Representações sociais sobre o medo de cair e qualidade de vida de pessoas idosas com dor crônica no desempenho em dupla tarefa

Abstract

Aging can be accompanied by the occurrence of physical and functional changes that contribute to the emergence of chronic pain processes. Painful symptoms increase the predisposition of the elderly to the risk of falls, which can influence the performance in dual tasking (DT), as well as reduce functional independence and trigger the fear of falling, which negatively influence quality of life (QL). The general objective of the study was to analyze the impact of social representations on the fear of falling and quality of life of elderly people with chronic pain on dual-tasking performance. This is a mixed-approach study conducted with 50 elderly people who report chronic pain. Data collection was carried out through a semi-structured interview, using the following instruments: questions based on the Theory of Social Representations (SRT); FES-I to assess the fear of falling; WHOQOL-OLD to measure QL; the Timed Up and Go (TUG) test to assess the risk of falling; and the dual-tasking cost (DTC). The collected data were organized in a database and processed with the aid of the IRaMuTeQ software, with a corpus utilization of 80.95%. The mean age of the users in the sample was 67.96 years and, based on a corpus consisting of 50 interviews, the data seized established five semantic classes, namely: Class 1 - Risk of falls among the elderly; Class 2 - Positioning regarding fall prevention; Class 3 - Knowledge of factors that predispose to falls; Class 4 - Meanings associated with QL for the elderly; Class 5 - Negative dimensions of the fear of falling. It was observed that the ideas that built the semantic class 4 are based on the mean score of 84.88 of QoL, with the facets of intimacy (12.82) and autonomy (13.64) having the lowest scores, reinforcing the influence of health conditions associated with the presence of chronic pain on the perception of QL among the interviewees. The fall variable was most central to the complexity of relationships, followed by social participation as one of the facets of QoL. The average score of fear of falling was 31.42, while the average number of falls among the users in the sample was 1.86 events in the last 12 months. The DTC showed a strong positive association with falls, as seen in the discourses elaborated by the participants of semantic class 5 when they correlated accidents due to falls with their possible adverse outcomes, including damage to social participation. There was a positive correlation between group 1 (TUG; VAS) and falls and negative correlation between group 2 (present, past and future activities; autonomy; social participation) and falls. In this context, the social representations constructed by the interviewees indicate that the elderly begin to perceive their quality of life positively when they are able to perform their daily activities as long as they remain independent, even in the face of limitations imposed by health conditions characterized by the presence of chronic pain and the fear of falling, while experiencing the multiple biopsychosocial transformations resulting from aging.