Kronik Ağrılı ve Bedensel Engelli Bireylerde Kas-İskelet Sistemi Sağlık Durumu, Ağrı Kabulü ve Başa Çıkma Stratejilerinin Belirlenmesi: Kesitsel Karşılaştırmalı Bir Çalışma

Öz

Amaç: Bu çalışmanın amacı, kronik ağrılı ve bedensel engelli bireylerin kas-iskelet sistemi sağlık durumu, ağrı kabulü ve başa çıkma stratejilerinin belirlenmesi ve kontrol grubuyla karşılaştırılmasıdır. Gereç ve Yöntem: Bu kesitsel çalışmaya çalışma grubu (kronik ağrısı ve bedensel engeli olan bireyler; n=44) ve kontrol grubu (kronik ağrısı olan ancak engeli olmayan bireyler; n=44) olmak üzere iki gruptan oluşan toplam 88 katılımcı dahil edildi. Katılımcıların sağlık durumu Kas-İskelet Sistemi Sağlık Durumu Anketi (MHQ), ağrı kabulü Kronik Ağrı Kabul Anketi (CPAQ) ve başa çıkma stratejileri COPE envanteri kullanılarak değerlendirildi. Sonuçlar: Gruplar arasında, MHQ ve COPE puanları açısından kontrol grubu lehine anlamlı farklılıklar varken (p<0.05), CPAQ puanları açısından anlamlı fark yoktu (p>0,05). Tartışma: Çalışma sonuçları, disiplinler arası kronik ağrı yönetimi programlarında bedensel engelli bireylerde başa çıkma stratejilerinin dikkatli değerlendirilmesi ve kişiye uygun başa çıkma stratejilerinin müdehale programına dahil edilmesi konularına dikat çekmektedir.

Anahtar Kelimeler

• Ağrı kabulü
• Başa çıkma
• Kronik ağrı
• Bedensel engel
• kas-iskelet sistemi sağlık durumu anketi

Identification of Musculoskeletal Health Status, Pain Acceptance, and Coping Strategies in Individuals with Chronic Pain and Physical Disabilities: A Cross-Sectional Comparative Study

Öz

Purpose: The purpose of this study is to determine the musculoskeletal health status, pain acceptance, and coping strategies of individuals with chronic pain and physical disabilities and compare them with control group. Material and Methods: This cross-sectional study included a total of 88 participants, divided into two groups: the study group (individuals with chronic pain and physical disabilities; n=44) and the control group (individuals with chronic pain but without disabilities; n=44). Participants' musculoskeletal health was assessed using the Musculoskeletal Health Questionnaire (MHQ), pain acceptance using the Chronic Pain Acceptance Questionnaire (CPAQ), and coping strategies were evaluated using the COPE inventory. Results: Significant differences were observed between the groups in terms of MHQ scores and COPE scores (p<0.05), favoring the control group. However, there were no significant differences in terms of CPAQ scores (p>0.05). Discussion: This results emphasizes the need for a careful assessment of coping strategies in individuals with chronic pain and physical disabilities in interdisciplinary chronic pain management programs, as well as the inclusion of personalized coping strategies in the intervention program.

Anahtar Kelimeler

• Chronic pain
• disabled persons
• coping strategies
• acceptance process
• musculoskeletal diseases

Kaynakça

1. Akkubak, Y., & Külünkoğlu, B. A. (2020). Reliability and validity of the Turkish version of Arthritis Research UK Musculoskeletal Health Questionnaire. Arc Rheumatol, 35(2). https://doi.org/10.46497/ArchRheumatol.2020.7471
2. Akmaz, H. E., Meltem, U., Yildirim, Y. K., & Korhan, E. A. (2018). Validity and reliability of the Turkish chronic pain acceptance questionnaire. Balkan Med J, 35(3), 238.
3. Burcu, E. (2011). Cultural definitions regarding disabled individuals within turkey: example of Ankara. Hacettepe University Journal of Faculty of Letters, 19(1), 37-54.
4. Collins, S. L., Moore, A. R., & McQuay, H. J. (1997). The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain, 72(1-2), 95-97. https://doi.org/10.1016/S0304-3959(97)00005-5
5. De la Vega, R., Groenewald, C., Bromberg, M. H., Beals‐Erickson, S. E., & Palermo, T. M. (2018). Chronic pain prevalence and associated factors in adolescents with and without physical disabilities. Dev Med Child Neurol, 60(6), 596-601. https://doi.org/10.1111/dmcn.13705
6. Dicle, A. N., & Ersanlı, K. (2015). Başa Çıkma Tutumlarını Değerlendirme Ölçeği’nin Türkçeye uyarlama geçerlik ve güvenirlik çalışması. Akademik Sosyal Araştırmalar Dergisi, 3(16), 111-126. https://doi.org/10.16992/ASOS.783
7. Ehde, D. M., Jensen, M. P., Engel, J. M., Turner, J. A., Hoffman, A. J., & Cardenas, D. D. (2003). Chronic pain secondary to disability: a review. Clin J Pain, 19(1), 3-17.
8. Engel, J. M., Kartin, D., Carter, G. T., Jensen, M. P., & Jaffe, K. M. (2009). Pain in youths with neuromuscular disease. Am J Hosp Palliat Care, 26(5), 405-412. https://doi.org/10.1177/1049909109346165

