Abstract
The aim of this work was the interconnection of knowledge about the pain and attachment theory and to investigate the possible relationship between the attachment and the clinical and demographic variables of chronic pain patients treated by physiotherapy and outcomes of physiotherapy treatment. Methodology: The sample included outpatients and inpatients undergoing physiotherapy treatment, who have been approached and agreed with the informed consent to participate in the questionnaire survey research.
First part of the questionnaires had to be filled in the first physiotherapeutic session, the second part at the final session after physiotherapy. The questionnaires included an anamnestic questionnaire, a visual analogue scale (VAs) for intensity, discomfort and pain anxiety, pain interference with daily activities questionnaire (DIBDA), pain map, Fear of Pain Questionnaire (FPQ-III-CZ) and experience in Close Relationships questionnaire (eCR) (attachment - anxiety and avoidance scale).
It was also recorded how many therapies the individual has gone through. Inclusive criteria: Pain lasting more than 3 months.
Exclusive criteria: patients with a diagnosis of neurological or oncological disease and patients under the age of 18 years. Results: 42 (21% from all) from 200 distributed questionnaires by leading physiotherapists of the departments returned, of which 4 had to be excluded for exclusive criteria.
Thus, 38 questionnaires, were evaluated (n = 38), of which 33 were complete (it was finaly 16,5% from all distributed). The mean age of the patients was 48.2 years, of which 68.4% were women.
The mean pain duration was 44.3 months, mean pain intensity (VAs) 39.1mm, pain discomfort 47.3mm, pain anxiety 16.7mm, interference pain with daily activities DIBDA 2.4 and analgetic drugs used 52.6%, 25% from them over the long term. After treatment, an average of 13.8 therapies lasting 30-60 minutes, the average pain intensity was 25.3mm (difference 13.9), pain discomfort 28.3mm (difference 18.2), pain anxiety 11.3mm (difference 4,6), pain interference with daily activities 1.7 (difference 0.7).
The use of analgesics was reduced by 12.1%, in 3.0% increased, 38.5% over long term after physiotherapy (the number before and after the therapy did not change). 90.9% of patients reported that they consistently followed the recommendations and regimens. The mean ear of great pain was 17.8, of small pain of 16.0 and of medical treatment 16.1, the mean generall fear of pain was 49.8.
The mean of attachment anxiety scale was 3.36 and the mean of attachment avoidance scale was 3.11. Conclusions: Although there was a statistically significant reduction in pain and interference of pain with daily activities after physiotherapy treatment, there was no significant correlation with clinical or demographic variables (also attachment) beyond correlation of the length of the relationship with the reduction of pain interference with daily activities.
Also, in this study attachment anxiety negatively correlated with age and positively correlated with the fear of both great and small pain and the fear of pain in general. In our clinical smaple relationship avoidance negatively correlated with analgesic use before physiotherapy and negatively correlated with the fear of great pain and fear of pain in general.
Fear of medical interventions negatively correlated with age. These results can be affected by smaller sample size