Yoğun Bakım Hemşireliğinde Ağrı Değerlendirmesi ve Ağrı Yönetimi

Abstract

ÖzetKanıtlar YBÜ'de hastaların entübasyon ve sedasyon gibi çeşitli nedenlerle iletişim kuramama problemlerinin yatışları süresince hoş olmayan duygular, stres ve kötü deneyimler yaşamalarına sebep olduğunu belirtmektedir. Ağrı, yalnızlık duygusu, izolasyon, iletişim yetersizliği, uyku bozukluğu, korku ve kabuslar bunlar arasında sayılabilir. Bu olumsuz deneyimler arasında ağrı, önemli bir "stresör" olarak yoğun bakım hastalarının karşısına çıkmaktadır. Ağrı değerlendirmesinde en güvenilir kaynak hastanın kendisidir. Ancak ağrılarını entübasyon ve sedasyon nedeniyle sözel olarak ifade edemeyen yoğun bakım hastaları çeşitli davranışsal ve fizyolojik belirtilerle ağrılarını ifade etmektedirler. Bu nedenle yoğun bakımlarda ağrıya davranışsal ve davranışsalfizyolojik yanıtın değerlendirildiği özel tanılama araçlarının kullanılması önemlidir. Yoğun bakım hemşireleri bakım temelli ekip üyeleri olmaları sebebiyle hasta ile en çok vakit geçiren ve onları yakından izleyen sağlık profesyonelleri oldukları için ağrının değerlendirilmesi ve yönetiminde anahtar rol oynamaktadır. AbstractEvidence suggests that patients with communication inability problems for various reasons, such as intubation and sedation, cause unpleasant, stress and bad experiences during their time in intensive care unit. Pain, loneliness, isolation, communication inability, sleep disturbance, fear and nightmares can be counted. Among these negative experiences, pain is encountering intensive care patients as an important "stressor". The most reliable source of pain assessment is the patient itself. However, intensive care patients who cannot express their pain verbally due to intubation and sedation express their pain with various behavioral and physiological indications. For this reason, it is important to use special diagnostic tools that assess behavioral and behavioralphysiological responses to pain in intensive care. Intensive care nurses play a key role in the evaluation and management of pain because they are health care professionals who spend most of their time with patients and closely monitor them because they are maintenance-based team members.

The effects of post‐COVID‐19 fatigue in nurses on organizational outcomes

“…Previous studies have shown that the main reason for fatigue in nurses can not only be their work schedule, workflow, and complicated job demands but also their physical and cognitive workloads (Cho et al, 2022; Steege et al, 2015). A systematic review determined that fatigue in nurses was influenced by factors that affect their workload such as long shifts, working the night shift, the number of days in the week on which they work, spending long times standing up, walking long distances, and the high number of patients under their care (Şapulu Alakan & Akansel, 2021). Moreover, it was determined that exposure to COVID‐19 affected the workload of nurses (Shoja et al, 2020), and the fatigue levels of those who provided care to a COVID‐19 patient increased (Sikaras et al, 2022).…”

The effect of local cold compresses for nitroglycerin‐induced headache: An observational pretest–posttest study

“…11 However, the intense and incorrect use of analgesics has negative aspects like the burden to the economy of the country and individuals, and worsening some physiological functions of individuals. 12 Another approach used for pain control is non-pharmacological methods. Non-pharmacological methods act by increasing the individual's sense of control, reducing their feeling of powerlessness, increasing the activity level, reducing stress and anxiety, reducing the dose of analgesic drugs and reducing the level of pain.…”

“…In intensive care units, position change, massage, music therapy, cold and hot application, which are nonpharmacological methods, are the most applied and most studied practices performed by intensive care nurses. 12 Research studies [14][15][16][17][18] revealed that the use of non-pharmacological methods alone or together with pharmacological methods is effective in reducing pain severity. In these studies, non-pharmacological approaches such as herbal products, vitamin and mineral use, pressure, hot and cold compresses, were identified for use to prevent or minimize headache.…”

“…are included in treatment for many headache types 11 . However, the intense and incorrect use of analgesics has negative aspects like the burden to the economy of the country and individuals, and worsening some physiological functions of individuals 12 . Another approach used for pain control is non‐pharmacological methods.…”

“…There are many non‐pharmacological methods that can be applied to reduce or eliminate pain. In intensive care units, position change, massage, music therapy, cold and hot application, which are non‐pharmacological methods, are the most applied and most studied practices performed by intensive care nurses 12 . Research studies 14–18 revealed that the use of non‐pharmacological methods alone or together with pharmacological methods is effective in reducing pain severity.…”