9. Findlay, B., Switzer, L., Narayanan, U., Chen, S., & Fehlings, D. (2016). Investigating the impact of pain, age, Gross Motor Function Classification System, and sex on health‐related quality of life in children with cerebral palsy. Dev Med Child Neurol, 58(3), 292-297. https://doi.org/10.1111/dmcn.12936
10. Gottlieb, C. A., Maenner, M. J., Cappa, C., & Durkin, M. S. (2009). Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: data from the third round of UNICEF's Multiple Indicator Cluster Survey (2005–06). The Lancet, 374(9704), 1831-1839. https://doi.org/10.1016/S0140-6736(09)61871-7
11. Hill, J. C., Kang, S., Benedetto, E., Myers, H., Blackburn, S., Smith, S., et al. (2016). Development and initial cohort validation of the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open, 6(8), e012331. https://doi.org/10.1136/bmjopen-2016-012331
12. Hughes, L. S., Clark, J., Colclough, J. A., Dale, E., & McMillan, D. (2017). Acceptance and commitment therapy (ACT) for chronic pain. Clin J Pain, 33(6), 552-568. https://doi.org/10.1097/AJP.0000000000000425
13. Jakobsson, U., Klevsgård, R., Westergren, A., & Hallberg, I. R. (2003). Old people in pain: a comparative study. J Pain Symptom Manage, 26(1), 625-636. https://doi.org/10.1016/S0885-3924(03)00145-3
14. Jensen, M. P., Moore, M. R., Bockow, T. B., Ehde, D. M., & Engel, J. M. (2011). Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review. Arch Phys Med Rehabil, 92(1), 146-160. https://doi.org/10.1016/j.apmr.2010.09.021
15. Kara, B., & Açıkel, C. H. (2012). Predictors of coping in a group of Turkish patients with physical disability. J Clin Nurs, 21(7‐8), 983-993. https://doi.org/10.1111/j.1365-2702.2011.03890.x
16. Livneh, H., & Martz, E. (2014). Coping strategies and resources as predictors of psychosocial adaptation among people with spinal cord injury. Rehabil Psychol, 59(3), 329. https://doi.org/10.1037/a0036733
17. McCracken, L. M. (1998). Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74(1), 21-27. https://doi.org/10.1016/S0304-3959(97)00146-2
18. Miró, J., de la Vega, R., Tomé-Pires, C., Sánchez-Rodríguez, E., Castarlenas, E., Jensen, M. P., et al (2017). Pain extent and function in youth with physical disabilities. J Pain Res, 10, 113. https://doi.org/10.2147/JPR.S121590
19. Miró, J., Castarlenas, E., de la Vega, R., Solé, E., Tomé‐Pires, C., Jensen, M. P., et al (2016). Validity of three rating scales for measuring pain intensity in youths with physical disabilities. Eur J Pain, 20(1), 130-137. https://doi.org/10.1002/ejp.704
20. Noel, M., Groenewald, C. B., Beals-Erickson, S. E., Gebert, J. T., & Palermo, T. M. (2016). Chronic pain in adolescence and internalizing mental health disorders: a nationally representative study. Pain, 157(6), 1333. https://doi.org/10.1097/j.pain.0000000000000522
21. Smith, B. H., Elliott, A. M., Chambers, W. A., Smith, W. C., Hannaford, P. C., & Penny, K. (2001). The impact of chronic pain in the community. Family Practice, 18(3), 292-299. https://doi.org/10.1093/fampra/18.3.292
22. Stanos, S. (2012). Focused review of interdisciplinary pain rehabilitation programs for chronic pain management. Curr Pain Headache Rep, 16(2), 147-152. https://doi.org/10.1007/s11916-012-0252-4
23. Turk, D. C., Wilson, H. D., & Cahana, A. (2011). Treatment of chronic non-cancer pain. Lancet, 377(9784), 2226-2235. https://doi.org/10.1016/S0140-6736(11)60402-9
24. WHO (2001). International Classification of Functioning, Disability and Health (ICF). Geneva.
25. Wilson, S., Washington, L. A., Engel, J. M., Ciol, M. A., & Jensen, M. P. (2006). Perceived social support, psychological adjustment, and functional ability in youths with physical disabilities. Rehabil Psychol, 51(4), 322. https://doi.org/10.1037/0090-5550.51.4.322