Influence of Pain on the Quality of Life in Patients with Venous Ulcers: Cross-sectional Association and Correlation Study in Brazilian Primary Health Care

Description

This study aimed to verify the association and correlation between pain and QoL in people with VU assisted in Brazilian PHC. Descriptive, observational, cross-sectional study with a quantitative approach, carried out from August to October 2019, with patients treated at the PHC in the municipality of Parnamirim, State of Rio Grande do Norte, Brazil. The city has 29 Basic Health Units (UBS) distributed among the 23 neighborhoods of the city, which has a population of 272,490 inhabitants and is located in the Metropolitan Region of Natal, the state capital. Before data collection, each health unit was previously visited to obtain the total number of people with VU treated, which totaled 157 patients. Based on this quantity, the sample calculation was performed using an online formula of quantitative variables for finite populations (https://calculareconverter.com.br/calculo-amostral/). A population size of 157 was considered, with a confidence level of 95% and a margin of error of 5%, resulting in 112 individuals. All units could be consulted and the final sample had representatives from all UBS. A total of 103 individuals who were located and surveyed completed the study. The Short Form Health Survey 36 (SF-36) and the Visual Analog Pain Scale (VAPS) were used. Data collection took place in the form of face-to-face interviews during consultations in the office of the specialized service in VU treatment and were guided by the questions of the selected instruments. For nominal variables, the normality test (Kolmogorov-Smirnov) was applied, identifying a non-normal sample. For sample characterization, absolute (n) and relative (%) frequencies were used. Pearson's non-parametric chi-square test was used to assess the association between sample characteristics and the presence of ulcers, and the percentiles with the SF-36 domains and dimensions. The Kruskal-Walis test was used to assess the association between the domains and dimensions of the SF-36 instrument and the pain scale, and the Spearman Rho test was used to assess the correlation (r) between these scalar variables of pain and QOL . In the correlation analysis, we adopted the following parameters to classify the correlation strength: weak <0.39, moderate between 0.40 and 0.50, and strong correlation >0.50. By Cronbach's α test, the SF-36 was evaluated with good internal consistency, due to α=0.78, in which values greater than 0.70 reveal good consistency. For all tests, we considered a 5% margin of error, a 95% Confidence Interval (CI) and a statistical significance value when p<0.05. 103 patients participated in the study. Higher QoL scores associated with moderate pain were found, especially in the Physical role functioning, Physical functioning and Vitality domains. The correlation analysis pointed out its greater strength (moderate) in the interaction between the highest scores in the Physical role functioning and Emotional role functioning domains and the lowest pain levels.

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