Fátima Aparecida Emm Faleiros Sousa

Mensuração da dor no idoso: uma revisão

This study revised and examined the theoretical and practical base of pain measurement in elderly persons through clinical studies and bibliographical reviews. We discussed the advantages and limitations of the ordinal instruments more frequently used in situations in which alterations characteristic of aging coexist, whose actions in feelings of pain have not been clarified yet. Moreover, we indicated the factors that intervene in the evaluation process of painful experiences leading to underestimation and inadequate control of pain in elderly persons.A base teorica e pratica da mensuracao de dor em idosos foi revisada e examinada atraves de estudos clinicos e revisoes bibliograficas. As vantagens e limitacoes dos instrumentos ordinais mais frequentemente utilizados foram discutidas em situacoes nas quais coexistem alteracoes proprias do envelhecimento, cuja acao na sensacao dolorosa ainda nao esta bem esclarecida. Os fatores que interferem no processo de avaliacao da experiencia dolorosa, levando a subestimacao e controle inadequados da dor em individuos idosos, foram apontados.La base teorica y practica de la mensuracion del dolor en los ancianos fue revisada y examinada a traves de estudios clinicos y revisiones bibliograficas. Las ventajas y limitaciones de los instrumentos ordinales mas frecuentemente utilizados fueron discutidas en situaciones en las cuales coexisten alteraciones propias del envejecimiento, cuya accion dolorosa todavia no esta bien aclarada. Los factores que interfieren en el proceso de evaluacion de la experiencia dolorosa, llevando a la desvalorizacion y control inadecuados del dolor en ancianos, fueron apuntados.

Mensuração e avaliação da dor pós-operatória: uma breve revisão

: How to measure pain is a great challenge to those who desire to control adequately such a complex experience. Standardized instruments that take into consideration the patients own account, have been developed in order to make such a task easier. In this article we carry out a revision of the instruments used mostly for measuring postoperative pain, and we point out some of the advantages and disadvantages. We emphasize the need for specific research focusing on the measurement of surgical pain, taking into consideration the multiple dimensions of a painful experience.How to measure pain is a great challenge to those who desire to control adequately such a complex experience. Standardized instruments that take into consideration the patients own account, have been developed in order to make such a task easier. In this article we carry out a revision of the instruments used mostly for measuring postoperative pain, and we point out some of the advantages and disadvantages. We emphasize the need for specific research focusing on the measurement of surgical pain, taking into consideration the multiple dimensions of a painful experience.Mensurar el dolor ha sido gran desafio para aquellos que desean controlar adecuadamente tan compleja experiencia. Instrumentos estandenizados, que consideran el relato subjetivo del propio paciente han sido elaborados buscando facilitar tal tarea. En ese articulo revisamos los instrumentos mas utilizados para la mensuracion del dolor postquirurgico, apuntando hacia algumas de sus ventajas y desvantajas. Enfatizamos la necesidad de investigaciones especificas que focalicen la mensuracion del dolor en el medio quirurgico, considerando la multidimensionalidad de la experiencia dolorosa.

Uso e aplicação da metodologia psicofísica na pesquisa em enfermagem

Conceitos e fenomenos subjetivos, tais como atitudes sociais, opinioes e processos de julgamentos tem sido dificeis de serem mensurados acuradamente. Muitos conceitos ou variaveis em Enfermagem sao de natureza subjetiva. Como nas ciencias sociais, a profissao de enfermagem enfrenta muitos problemas para obter medidas precisas de tais variaveis. A metodologia psicofisica, especialmente os procedimentos de estimacao de magnitude e de emparelhamento intermodal, desenvolvidos na psicofisica sensorial e sendo atualmente usados nas ciencias sociais, tem se mostrado promissora em Enfermagem como um instrumento para escalonar fenomenos subjetivos. O proposito deste trabalho e descrever essas tecnicas de mensuracao, o paradigma teorico sobre o qual elas sao baseadas e tambem varios estudos de âmbito social, clinico e de enfermagem, nos quais foram utilizadas essas estrategias de mensuracao.

Psychophysical evaluation of the descriptors of pain in the postoperative

This experimental study aimed to evaluate 20 descriptors of the post-operative pain considering the adequate level of each in describing it. A total of 48 post-operated patients, age between 14 and 70 years old, 60.4% male, participated in the experiment. They judged the descriptors through the Magnitude Estimation Method aiming to qualify and select those with the highest and lowest frequency of attributions in the description of the post-operative pain. The results showed that among the descriptors evaluated, terrible, strong, unbearable, intense and violent were the most frequently ones, whereas the least frequently attributed descriptors were: colossal, smashing, fulminating, blinding and lacerating. The results showed that the most frequently attributed descriptors in the description of post-operative pain are those that represent high magnitude of pain.This experimental study aimed to evaluate 20 descriptors of the post-operative pain considering the adequate level of each in describing it. A total of 48 post-operated patients, age between 14 and 70 years old, 60.4% male, participated in the experiment. They judged the descriptors through the Magnitude Estimation Method aiming to qualify and select those with the highest and lowest frequency of attributions in the description of the post-operative pain. The results showed that among the descriptors evaluated, terrible, strong, unbearable, intense and violent were the most frequently ones, whereas the least frequently attributed descriptors were: colossal, smashing, fulminating, blinding and lacerating. The results showed that the most frequently attributed descriptors in the description of post-operative pain are those that represent high magnitude of pain.

