Rev Dor. São Paulo, 2011 jul-set;12(3):221-25 RESUMO JUSTIFICATIVA E OBJETIVOS: O trauma tem importância no âmbito mundial por ser uma das principais causas de morte e invalidez. A dor aguda sempre acompanha os pacientes vítimas de trauma e os profissionais da saúde têm dificuldade em identificá-la e consequentemente controlá-la. O objetivo deste foi caracterizar a percepção e as dificuldades da equipe de enfermagem frente à identificação, quantificação e manuseio da dor dos pacientes vítimas de trauma e treiná-la para sua avaliação e adequado tratamento. cientes vítima de trauma. Foi aplicado um questionário com perguntas relacionadas à caracterização dos profissionais e a maneira pela qual eles identificam, quantificam e intervêm no tratamento da dor, antes e depois de um curso de capacitação dos profissionais, no qual foram ministradas aulas que abordavam os temas contidos no questionário. RESULTADOS: A maioria dos profissionais incluídos no estudo conhecia o conceito "dor o quinto sinal vital", os instrumentos para quantificar a dor, os medicamentos utilizados no tratamento e seus efeitos adversos, porém com treinamento, o conhecimento sobre a avaliação e tratamento da dor aumentou significativamente. CONCLUSÃO: A maioria dos profissionais de enfermagem tem conhecimento insuficiente sobre a identificação, quantificação e tratamento da dor. O treinamento propiciou a sua atualização, para atuar de forma mais adequada e eficiente no controle e alívio da dor. Descritores: Dor, Medição da dor, Traumatismo múlti-plo, Unidade de terapia intensiva. MÉTODO: SUMMARY BACKGROUND AND OBJECTIVES:Trauma is globally important for being one of the major causes of death and disability. Trauma is also followed by acute pain and health professionals have difficulties to identify and control it. This study aimed at characterizing nursing teams perceptions and difficulties to identify, quantify and manage pain of trauma patients and at training the nursing team to adequately evaluate and treat it. METHOD: Prospective and quantitative study involving 51 nursing professionals working in an intensive
RESUmoPesquisa quantitativa que objetivou identificar o custo total médio (CTM) da instalação, manutenção e desligamento da bomba de analgesia controlada pelo paciente (PCA) no manejo da dor. A amostra não probabilística correspondeu à observação de 81 procedimentos em 17 Unidades do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Calculou-se o CTM multiplicando-se o tempo despendido pelas enfermeiras pelo custo unitário da mão de obra direta, somando-se ao custo dos materiais e medicamentos/soluções. O CTM da instalação foi de R$ 107,91; da manutenção R$ 110,55 e do desligamento R$ 4,94. Os resultados obtidos subsidiarão discussões acerca da necessidade de repasse monetá-rio do Sistema Único de Saúde às unidades hospitalares que realizam essa técnica de terapia antálgica e contribuirão para o gerenciamento de custos visando à tomada de decisão eficiente e eficaz na alocação dos recursos disponíveis.
No abstract
BACKGROUND AND OBJECTIVES: Very often, chronic pain is undermanaged in patients with chronic non-malignant pain due to its complexity, and the long term success of the treatment is difficult. This study aimed at understanding nurses' perception about administering opioids to relieve chronic non-malignant pain (CNMP). METHOD: After the Ethics Committee approval, participated in this study clinical nurses with experience in managing chronic pain patients, who answered a questionnaire about using opioids for CNMP. RESULTS: Participated in this study 60 nurses, of whom 56.7% identified patients' pain by their complaints, 40% reported that dipirone was the drug used to treat CNMP, 50% reported that massage was the non-pharmacological therapy to treat CNMP, most have mentioned morphine and tramadol as the most widely used opioids to relieve chronic non-cancer pain, 50% stated that they evaluate pain intensity and administer prescribed opioids if needed when the pain is moderate or severe, 60% of nurses believe that opioids interfere with patients' rehabilitation, most have mentioned addiction (65%) and respiratory depression (46.7%) as the best known side-effects and 61.7% have stated that they have no restriction for the use of opioids to treat CNMP. CONCLUSION: Most nurses have no restriction for the administration of opioids for CNMP patients.
Sociedade Brasileira para o Estudo da Dor c 196 Rev Dor. São Paulo, 2011 abr-jun;12(2):196-7
Objective: To test the effects of a brief interprofessional intervention for chronic pain management. Methods: Before and after pilot study. The brief interprofessional intervention had a psychoeducational focus and was based on the Self-Efficacy Theory, using Cognitive-Behavioral Therapy strategies. The intervention aimed to improve the management of chronic pain. It was conducted in group, over six weeks, with a two-hour weekly meeting, including educational strategies on pain management, stretching, and relaxation techniques. Self-efficacy, pain intensity, disability, fatigue, and depressive symptoms were assessed. Data were analyzed using the paired t-test and Pearson’s correlation. Results: Adults with moderate to severe pain took part in the study. Post-intervention analysis showed significant improvement in self-efficacy (p = 0.004) and significant reduction in pain intensity (p = 0.024), disability (p = 0.012), fatigue (p = 0.001), and depressive symptoms (p = 0.042). Conclusion: The effects of brief interprofessional intervention were positive for chronic pain management. We suggest the conduction of studies with more robust designs and a larger sample to confirm these findings.
BACKGROUND AND OBJECTIVES: Chronic pain has a negative impact on the quality of life of individuals and requires multidisciplinary attention. The aim of this study was to assess the feasibility of a brief multidisciplinary intervention for the management of chronic pain. METHODS: A pilot feasibility study. The participants were individuals with chronic pain. The intervention had a psychoeducational focus and was carried out in a group for six weeks, with a two-hour weekly meeting. Participants received education on pain management, practiced stretching and relaxation techniques. The intervention was applied by two nurses, a psychologist and a physical therapist. The specific objective of this study was to assess the feasibility of the intervention through indicators of acceptability and feasibility. RESULTS: Forty-eight people with chronic pain eligible to participate in the study were identified. Among the acceptability indicators, the acceptance rate to participate in the intervention was 52% and the retention rate among participants was 60%. The rate of adherence to the recommendations was moderate for walking (53.3%) and satisfactory for stretching (100%) and relaxation (73.3%). As for the feasibility indicators, the following aspects were considered "great": access to Brief multidisciplinary intervention for chronic pain management: pilot feasibility studyIntervenção multidisciplinar breve para manejo da dor crônica: estudo piloto de viabilidade
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