Construção de instrumento de triagem biopsicossocial para abordagem de pacientes com dor orofacial

Abstract

Introduction: The biomedical model followed by the medical society over time considers only the biological and physical changes of the individual in the search for diagnosis and treatment of illnesses. The biopsychosocial model is broad and aims to study the cause or the disease progress, based on biological, psychological and social factors. It is a model that covers subjects ranging from medicine to psychology and sociology. Changes caused by orofacial pain can interfere with the affected individual's daily social activities leading to a negative effect on social function, emotional health and energy level. Pains that occur in head and neck region can be associated with inflammation, neoplasms, diseases ophthalmic, neurological, psychiatric, orthopedic, dental, in addition to other disorders. The screening of this patient is very important for the differential and correct diagnosis forwarding. Some studies report that patients with orofacial pain experience deregulation of the Autonomic Nervous System and, in addition, these individuals show a higher frequency of psychiatric disorders, anxiety, depression, alexithymia and are catastrophic. The proposal of this research was to build a biopsychosocial screening instrument for patients with pain orofacial. Objective: to investigate, through a systematic literature review, which predictors pain are more often associated with temporomandibular disorder and building a screening instrument for the biopsychosocial profile of patients with orofacial pain as well as validating the built instrument. Materials and Methods: the Systematic Review was developed according to the Preferred Items guidelines for Systematic Review and Meta-Analysis Reports (PRISM). The construction of the screening instrument is a descriptive study of methodological development of the validation type, being developed from the approaches qualitative and quantitative - developed in three stages. The first step was a review bibliographic focused on pain predictors; the second, qualitative step, had as an instrument for data collection a focus group, aimed at verifying users' perceptions of the defined theoretical framework; the third step, quantitative, was the development process questions, content validation, face, construct and verification of the reliability of the instrument, which was made in the second moment. Statistical analysis: To assess homogeneity, Cronbach's alpha> 0.70 was applied after applying the questionnaire to 13 patients. Conclusions: The predictors of pain most frequently associated with temporomandibular disorders are psycho-emotional factors, parafunction, sleep, genetic factors and myofascial pain. The questionnaire was completed within the proposed protocol, contemplating the biopsychosocial approach. All items included in the questionnaire were approved according to clarity, objectivity, relevance, appearance and precision by the committee of experts who were part of the process.