| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.85 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Enquadramento: A qualidade é um pilar fundamental no sector da saúde. O
crescente interesse pelas questões da qualidade segue, ao longo das últimas décadas, uma
tendência mundial nos sistemas de saúde.
Objetivo: Identificar recomendações baseadas na evidência científica, para práticas
de qualidade na prestação de cuidados de enfermagem à criança/família hospitalizada, para
o manejo da dor
Métodos: Revisão sistemática da literatura, com base nas orientações do Manual
Cochrane 5.1.0 de Higgins & Green (2011). Foram pesquisados estudos nas bases de
dados: Medline, Cochrane, Scielo, B-on, Lilacs, Uptodate, American Academy of Pediatrics,
Proquest, World Health Organization, PubMed, publicados nos idiomas portugueses e
inglês, posteriormente ao ano 2013, segundo critérios de inclusão e exclusão previamente
estabelecidos. Dos 726 estudos selecionados, 11 foram sujeitos ao teste de relevância II e
avaliação crítica da qualidade metodológica por dois investigadores independentes, tendo
sido incluídos 4 estudos, dos quais 2 de evidência científica A e 2 de evidência B.
Resultados: As principais recomendações sugeridas após análise dos estudos são:
A abordagem da dor deve ser multidisciplinar; deve efetuar-se a avaliação sistemática da
dor, tal como os restantes sinais vitais; intervir até que a criança não apresente dor,
recorrendo a medidas farmacológicas e não farmacológicas; o uso de lidocaína tópica é uma
estratégia fundamental para diminuir a dor em procedimentos invasivos; ajustar o algoritmo
das escalas de avaliação da dor; considerar outros fatores, como idioma, etnia e fatores
culturais que possam influenciar a expressão e a avaliação da dor; fornecer aos
pais/cuidador informações escritas sobre aconselhamento e avaliação da dor na alta da
criança; o auto-relato das crianças deve ser sempre que possível obtido; a formação
contínua dos enfermeiros na gestão e controlo da dor tem impacto na valorização da dor e
na administração de analgésicos.
Conclusões: Os enfermeiros devem procurar orientar a sua prática com base nas
evidências científicas. Este trabalho salienta as principais recomendações divulgadas nos
estudos de qualidade científica que foram alvo da análise, representando assim uma linha
orientadora na gestão e controlo da dor em crianças/ adolescentes hospitalizadas, de forma
a uniformizar cuidados nesta área levando a uma prática de excelência e contribuindo para
a melhoria da qualidade nas práticas profissionais dos enfermeiros.
ABSTRACT Background: Quality is a key pillar in the health sector. The growing interest in quality issues has, over the last decades, followed a worldwide trend in health systems. Objective: To identify scientific evidence-based recommendations for quality practices of nursing care in the delivery of hospitalized child / family, for the management of pain. Methods: A systematic review of the literature was carried out, based on the guidelines of the Cochrane 5.1.0 Handbook by Higgins & Green (2011). We selected studies in the databases: Medline, Cochrane, Scielo, B-on, Lilacs, Uptodate, American Academy of Pediatrics, Proquest, World Health Organization, PubMed, made in Portuguese and English, and published after 2013, according to previously established inclusion and exclusion criteria. Of the 726 studies selected, 11 were subjected to the relevance II test and evaluation of methodological quality by two independent researchers. Four studies were included, of which 2 were scientific evidence A and 2 scientific evidence B. Results: After studies analysis the main recommendations suggested are: The pain approach should be multidisciplinary; a systematic evaluation of pain should be performed, as should all other vital signs; intervene until the child does not present pain, using pharmacological and non-pharmacological measures; the use of topic lidocaine is a fundamental strategy to reduce pain in invasive procedures; adjust the algorithm of pain evaluation scales; consider other factors such as language, ethnicity, and cultural as factors that may influence the expression and assessment of pain; provide parents / caregivers with written information about counseling and assessment of pain on the child discharge; selfreporting of children should be wherever possible obtained; the continuous training of nurses in the management and control of pain has an impact on the evaluation of pain and the administration of analgesics. Conclusions: Nurses should seek to guide their practice on the basis of scientific evidence. This paper highlights the main recommendations published in the scientific quality studies that were the subject of the analysis, thus representing a guideline in the management and control of pain in hospitalized children / adolescents, in order to standardize care in this area leading to a practice of excellence and contributing to the improvement of quality in nurses' professional practices.
ABSTRACT Background: Quality is a key pillar in the health sector. The growing interest in quality issues has, over the last decades, followed a worldwide trend in health systems. Objective: To identify scientific evidence-based recommendations for quality practices of nursing care in the delivery of hospitalized child / family, for the management of pain. Methods: A systematic review of the literature was carried out, based on the guidelines of the Cochrane 5.1.0 Handbook by Higgins & Green (2011). We selected studies in the databases: Medline, Cochrane, Scielo, B-on, Lilacs, Uptodate, American Academy of Pediatrics, Proquest, World Health Organization, PubMed, made in Portuguese and English, and published after 2013, according to previously established inclusion and exclusion criteria. Of the 726 studies selected, 11 were subjected to the relevance II test and evaluation of methodological quality by two independent researchers. Four studies were included, of which 2 were scientific evidence A and 2 scientific evidence B. Results: After studies analysis the main recommendations suggested are: The pain approach should be multidisciplinary; a systematic evaluation of pain should be performed, as should all other vital signs; intervene until the child does not present pain, using pharmacological and non-pharmacological measures; the use of topic lidocaine is a fundamental strategy to reduce pain in invasive procedures; adjust the algorithm of pain evaluation scales; consider other factors such as language, ethnicity, and cultural as factors that may influence the expression and assessment of pain; provide parents / caregivers with written information about counseling and assessment of pain on the child discharge; selfreporting of children should be wherever possible obtained; the continuous training of nurses in the management and control of pain has an impact on the evaluation of pain and the administration of analgesics. Conclusions: Nurses should seek to guide their practice on the basis of scientific evidence. This paper highlights the main recommendations published in the scientific quality studies that were the subject of the analysis, thus representing a guideline in the management and control of pain in hospitalized children / adolescents, in order to standardize care in this area leading to a practice of excellence and contributing to the improvement of quality in nurses' professional practices.
Description
Keywords
Dor Gestão da dor Cuidados de enfermagem Família Criança Hospitalização Qualidade de cuidados de saúde Revisão Child Family Hospitalization Nursing care Pain management Pediatric nursing Quality of health care Review