Difficulties faced by nurses to use pain as the fifth vital sign and the mechanisms/actions adopted: an integrative review

Abstract

BACKGROUND AND OBJECTIVES: Pain was recognized as the fifth vital sign in 1996, and many nurses have difficulty in evaluating it. Since it is necessary to know the difficulties to use pain as a fifth vital sign, this study aims at acquiring a better knowledge about pain, assessment methods and strategies/ actions to guarantee its control. The objective of this study was to identify and analyze, in the Brazilian and international literature, the difficulties faced by nurses to use pain as the fifth vital sign and the mechanisms/actions adopted. CONTENTS: It is an integrative review in which the search for scientific articles was carried out in LILACS, BDENF, Scielo, Pubmed, Scopus and Web of Science databases, using the descriptors nursing, pain, and pain and vital signs management in Portuguese, English, and Spanish. The selection criteria were the period from 1995 to 2017 in the three languages mentioned. After searching and reading the articles, nine studies were included. Two categories were listed after reading the articles: 1) difficulties faced by nurses to use pain as a fifth vital sign and 2) mechanisms/actions adopted to minimize the difficulties faced by nurses to use pain as a fifth vital sign. CONCLUSION: It was evidenced that it is important that nurses consider/assess pain as the fifth vital sign, therefore aiming at better care, which, consequently, will influence the quality of care provided, improving patient's health and quality of life.

Knowledge, perceived barriers, and practices of oncology nurses regarding cancer pain management

“…In addition, nurses' experience providing care for cancer patients scored higher than general nurses' experience; this was supported by a study conducted in China [25]. According to Valério et al, nurses' knowledge scores increased significantly with increased work experience [28]. These findings may be related to nurses' work areas, as those nurses have sufficient experience in caring for cancer patients.…”

“…As a result, effective pain management in hospitals requires collaboration. As a result, it is critical to foster a supportive team spirit among doctors and nurses; thus, meetings to facilitate the discussion of pain management and emphasize clear and effective communication between all healthcare team members, respectively, are possible interventions to reduce the delay caused by these processes [28]. In addition, the workplace environment was discovered to impact pain management knowledge.…”

A avaliação e registo da dor no serviço de urgência: um estudo transversal

“…A desvalorização da dor pelos profissionais foi referida por diversos autores. (12,13,14) A subnotificação dos registos da dor foi evidenciada por Gimenes et al (15) que referiram disparidade entre os registos realizados e os relatos de dor recolhidos junto das pessoas. No seu estudo, 33,3 % das pessoas que manifestaram dor aguda não tinham qualquer registo da sua avaliação.…”

“…Os aspetos que dificultam a avaliação da dor foram identificados na literatura e prendem-se com a sobrecarga de trabalho, a situação clínica da pessoa, a desvalorização da dor pelos profissionais, o défice de conhecimento sobre as escalas e sua aplicação e a utilização de linguagem técnica. (12,13,14) Evidencia-se também na literatura a necessidade de formação e treino dos profissionais de saúde para a avaliação da dor e para a utilização adequada das escalas de avaliação da dor. (11,12,13,1415)…”

O uso da escala da dor pelos profissionais de enfermagem no contexto da urgência e emergência: uma revisão integrativa

“…Em 1996, James Campbell (Presidente da Associação Americana de Dor) citou e reconheceu a dor como quinto sinal vital, o manuseio precoce da dor e conscientizar profissionais da enfermagem quanto a importância de avalia-la foram alguns de seus objetivos (Valério, Fernandes, Miranda, & Terra, 2019).…”