Associação de dor crônica com uso de serviços de saúde em idosos residentes em São Paulo

Abstract

OBJECTIVE:Evaluate the association between use of health care services by older adults with chronic pain and sociodemographic and health variables. METHODS:Cross-sectional study whose population sample of 1,271 older adults with chronic pain and with no cognitive deficit was obtained through home surveys in Sao Paulo, SP, Southeastern Brazil,, in 2006. The study considered pain lasting for six or more months as chronic. The criterion for health care service use was more than four doctor appointments or having been admitted to a hospital during the past year. For those in chronic pain for at least one year, the existence of an association between the use of health care services and independent variables (pain and socio-demographical characteristics and self-reported morbidities) was tested using univariate (RaoScott test of association) and multivariate analysis (Cox Multiple Regression with robust variance). Stata 11.0 was used for the statistical analysis, and the significance level adopted was p < 0.05. RESULTS:The prevalence of health care service use among older people with pain was 48,0% (95%CI 35.1;52.8) and did not differ from older adults without chronic pain (50.5%, 95%CI 45.1;55.9). The multivariate analysis showed that the chance of using health care services was 33,0% lower for older adults with pain for more than two years than those with pain between one and two years (p = 0.002). The chance was 55,0% higher for those with intense pain (p = 0.003) and 45,0% higher for those with moderate pain interference in the work (p = 0.015). CONCLUSIONS:Chronic pain was found to be common and was associated with negative effects on independence and mobility. More intense and recent chronic pain that affected work resulted in greater use of health care services.

Comparação entre os métodos subjetivo e objetivo para avaliação da dor em idosos

“…Um estudo realizado na cidade de São Paulo, envolvendo 377 idosos, apresentou como locais de maior dor referida a região lombar e membros inferiores 5 . Outro estudo feito com uma amostra de 451 idosos na cidade de Londrina (PR) apontou como os principais locais de dor em idosos a região lombar e membros inferiores 6 .…”

Access determinants and use of health services among the elderly

“…In this perspective, aging confers changes in demands for health services with greater demand for elderly (DELLAROZA et al, 2013;VERAS, 2009). Hospital admissions are more frequent and the bed occupancy time is longer when compared to other age groups (VERAS, 2009).…”

“…The use of health services for the elderly is multifactorial and is related to the individual and structural factors and aspects of the social environment where the elderly is inserted (DELLAROZA et al, 2013). The access is understood as an element of the health system that covers the entry and treatment follow-up (TEIXEIRA; OLIVEIRA; SILVA, 2011).…”

“…), physical activity participants (VIRTUOSO et al, 2012), elderly with chronic pain (DELLAROZA et al, 2013) and disability (FIALHO et al, 2014).…”

Itinerário terapêutico de idosas com lombalgia crônica

“…Em pesquisa realizada para identificar a prevalência e características da dor crônica de idosos numa grande metrópole, observou-se prevalência de 29,7% de dor crônica, sendo a região lombar o local com maior frequência de acometimento 5 . Em função da gravidade do quadro e do desconforto gerado pela dor, esses sujeitos percorrem caminhos distintos durante a busca por tratamento, resultando no que chamamos de itinerário terapêutico.…”