Multimodalni pristup u liječenju kronične boli

master's thesis

• Title (english): Multimodal approach in chronic pain treatment
• Author: Anisa Stanić
• Mentor: Jana Kogler (mentor)
• Committee member: Daniela Bandić Pavlović (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Jana Kogler (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology

Abstract

Bol je kompleksno i vrlo subjektivno iskustvo. Procesuiranje boli je složene patofiziologije te je određeno raznolikim biološkim, psihološkim i socijalnim čimbenicima, koji su u međusobnoj interakciji i formiraju izlaznu bolnu senzaciju karakterističnu za pojedinca. Akutna bol predstavlja signal potencijalnog oštećenja tkiva i evolucijski je značajna, dok je kronična bol nesvrsishodna, uzrok značajne patnje i “bolest sama za sebe”. Kronična bol je naziv za širok spektar bolnih stanja koja su klasificirana u skupinu primarne ili sekundarne kronične boli. Život s kroničnom boli predstavlja teret za pojedinca i zajednicu te utječe na različite aspekte fizičkog i mentalnog zdravlja i socijalne uloge. Biopsihosocijalni model bolesti posebice je primjenjiv u kontekstu kronične boli te nalaže kako je ona rezultat ispreplitanja brojnih čimbenika, koji potom definiraju obilježja bolnog sindroma, poput intenziteta boli, psihičkog stanja, socijalnog funkcioniranja i ukupne kvalitete života bolesnika. Ovaj model polazište je za dijagnostiku i evaluaciju kroničnog bolnog stanja i pacijenta u cijelosti te susljedno formiranje individualiziranog terapijskog pristupa. S obzirom na kompleksnost kroničnog bolnog sindroma, njegovo liječenje je multimodalno. Dostupne su različite farmakološke i nefarmakološke metode liječenja koje je moguće kombinirati i prilagoditi ovisno o specifičnim pacijentovim potrebama. Povrh kontrole intenziteta boli, posebice je značajno obratiti pažnju na psihosocijalne faktore i intervenirati s ciljem osiguranja optimalnog funkcioniranja i vođenja kvalitetnog života usprkos kroničnoj boli.
Cilj ovog preglednog rada bio je izložiti suvremenu definiciju, klasifikaciju i patofiziologiju boli, opisati pristup u dijagnostici i liječenju kronične boli te prikazati pojedine modalitete liječenja.

Abstract (english)

Pain is a complex and highly subjective experience. Pain processing is pathophysiologically complex and is determined by various biological, psychological, and social factors, that reciprocally interact and form a pain sensation characteristic of the individual. Acute pain is a signal of potential tissue damage and is evolutionary important, while chronic pain doesn’t serve a purpose, represents a great deal of suffering, and is considered “a disease in its own right”. Chronic pain is a term that encompasses a wide range of painful conditions that are classified either as primary or secondary chronic pain. Living with chronic pain is a burden to the individual and the community, and affects different aspects of physical and mental health, as well as social roles. The biopsychosocial model of disease is particularly applicable to chronic pain and recognizes that it is the result of interaction of many factors that then define the characteristics of a pain syndrome, such as pain intensity, mental state, social functioning, and overall quality of life. This model is a starting point for the diagnostics and evaluation of a chronic pain condition and the patient as a whole, and the consequent formation of an individualized therapeutic approach. Considering the complexity of a chronic pain syndrome, its treatment has to be multimodal. There is a variety of pharmacological and non-pharmacological options that can be combined and adjusted according to specific patient needs. Besides the control of pain intensity, it is especially important to address psychosocial factors and intervene in order to provide optimal functioning and quality of life despite chronic pain.
The purpose of this review was to present the contemporary definition, classification, and pathophysiology of pain, as well as to describe the diagnosis, general treatment and treatment modalities of chronic pain.

• Keywords: kronična bol; biopsihosocijalni model; multimodalno liječenje; farmakološke metode; nefarmakološke metode
• Keywords (english): chronic pain; biopsychosocial model; multimodal treatment; pharmacological methods; non-pharmacological methods
• Language: croatian
• URN:NBN: urn:nbn:hr:105:479949
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-24 13:22:03