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As novas tecnologias no controle da dor em contexto pediátrico : Scoping review
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Introdução: A formação em enfermagem especializada exige não apenas conhecimento teórico sólido, mas também vivência prática que contribua para o desenvolvimento de competências clínicas, éticas e comunicacionais. No âmbito da enfermagem de saúde infantil e pediátrica, o ensino clínico desempenha um papel fundamental na preparação de profissionais capazes de responder às necessidades complexas da criança e da sua família. Este artigo apresenta uma reflexão crítica sobre a experiência no ensino clínico enquanto enfermeira especialista em saúde infantil e pediátrica, destacando os desafios, aprendizagens e contributos para a prática profissional.
As novas tecnologias têm assumindo um papel cada vez mais relevante na área da saúde, proporcionando abordagens inovadoras para o controle da dor, especialmente em pacientes pediátricos. Recursos como a realidade virtual e os aplicativos móveis têm sido explorados como alternativas ou complementos às estratégias convencionais do alívio da dor. No entanto, a confirmação da eficácia e dos benefícios destas tecnologias exige evidências científicas que atestem a sua segurança e aplicabilidade hospitalar. Desta forma, este estudo tem como objetivo analisar a literatura disponível para determinar se estas inovações são, de facto, benéficas no controle da dor em crianças, contribuindo para uma prática de enfermagem mais eficaz e humanizada.
Objetivo: Aquisição de competências na área da Saúde Infantil e Pediátrica. Analisar evidências científicas que permitam verificar se as novas tecnologias são consideradas benéficas no controlo da dor em pacientes pediátricos.
Critérios de inclusão: Os participantes (P) são definidos como sendo: crianças sujeitas a procedimentos doloroso; os conceitos (C): novas tecnologias, distração, benefícios no controlo da dor; o contexto (C) internamento hospitalar.
Métodos: Método expositivo e reflexivo referente aos ensinos clínicos. Foi desenvolvida uma estratégia de pesquisa da literatura. O estudo foi relatado utilizando a extensão Preferred Reporting Items for Systematic Reviews and Meta-Analyses para Scoping Reviews (PRISMA-ScR). Foram incluídos todos os artigos que analisavam a utilização das novas tecnologias, como distração, no controlo da dor no internamento pediátrico. A pesquisa dos artigos foi realizada sem limite temporal, de modo a obter uma visão ampla e extensa da evolução das evidências científicas ao longo do tempo, proporcionando uma análise mais completa e robusta. Foram considerados elegíveis artigos que analisavam a utilização das novas tecnologias, como distração, no controlo da dor no internamento pediátrico. Foram igualmente considerados estudos primários (quantitativos e qualitativos), estudo secundários (revisões sistemáticas, revisões integrativas e scoping review) e literatura cinzenta. As pesquisas foram realizadas nas bases de dados PubMed, EBSCOhost (CINAHL complete, Medline Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviewa, Cochrane Methodology Register, Library, Information Science & Technology Abstratcs, MedicLatina, Cochrane Clinical Answers) e B-On. A pesquisa foi efetuada a 10 de janeiro de 2025; em língua portuguesa e inglesa. Depois da pesquisa nas bases de dados, um total de 188 registos foram obtidos e exportados para o software de gestão de seleção Rayyan, possibilitando, antes da triagem, a eliminação de 106 artigos duplicados.
Resultados: Foram incluídos na revisão 11 artigos. Os videojogos emergem como uma das estratégias mais eficazes, proporcionando envolvimento ativo e redução significativa da dor e da ansiedade. A Realidade Virtual (RV) também se destaca como uma intervenção promissora, sendo eficaz na redução da dor durante procedimentos invasivos, como punções venosas, queimaduras e circuncisões. Diversos estudos demostram que a sua aplicação combinada com analgésicos potencia os efeitos analgésicos, enquanto novas pesquisas sugerem que a RV poderia até substituir a analgesia farmacológica em alguns contextos.
