patients admitted to the unit with musculoskeletal pain were submitted to initial evaluation by the nursing team, and then were referred to the physician for clinical consultation and diagnosis of referred pain. In case of chronic musculoskeletal pain, patients were referred to physiotherapy. CONCLUSION: The implementation of the strategy has allowed for more systematic integration among Family Health Strategy professionals. For physiotherapists, the experience has brought further guidance as to the actions of the category in basic health care with regard to prevention, promotion and health education.

Catastrophic thinking and functional disability in Primary Health Care chronic pain patients

“…Despite the inference that CMP is a serious public health problem 1,2,4,7 and the reasonable number of publications on the topic, there is no intervention routine for managing the psychosocial aspects of CP in primary health care 7 .…”

“…The construct of pain perception occurs through subjective processes and is, therefore, an individual and multidimensional experience 1 . Chronic pain (CP) is defined as a discomfort that persists continuously or episodically for more than 3 months 1 , often related to musculoskeletal origins 2 . The worldwide prevalence of CP in adults is 40% 3 .…”

“…Although CMP is one of the main causes that lead the population to seek care in Brazil's Basic Health Units (UBS -Unidades Básicas de Saúde), the scope of primary health care doesn't encompass treatment directed to the biopsychosocial model of pain. Although it's possible to institute an efficient and safe multidisciplinary approach in primary care, in many UBS patients are referred to specialists or receive only pharmacological treatment 7 ; or yet, in most cases, the result of the therapeutic intervention frustrates patients and the health staff 2 . Additionally, the study of the association between catastrophizing thoughts, pain intensity and functional disability has often been directed to very specific pains such as knee osteoarthritis, knee arthroplasty and shoulder CP, thus the conclusions of these analyses are restricted to these special health conditions 12 .…”

A prática do Fisioterapeuta na Atenção Primária: Revisão integrativa

“…A atuação do fisioterapeuta junto a equipe multiprofissional por meio de programas de residência é revelada por Araújo et al (2018), Sales (2016) e Silva et al (2016).…”

“…Por último,Silva et al (2016), exploram a atuação do residente inserido em uma estratégia intitulada "Estratégia Vigilância à Dor Crônica de Origem Osteomioarticular", em que o profissional exerce papel de avaliar o indivíduo e identificar as necessidades do usuário, seguindo critérios para cada caso. Durantes estes atendimentos, tem-se a prática de realizar orientações sobre determinada patologia que o indivíduo apresente, sobre hábitos saudáveis, estimulo a adesão da prática de exercícios físicos na rotina e técnicas para analgesia e melhora do quadro clinico e qualidade de vida.…”