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Previous issue date: 2008-02-13 / Temporomandibular Disorder (TMD) is defined as a group of muscular and articular disorders in the masticatory muscles fitted in the orofacial region. The pain is the main symptom and is often accompanied by behavioral factors that may contribute to the establishment and maintenance of the pain. The purpose of this study was to analyze the pain behavior of individuals suffering from TMD and the contingencies operating in the familiar environment. The research was carried out in a specialized attendance treating sufferers of TMD. Six patients complaining of facial pain during six months or more and diagnosed with miofascial pain, together with one relative of each patient took part, They were: P1 (patient and husband), P2 (patient and sister), P3 (patient and wife), P4 (patient and son), P5 (patient and daughter) and P6 (patient and mother). At fist the patients were attended by dentists and afterward forwarded to the researcher who conducted an interview with patient and his/her relative on the same day and all of them registered in a diary their behavior during seven days. The interviews and diaries were transcribed and sorted into categories: 1- characteristics of the pain , 2- pain behaviors , 3- accomplishment of activities with pain , 4- behavior of the relatives , 5- familiar context, and 6- work context . From the data obtained, were carried out statistical analysis about the accordance between de answers of patient and relatives concerning the intensity of the pain and the answers registered in the diaries and interviews. The Mann-Whitney test was used to test whether the groups were different in relation to intensity of the pain, in all comparisons there were no statistically significant differences (p> 0,05). It was used Spearman Correlation to test the correlation between the intensities reported by each patient and their relative. The correlations were positive and significant, respectively, for P1 (rs=0,96 p=0,0028), P2 (rs=0,89 p=0,0333), P3 (rs=0,8 p=0,0341) and P5 (rs=0,87 p = 0,0333). In the interviews and dairies were used Chi-Square tests of adherence comparing the frequency of the reports of the patient and relatives in each category (the subcategories were grouped), to check out the existence of significant statistical difference, the values calculated from Chi-Square were compared with x2=3,841. Differences were found in P1 in categories 1, x2=13,3704 and 2, x2=9,3077, P2 in categories 1, x2=4,8286 and 4, x2=3,8571, P3 in categories 1, x2=17,0645 and 2, x2=4,5675 and in P6 in category 2, x2=5,5538. In the dairies the difference was significant in P4 in category 2, x2=7,7586. The most frequent behaviors were pain behaviors and behavior of the relative related to pain behaviors . This research described the probable function of the operant pain in the familiar environment and contributed to examine the role of the behavioral therapist in the health team, which in addition to the consultations, should guide the team about the operant function of pain and its role in keeping the behaviors which increase the disability of patients and decrease the compliance to the treatment. / A Disfun??o Temporomandibular (DTM) ? definida como um conjunto de dist?rbios articulares e musculares na regi?o orofacial e m?sculos da mastiga??o. A dor ? o sintoma principal e ? freq?entemente acompanhada por fatores comportamentais que podem contribuir para o estabelecimento e manuten??o da dor. O objetivo do presente trabalho foi analisar o comportamento de dor de indiv?duos com DTM e as conting?ncias em opera??o no ambiente familiar. A pesquisa foi realizada em um servi?o especializado no atendimento de DTM. Participaram seis pacientes, com queixa de dor facial h? seis meses ou mais, com diagn?stico de dor miofascial e seus respectivos familiares, que foram: P1 (paciente e marido), P2 (paciente e irm?), P3 (paciente e esposa), P4 (paciente e filho), P5 (paciente e filha) e P6 (paciente e m?e). Os pacientes primeiramente foram atendidos por dentistas e depois encaminhados para a pesquisadora que realizou uma entrevista com paciente e familiar no mesmo dia e todos preencheram um di?rio por sete dias. As entrevistas e di?rios foram transcritos e as verbaliza??es categorizadas em 1- caracter?sticas da dor , 2- comportamentos de dor , 3- realiza??o de atividades com dor , 4- comportamentos do familiar , 5- contexto familiar e 6- contexto trabalho . A partir dos dados obtidos com as categoriza??es, foram realizadas an?lises estat?sticas sobre a concord?ncia das respostas entre paciente e familiar no que se referiu a intensidade da dor e nas respostas dos di?rios e entrevistas. O teste Mann-Whitney foi utilizado para testar se os grupos foram diferentes em rela??o ? intensidade da dor, em todas as compara??es n?o existiram diferen?as estatisticamente significantes (p>0,05). Utilizou-se a Correla??o de Spearman para testar a correla??o entre as intensidades relatadas por cada paciente e respectivo familiar, as correla??es foram positivas e significantes, respectivamente, para P1 (rs=0,96 e p=0,0028), P2 (rs=0,89 e p=0,0333), P3 (rs=0,8 e p=0,0341) e P5 (rs=0,87 e p=0,0333). Nas entrevistas e di?rios aplicaram-se testes Qui-Quadrado de Ader?ncia, comparando a freq??ncia dos relatos do paciente e do familiar em cada categoria (as subcategorias foram agrupadas), para verificar a exist?ncia de diferen?a estat?stica significante, os valores calculados do Qui-Quadrado foram comparados com o valor tabelado (x2=3,841) com 1 grau de liberdade, foram encontradas diferen?as em P1 nas categorias 1, x2=13,3704 e 2, =9,3077, P2 nas categorias 1, x2=4,8286 e 4, x2=3,8571, P3 nas categorias 1, x2=17,0645 e 2, x2=4,5675 e P6 na categoria 2, x2=5,5538. Nos di?rios a diferen?a foi significante em P4 na categoria 2, x2=7,7586. Os comportamentos mais freq?entes foram comportamentos de dor e comportamentos do familiar em rela??o aos comportamentos de dor . Esta pesquisa descreveu a prov?vel fun??o da dor operante no ambiente familiar, em que provavelmente os comportamentos de dor s?o refor?ados. E contribuiu para analisar a fun??o do terapeuta comportamental dentro da equipe de sa?de, que al?m de realizar atendimentos, deve orientar a equipe sobre a fun??o operante da dor e seu papel na manuten??o de comportamentos que aumentam a incapacidade dos pacientes e diminuem a ades?o ao tratamento.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede.bibliotecadigital.puc-campinas.edu.br:tede/206 |
| Date | 13 February 2008 |
| Creators | Scarpelli, Paula Brand?o |
| Contributors | Amaral, Vera Lucia Adami Raposo do, Gorayeb, Ricardo, Laloni, Diana Tosello |
| Publisher | Pontif?cia Universidade Cat?lica de Campinas, Programa de P?s-Gradua??o em Psicologia, PUC-Campinas, BR, CCV ? Centro de Ci?ncias da Vida |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_CAMPINAS, instname:Pontifícia Universidade Católica de Campinas, instacron:PUC_CAMP |
| Rights | info:eu-repo/semantics/openAccess |
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