O efeito mediador das crenças e atitudes frente a dor na relação entre dor crônica e incapacidade em trabalhadores com LER

Abstract

Several studies have pointed an interaction among physical and psychosocial factors to explain the occurrence of disability. Under such conceptual framework, pain beliefs and attitude are described as important predictors of disability associated with chronic pain. However, characterization of the influence of these variables on the relation between pain and disability in workers is still not fully explored. The objective of this study was to test the hypothesis that pain beliefs and attitude are mediators of physical disability in a population of workers with chronic pain developed by Work Related Musculoskeletal Disorder (WRMD). A sample of 115 subjects answered a survey including information on multidimensional pain evaluation, pain beliefs and attitudes, disability, depression, socio-demographic and clinical data. The test of mediator effect, proposed by Baron & Kenny, was applied. The results confirmed the hypothesis that pain beliefs and attitudes are partial mediators of the relation between pain and disability (R2 = 0.36). Depression was also positively associated in the outcome, confirming results from other studies that pointed this variable as an important risk factor for disability (R2 = 0.50). Pain is a stressor agent, which results in negative consequences in ones life, acting over the physical, psychological and social domains. Psychological factors, as depression, can affect the perception of pain and functional performance. The unpredictability of the progression in the cases of chronic pain may reinforce negative emotions, leading to additional disability through a vicious circle. Indeed, it is necessary that rehabilitation professionals and clinicians are able to detect the most negative beliefs, depressive humor, limited social support and offer intervention that are in accordance with the needs of each patient, emphasizing his/her functioning.