Medical and sociological study of chronic pain problems associated with combat trauma

Background. Objective: to present the results of a sociological study on pain problems related to combat injury. Materials and methods. Analytical and statistical methods were used in the study. The materials were the results of a survey of patients undergoing treatment in Ukrainian hospitals, as well as individual face-to-face interviews and self-reported questionnaires. The error did not exceed 3.1 % (without considering the design effect). A total of 1015 respondents were surveyed. The study was conducted from March 19 to May 9, 2025, in 30 hospitals across all regions of Ukraine. Data processing was performed using Microsoft Excel® (trial version); statistical processing of the results was carried out using statistical ana­lysis software package StatSoft Statistica® ver. 10 (STA999K347156-W) and IBM SPSS 25.0 (trial version). Results. A small proportion of the wounded (24.2 %) received pain relief at the battlefield, using medications from a first-aid kit. Du­ring evacuation, 43.1 % of surveyed patients received pain relief; 19.5 % reported receiving pain relief in a healthcare facility close to the front line; 6.1 % — in a hospital where they were surveyed; 7.2 % could not recall at which stage they received pain relief. The highest proportion of pain relief, according to the survey, was administered during evacuation (43.1 %), immediately after the injury from a first-aid kit — only 24 %, in a healthcare facility close to the front line — 19.5 %, and in the hospital of the next stage of medical care — 6.1 %. Of the total number of surveyed, 7.2 % did not remember where pain relief was administered. Regarding the pain localization, most military personnel participating in the study indicated that they primarily experienced pain at the wound site — 68.4 %, in the stump — 7.6 %, and in the absent limb (phantom pain) — 12.1 %. Conclusions. Based on the study results, a significant association was established between patient age and pain level (p = 0.031): younger patients (18–30 years old) significantly more often reported severe pain compared to older age groups (46–60 years old). No significant association was found between the pain level described by respondents and the location of the first pain relief administration (p = 0.177). There was a significant (p = 0.024) association of a higher pain level in patients reporting bodily pain compared to those indicating pain in other localizations (by analysis of standardized residuals, patients in the “no pain” paragraph primarily indicated stump pain and pain at the wound site). No significant association was determined between injury localization and pain severity (p = 0.193). A significant (p = 0.016) association was found between amputation localization and pain level (patients with amputated left leg more often reported “no” and “moderate” pain, while “mild” pain was more characteristic of right arm amputations.