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Abstract(s)
Introdução: Em Portugal, a Dor Lombar Crónica (DLC) é uma das manifestações reumatológicas
mais frequentes, afectando 12,3% (95%IC: 10,5-14,3) dos indivíduos adultos. Na complexidade da
DLC, parecem existir diferentes componentes de dor, isto é, dor Nociceptiva (NOC), Neuropática
(NEP) e mista que podem contribuir para diferentes tipos de dor num indivíduo.
Objectivo: Contribuir para a validação do PAIN DETECT QUESTIONNAIRE através do estudo da
sua fiabilidade, validade de constructo na classificação da componente NOC/NEP e mista, em
utentes com DLC.
Metodologia: Realizou-se um estudo metodológico, transversal para avaliar as propriedades
psicométricas da versão portuguesa da PDQ em 102 indivíduos com DLC. Foi realizado o estudo da
validade estrutural do PDQ-PT através da Análise Fatorial Exploratória (AFE), da consistência
interna, fiabilidade teste-reteste e validade de constructo (convergente e discriminativa). Para
avaliação da validade de constructo convergente e discriminativa foram estabelecidas hipóteses
apriori relativas à força da correlação e significado estatístico com a DN4-PT (validade convergente)
e relativas à capacidade do instrumento detetar diferenças com significado estatístico entre os
subgrupos NOC e NEP na intensidade da dor (escala numérica de Dor) e na incapacidade funcional
(Quebec Back Pain Disability Scale).
Resultados: A AFE revelou uma solução fatorial inicial de apenas um fator comum (descritores da
dor neuropática), com um engeinvalue de 3,45 que explica 49,3% da variância total no conjunto dos
7 itens analisados. O PDQ-PT revelou uma excelente consistência interna (α de Cronbach=0,84) e
excelente fiabilidade teste-reteste (CCI= 0,97; IC 95%: 0,95-0,98, p<0.001). Relativamente à
validade de constructo foram corroboradas todas as hipóteses estabelecidas apriori. Foi observada
uma forte correlação entre o PDQ-PT e a DN4-PT (r=0,739, p<0.001) e detetou-se diferenças
significativas, no que respeita à intensidade da dor e incapacidade funcional, entre utentes DLC
NEP e NOC (p=0,005 e p=0.011, respetivamente).
Conclusões: O PDQ-PT demonstrou boa validade e fiabilidade, recomendando-se o seu uso na
medição e classificação do tipo de dor predominante (NOC/NEP e MISTA) em utentes com DLC,
em contexto clínico e de investigação.
Introduction: In Portugal, Chronic Low Back Pain (CLBP) is one of the most frequent rheumatological changes, which affects 12,3% (95%CI: 10,5-14,3) of adults individuals. In complexity of CLBP, there are different pain components, which are nociceptive NOC), neuropathic (NEP) and mixed that might contribute to different types of pain in an individual. Objective: Contribute to the validation of PAIN DETECT QUESTIONNAIRE (PDQ) through the study of its reliability and construct validity in classification of the NOC/NEP and mixed components, in patients with CLBP. Methodology: A cross-sectional methodological study was carried out to evaluate the psychometric properties of the Portuguese version of PDQ in 102 subjects with DLC. The study of the structural validity of PDQ-PT through Exploratory Factor Analysis (EFA), internal consistency, test reliability and construct validity (convergent and discriminative) was carried out. In order to evaluate the validity of the convergent and discriminative construct, a priori hypotheses regarding correlation strength and statistical significance were established with DN4-PT (convergent validity) and related to the instrument's ability to detect differences with statistical significance between the NOC and NEP subgroups in the intensity of the pain (numerical scale of pain) and functional disability (Quebec Back Pain Disability Scale). Results: Through AFE revealed an initial factorial solution of only one common factor (descriptors of neuropathic pain), with an eigenvalue of 3.45 that explains 49.3% of the total variance in the set of 7 items analyzed. PDQ-PT revealed excellent internal consistency (Cronbach's α = 0.84) and excellent test-retest reliability (ICC = 0.97, 95% CI: 0.95-0.98, p <0.001). Regarding the construct validity, all hypotheses established a priori were corroborated. Spearman correlation was observed between PDQ-PT and DN4-PT (r = 0.739, p <0.001) and fundamental differences were detected in subjects with DLC, regarding pain intensity and functional disability, among DLC NEP patients and NOC (p = 0.005 and p = 0.011, respectively). Conclusion: PDQ-PT demonstrated good validity and reliability, recommending its use in the measurement and classification of the predominant type of pain (NOC / NEP and MISTA) in patients with DLC, in clinical and research context.
Introduction: In Portugal, Chronic Low Back Pain (CLBP) is one of the most frequent rheumatological changes, which affects 12,3% (95%CI: 10,5-14,3) of adults individuals. In complexity of CLBP, there are different pain components, which are nociceptive NOC), neuropathic (NEP) and mixed that might contribute to different types of pain in an individual. Objective: Contribute to the validation of PAIN DETECT QUESTIONNAIRE (PDQ) through the study of its reliability and construct validity in classification of the NOC/NEP and mixed components, in patients with CLBP. Methodology: A cross-sectional methodological study was carried out to evaluate the psychometric properties of the Portuguese version of PDQ in 102 subjects with DLC. The study of the structural validity of PDQ-PT through Exploratory Factor Analysis (EFA), internal consistency, test reliability and construct validity (convergent and discriminative) was carried out. In order to evaluate the validity of the convergent and discriminative construct, a priori hypotheses regarding correlation strength and statistical significance were established with DN4-PT (convergent validity) and related to the instrument's ability to detect differences with statistical significance between the NOC and NEP subgroups in the intensity of the pain (numerical scale of pain) and functional disability (Quebec Back Pain Disability Scale). Results: Through AFE revealed an initial factorial solution of only one common factor (descriptors of neuropathic pain), with an eigenvalue of 3.45 that explains 49.3% of the total variance in the set of 7 items analyzed. PDQ-PT revealed excellent internal consistency (Cronbach's α = 0.84) and excellent test-retest reliability (ICC = 0.97, 95% CI: 0.95-0.98, p <0.001). Regarding the construct validity, all hypotheses established a priori were corroborated. Spearman correlation was observed between PDQ-PT and DN4-PT (r = 0.739, p <0.001) and fundamental differences were detected in subjects with DLC, regarding pain intensity and functional disability, among DLC NEP patients and NOC (p = 0.005 and p = 0.011, respectively). Conclusion: PDQ-PT demonstrated good validity and reliability, recommending its use in the measurement and classification of the predominant type of pain (NOC / NEP and MISTA) in patients with DLC, in clinical and research context.
Description
Dissertação de Mestrado em Fisioterapia
Relatório de Projeto de Investigação
Keywords
Pain Detect Questionnaire Validade Fiabilidade Dor Lombar Crónica Validity Reliability Chronic Low Back Pain
Citation
Publisher
Instituto Politécnico de Setúbal. Escola Superior de Saúde