Izhodišče. Depresija in anksioznost sta pogosti sočasni duševni motnji s kronično bolečino. Bolniki s tema motnjama doživljajo intenzivnejšo bolečino, ki traja dlje časa. Obstajajo tudi ...socialno-kontekstualni dejavniki bolečine, kot so spremenjena socialna vloga človeka s kronično bolečino oziroma socialna izločenost.
Background. Depression, anxiety and chronic pain are frequent co-occurrent disorders. Patients with these mental disorders experience more intense pain that lasts for a longer time.
Method. ...Questionnaire with 228 variables was applied to 109 randomly chosen patients that were treated at an outpatient clinic for treatment of chronic pain of the University Clinical Centre Ljubljana from March to June 2013. 87 patients responded to the questionnaire (79.8%). Location of pain considering diagnosis was the criterion in the discriminant analysis (soft tissue disorders; headache; symptoms not elsewhere classified; back pain) and following summative scores as predictors: level of depression and anxiety (The Zung Self-Rating Depression/Anxiety Scale), evaluation of pain and perceptions of being threatened in social relations.
Results. Average age of participants was M = 52.7 years (SD 13.9), with 70.9% female, 29.1% male participants. 63% of respondents achieved clinically important level of depression and 54% clinically important level of anxiety. On univariate level, the highest level of depression and anxiety was found for back pain and the lowest for headache. No significant difference was found in evaluation of pain and perceptions of being threatened in social relations regarding location of pain. Self-evaluation of depression has, in the framework of discriminant analysis, the largest weight for prediction of differentiation between different locations of pain.
Conclusion. Different locations of pain have different connections with mood levels. The results of research on a preliminary level indicate the need to consider mental experience in the treatment of chronic pain
Izhodišče. Depresija in anksioznost sta pogosti sočasni duševni motnji s kronično bolečino. Bolniki s tema motnjama doživljajo intenzivnejšo bolečino, ki traja dlje časa. Obstajajo tudi socialno-kontekstualni dejavniki bolečine, kot so spremenjena socialna vloga človeka s kronično bolečino oziroma socialna izločenost.
Metoda. Vprašalnike z 228 spremenljivkami smo aplicirali na 109 naključno izbranih bolnikov, ki so se zdravili v Ambulanti za zdravljenje bolečine Kliničnega centra Ljubljana od marca do junija 2013. 87 bolnikov je izpolnilo vprašalnik (79,8 %). V diskriminantni analizi je bil kriterij lokacija bolečine glede na diagnozo (motnja mehkih tkiv; glavobol in živčni pleteži; nespecifični simptomi; bolezni hrbta), kot prediktorji pa seštevne vrednosti depresivnosti (Zungova samoocenjevalna lestvica depresivnosti), anksioznosti (Zungova samoocenjevalna lestvica anksioznosti), evalvacije bolečine in zaznave lastne ogroženosti v socialnih odnosih zaradi bolečine.
Rezultati. Povprečna starost udeležencev je bila 52,7 leta (SD 13,9), 70,9 % žensk in 29,1 % moških. 63 % jih je doseglo klinično pomembno raven depresivnosti in 54 % klinično pomembno raven anksioznosti. Na univariatni ravni smo ugotavljali najvišjo raven depresivnosti in anksioznosti pri lokaciji bolečine v hrbtu, najnižjo pri glavobolu. Med prediktorji diskriminantne analize ima za napoved razlikovanja med bolečinskimi lokacijami izrazito največjo težo samoocena depresivnosti. Gre za zelo visoko korelacijo (0,93). Raven depresivnosti v naturalističnem vzorcu protibolečinske ambulante najbolje napoveduje lokacijo/diagnozo bolečine. Če so udeleženci ocenjevali raven svoje depresivnosti kot visoko, so sodili v skupino z diagnozo bolečine v hrbtu. Udeleženci z diagnozo bolečine v hrbtu tudi v pomembno večjem številu še vedno prebolevajo resne stresorje iz preteklega leta kot udeleženci z drugimi lokacijami bolečine. Udeleženci z lokacijo bolečine glavobol se glede raziskovanih spremenljivk (depresivnost, anksioznost, evalvacija bolečine, zaznava lastne ogroženosti v socialnih odnosih zaradi bolečine) najbolj razlikujejo od udeležencev z drugimi tremi lokacijami bolečine; najbolj so si podobni udeleženci z lokacijo mehkih tkiv in diagnozo nespecifičnih simptomov. Udeleženci pa se glede na lokacijo bolečine niso razlikovali med seboj glede tega, kako škodljivo doživljajo bolečino in kako prizadete se počutijo zaradi bolečine v svojih socialnih odnosih.
Zaključek. Različne lokacije bolečine se na različen način povezujejo z različno ravnijo razpoloženja. V raziskovanem vzorcu je ocena ravni lastne depresivnosti ekskluzivni napovedovalec lokacije bolečine. Rezultati raziskave na preliminarni ravni kažejo potrebo po upoštevanju duševnega doživljanja pri obravnavi bolnikov s kronično bolečino
Health-related absenteeism impacts individuals, companies, and society. Its consequences are reflected in the cost of benefits, substitutes, and reduced productivity. Research shows that ...musculoskeletal disorders (MSDs) are the most common work-related health problem reported by hospital staff. This study determines the groups at the Ljubljana University Medical Centre that are most susceptible to MSDs, especially low back pain.
Using data from the Health Data Centre of the Slovenian National Public Health Institute and the medical centre, this cross-sectional study analysed absenteeism among medical centre employees. The correlation between MSD / low-back pain risk factors and incidence was determined using logistic regression. An odds ratio was calculated to determine the probability of MSDs, most especially low back pain via sex, age, occupation, and education.
Sick leave at the medical centre is higher than 5%, exceeding the Slovenian healthcare sector average. MSDs, as the main reason for absence, is significantly more frequent in women, non-medical staff, and employees with a maximum secondary school education. Among the MSDs, low back pain predominates as a reason for absence and is most frequent among nurses, midwives, and employees of 20 to 44.9 years old.
This study offers insight into the health status of medical centre employees. The high percentage of sick leave is mainly due to musculoskeletal disorders, including low back pain. This is an important basis for further monitoring and analysis of sick leave indicators and for planning systematic and continuous workplace health-promoting measures to manage ergonomic risk factors and reduce health-related absenteeism.
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