Conclusão: Globalmente atinge os objetivos propostos para os ensinos clínicos. Os resultados da análise dos artigos incluídos neste estudo indicam que as novas tecnologias são eficazes na redução da dor, mostrando-se uma ferramenta promissora para melhorar a experiência de dor no ambiente pediátrico. Estas inovações contribuem significativamente para o controlo da dor, oferecendo uma alternativa eficaz e menos invasiva aos métodos convencionais, favorecendo o bem-estar das crianças e facilitando os cuidados de enfermagem. Assim, os resultados sugerem a necessidade de mais estudos primários em Portugal para avaliar a aplicabilidade das novas tecnologias no contexto local. Além disso, uma proposta de implementação poderia ser desenvolvida, testando a viabilidade destas inovações em hospitais pediátricos portugueses. Outros aspetos a considerar incluem a capacitação dos profissionais de saúde para o uso destas tecnologias e a análise do impacto económico da sua adoção no sistema nacional de saúde.
Palavras-Chave: enfermagem pediátrica, gestão da dor, intervenções não farmacológicas, jogos de vídeo, criança.
Abstract Introduction: Training in specialized nursing asks for not only solid theoretical knowledge, but also practical experience that contributes to the development of clinical, ethical and communication skills. Within the scope of child and pediatric health nursing, clinical teaching plays a fundamental role in preparing professionals capable of responding to the complex needs of the children and their families. This article presents a critical reflection on the experience in clinical teaching as a specialist nurse in child and pediatric health, highlighting the challenges, learnings and contributions to the professional practice. New technologies have been playing an increasingly important role in the health area, providing innovative approaches to pain control, especially in pediatric patients. Resources such as virtual reality and mobile applications have been explored as alternatives or complements to conventional pain relief strategies. However, the effectiveness and benefits of these technologies confirmation requires scientific evidence that attests their safety and hospital applicability. Therefore, these study objectives are to analyze the available literature to determine whether these innovations are, in fact, beneficial in pain control in children, contributing to a more effective and humanized nursing practice. Objective: Acquisition of competences in the area of child and pediatric health. To analyze scientific evidence that allows us to verify whether new technologies are considered beneficial in pain control in pediatric patients. Inclusion criteria: Participants (P) are defined as: children subjected to painful procedures; concepts (C): new technologies, distraction, benefits in pain control; context (C) hospitalization. Methods: Expository and reflective method related to clinical teaching. A literature search strategy was developed. The study was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR). All articles that analyzed the use of new technologies, such as distraction, in pain control in pediatric hospitalization were included. The search for articles was carried out without a time limit, in order to obtain a broad and extensive view of the evolution of scientific evidence over time, providing a more complete and robust analysis. Articles that analyzed the use of new technologies, such as distraction, in pain control in pediatric hospitalization were considered readable. Primary studies (quantitative and qualitative), secondary studies (systematic reviews, integrative reviews and scoping reviews) and grey literature were also considered. The searches were carried out in the databases PubMed, EBSCOhost (CINAHL complete, Medline Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviewa, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, Cochrane Clinical Answers) and B-On. The search was conducted on January 10th, 2025; in Portuguese and English. After searching the databases, a total of 188 records were obtained and exported to the Rayyan selection management software, enabling the elimination of 106 duplicate articles before screening. Results: Globally achieves the objectives proposed for clinical teaching. Eleven articles were included in the review. Video games emerge as one of the most effective strategies, providing active involvement and significant reduction in pain and anxiety. Virtual Reality (VR) also stands out as a promising intervention, being effective in reducing pain during invasive procedures, such as venipunctures, burns and circumcisions. Several studies show that its application combined with analgesics enhances the analgesic effects, while new research suggests that VR could even replace pharmacological analgesia in some contexts. Conclusion: The results of the analysis of the articles included in this study indicate that new technologies are effective in reducing pain, proving to be a promising tool for improving the pain experience in the pediatric environment. These innovations contribute significantly to pain control, offering an effective and less invasive alternative to conventional methods, promoting the well-being of children and facilitating nursing care. Thus, the results suggest the need for further primary studies in Portugal to assess the applicability of new technologies in the local context. In addition, an implementation proposal could be developed, testing the feasibility of these innovations in Portuguese pediatric hospitals. Other aspects to consider include training health professionals in the use of these technologies and analyzing the economic impact of their adoption in the national health system. Keywords: pediatric nursing, pain management, non-pharmacological strategies, video games, child.
