Ferreira Fernanda de Assis da Costa, Góes Angela Baroni de, Casarotto Raquel Aparecida, Fernandes Tiótrefis Gomes, Castro Shamyr Sulyvan de, Schmitt Ana Carolina Basso
Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo SP, Brasil.
Universidade Federal do Amazonas. Faculdade de Educação Física e Fisioterapia. Manaus AM, Brasil.
Rev Saude Publica. 2024 Dec 16;58:52. doi: 10.11606/s1518-8787.2024058005400. eCollection 2024.
To investigate the relationship between sociodemographic factors, musculoskeletal pain and its characteristics, and the type of primary health care received with self-reported disability. This is a cross-sectional study, interviewing individuals selected from spontaneous demand for health care in two types of care: health center and family health unit. Disability was investigated using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 and characteristics of intensity, frequency, duration, number of pain sites, and regions. Measures of association between predictors and disability were performed with non-parametric statistical tests, whereas non-parametric regression models were presented for pain characteristics and for the general population. In total, 2.3% of family health users and 7.2% of health center users had severe levels of disability. Health center users had more self-reported disability than family health users (p < 0.001). Fewer years of life (p = 0.034) and lower per capita income quintile (p = 0.014) were associated with greater disability. The most intense pain and pain in the greatest number of sites increased the disability score by 1.8 (95%CI = 1.0-2.6) and 6.3 (95%CI = 0.1-12.2) points, respectively. Users who had more disabilities sought care at walk-in health centers, had lower per capita income, presented musculoskeletal pain of worse intensity, and pain in a greater number of sites.
为了调查社会人口学因素、肌肉骨骼疼痛及其特征与自我报告的残疾状况所接受的初级卫生保健类型之间的关系。这是一项横断面研究，对从两种类型的医疗保健（健康中心和家庭健康单位）中自发寻求医疗保健的个体进行访谈。使用世界卫生组织残疾评估量表（WHODAS）2.0调查残疾情况，并调查疼痛强度、频率、持续时间、疼痛部位数量和区域等特征。采用非参数统计检验对预测因素与残疾之间的关联进行测量，同时针对疼痛特征和一般人群给出非参数回归模型。总体而言，家庭健康单位使用者中有2.3%、健康中心使用者中有7.2%存在严重残疾水平。健康中心使用者的自我报告残疾情况比家庭健康单位使用者更多（p<0.001）。寿命较短（p = 0.034）和人均收入五分位数较低（p = 0.014）与更高的残疾程度相关。最剧烈的疼痛和疼痛部位数量最多会使残疾评分分别增加1.8分（95%置信区间=1.0 - 2.6）和6.3分（95%置信区间=0.1 - 12.2）。残疾程度更高的使用者会在无需预约的健康中心寻求护理，人均收入较低，存在强度更严重的肌肉骨骼疼痛，且疼痛部位数量更多。