Abstract Introduction: Training in specialized nursing asks for not only solid theoretical knowledge, but also practical experience that contributes to the development of clinical, ethical and communication skills. Within the scope of child and pediatric health nursing, clinical teaching plays a fundamental role in preparing professionals capable of responding to the complex needs of the children and their families. This article presents a critical reflection on the experience in clinical teaching as a specialist nurse in child and pediatric health, highlighting the challenges, learnings and contributions to the professional practice. New technologies have been playing an increasingly important role in the health area, providing innovative approaches to pain control, especially in pediatric patients. Resources such as virtual reality and mobile applications have been explored as alternatives or complements to conventional pain relief strategies. However, the effectiveness and benefits of these technologies confirmation requires scientific evidence that attests their safety and hospital applicability. Therefore, these study objectives are to analyze the available literature to determine whether these innovations are, in fact, beneficial in pain control in children, contributing to a more effective and humanized nursing practice. Objective: Acquisition of competences in the area of child and pediatric health. To analyze scientific evidence that allows us to verify whether new technologies are considered beneficial in pain control in pediatric patients. Inclusion criteria: Participants (P) are defined as: children subjected to painful procedures; concepts (C): new technologies, distraction, benefits in pain control; context (C) hospitalization. Methods: Expository and reflective method related to clinical teaching. A literature search strategy was developed. The study was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR). All articles that analyzed the use of new technologies, such as distraction, in pain control in pediatric hospitalization were included. The search for articles was carried out without a time limit, in order to obtain a broad and extensive view of the evolution of scientific evidence over time, providing a more complete and robust analysis. Articles that analyzed the use of new technologies, such as distraction, in pain control in pediatric hospitalization were considered readable. Primary studies (quantitative and qualitative), secondary studies (systematic reviews, integrative reviews and scoping reviews) and grey literature were also considered. The searches were carried out in the databases PubMed, EBSCOhost (CINAHL complete, Medline Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviewa, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, Cochrane Clinical Answers) and B-On. The search was conducted on January 10th, 2025; in Portuguese and English. After searching the databases, a total of 188 records were obtained and exported to the Rayyan selection management software, enabling the elimination of 106 duplicate articles before screening. Results: Globally achieves the objectives proposed for clinical teaching. Eleven articles were included in the review. Video games emerge as one of the most effective strategies, providing active involvement and significant reduction in pain and anxiety. Virtual Reality (VR) also stands out as a promising intervention, being effective in reducing pain during invasive procedures, such as venipunctures, burns and circumcisions. Several studies show that its application combined with analgesics enhances the analgesic effects, while new research suggests that VR could even replace pharmacological analgesia in some contexts. Conclusion: The results of the analysis of the articles included in this study indicate that new technologies are effective in reducing pain, proving to be a promising tool for improving the pain experience in the pediatric environment. These innovations contribute significantly to pain control, offering an effective and less invasive alternative to conventional methods, promoting the well-being of children and facilitating nursing care. Thus, the results suggest the need for further primary studies in Portugal to assess the applicability of new technologies in the local context. In addition, an implementation proposal could be developed, testing the feasibility of these innovations in Portuguese pediatric hospitals. Other aspects to consider include training health professionals in the use of these technologies and analyzing the economic impact of their adoption in the national health system. Keywords: pediatric nursing, pain management, non-pharmacological strategies, video games, child.
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Keywords
Criança Dor - prevenção e controle Enfermagem pediátrica Gestão da dor Jogos de vídeo Revisão scoping Child Pain - prevention and control Pain management Pediatric nursing Scoping review Video games
Pedagogical Context
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