The prevalence and characterization of self-medication for obtaining pain relief among undergraduate nursing students

This study investigates the prevalence of self-medication among undergraduate nursing students seeking to relieve pain and characterizes the pain and relief obtained through the used medication. This epidemiological and cross-sectional study was carried out with 211 nursing students from a public university in Goiás, GO, Brazil. A numerical scale (0-10) measured pain intensity and relief. The prevalence of self-medication was 38.8%. The source and main determining factor of this practice were the student him/herself (54.1%) and lack of time to go to a doctor (50%), respectively. The most frequently used analgesic was dipyrone (59.8%) and pain relief was classified as good (Md=8.5;Max=10;Min=0). The prevalence of self-medication was higher than that observed in similar studies. Many students reported that relief obtained through self-medication was good, a fact that can delay the clarification of a diagnosis and its appropriate treatment.Los objetivos de este estudio fueron estimar la prevalencia de automedicacion entre estudiantes universitarios de enfermeria con dolor y caracterizar la experiencia dolorosa y el alivio obtenido por medio de los farmacos utilizados. Se trata de un estudio epidemiologico seccional, del cual participaron 211 estudiantes de una universidad publica de Goias, en Brasil. El dolor y el alivio fueron medidos por medio de una Escala Numerica (0-10). La prevalencia de automedicacion fue de 38,8%. La fuente generadora y los factores determinantes prevalentes de esta practica fueron el propio estudiante (54,1%) y la falta de tiempo para ir al medico (50%), respectivamente. La dipirona fue el analgesico mas utilizado (59,8%) y el alivio del dolor clasificado como bueno (Md=8,5;Max=10;Min=0). La prevalencia de la automedicacion fue mayor que aquella observada en estudios semejantes y para muchos estudiantes el alivio fue bueno, hecho que puede retardar la elucidacion del diagnostico y del tratamiento adecuado del dolor.

Multidimensional pain evaluation scale

Os objetivos deste estudo foram elaborar escala de avaliacao de dor e valida-la para a lingua portuguesa. Elaboracao de inventario - foram pesquisados 308 descritores de dor da literatura mundial e, a partir desses, seis juizes realizaram a validacao aparente e de conteudo. Como resultados foram encontrados 100 descritores de dor aguda e 100 de cronica, os quais foram utilizados na proxima etapa. Validacao estatistica - participaram 493 profissionais da saude e 146 portadores de dor aguda e de cronica. Usou-se, como material, instrucoes aos participantes, descritores de dor e suas definicoes, caneta e trena. Foram utilizados metodos psicofisicos: estimacao de categorias, estimacao de magnitudes e emparelhamento intermodal com modalidade em comprimento de linhas. Os resultados mostram escalonamento dos descritores de maior caracterizacao para a dor aguda e para a dor cronica, tendo sido encontrado expoente igual a 0,99, proximo ao predito (um) ao utilizar comprimentos de linhas e estimativas numericas. Foi validada para a lingua portuguesa a Escala Multidimensional de Avaliacao de Dor (EMADOR).This study developed a pain evaluation scale and validated it for the Portuguese language. Development of the inventory--308 readily available pain descriptors--were searched in international literature and validated by six judges. One hundred descriptors of acute pain and 100 descriptors of chronic pain were found, which were used in the next stage. Statistical validation--493 health professionals and 146 patients experiencing acute and chronic pain participated in the study. Instructions, pain descriptors and respective definitions, pen and measuring tape were provided to participants. Psychophysical methods were used to establish categories, magnitude and cross-modality matching using line-length. Results revealed the ranking of the most frequently used descriptors of acute and chronic pain, with power equal to 0.99, close to the predicted (one), using line-length estimations. The Multidimensional Pain Evaluation Scale is thus validated for the Portuguese language.

Estimação em categorias dos descritores da dor pós-operatória

En este estudio investigamos el lenguaje utilizado por enfermeros en la caracterizacion del dolor postquirurgico. Para esto, fue elaborado un instrumento conteniendo, inicialmente, 308 descriptores de dolor, los cuales fueron analizados en su validad aparente y de contenido. Despues de ese analisis, con 119 descriptores, el instrumento fue aplicado a 116 enfermeros. Se utilizo el metodo de estimacion en categorias con escores variando de 1 a 7. Fueron calculados la media aritmectica y la desviacion estandar de los escores obtenidos. Los descriptores de mayor atribucion, en orden decreciente, fueron: intensa, fuerte, aguda, insoportable y continua; los de menor atribuicion fueron: circulante, punzante, lento y formidable.: In this study we investigate the language used by nurses in the characterization of postoperative pain. In order to do this, an instrument was elaborated containing initially 308 pain descriptors, which were studied as to their apparent and content validity. After this study, using 119 descriptors, the instrument was applied to 116 nurses. The category estimation method was used, with scores varying from 1 to 7. The mean score and standard deviation were calculated for the scores obtained. The descriptors of highest ascriptions were, in a decreasing order: intense, strong, acute, unbearable and continuous; those of lower ascriptions were: circulating, assailing, circular, slow and formidable.In this study we investigate the language used by nurses in the characterization of postoperative pain. In order to do this, an instrument was elaborated containing initially 308 pain descriptors, which were studied as to their apparent and content validity. After this study, using 119 descriptors, the instrument was applied to 116 nurses. The category estimation method was used, with scores varying from 1 to 7. The mean score and standard deviation were calculated for the scores obtained. The descriptors of highest ascriptions were, in a decreasing order: intense, strong, acute, unbearable and continuous; those of lower ascriptions were: circulating, assailing, circular, slow and formidable.Neste estudo investigamos a linguagem utilizada por enfermeiros na caracterizacao da dor pos-operatoria. Foi elaborado um instrumento contendo, inicialmente, 308 descritores de dor. Este foi analisado quanto a validade aparente e de conteudo. Apos essa analise, com 119 descritores, aplicamos o instrumento para 116 enfermeiros. Foi utilizado o metodo de estimacao em categorias, com escores variando de 1 a 7. Foram calculados a media aritmetica e o desvio-padrao dos escores obtidos. Os descritores de maior atribuicao, em ordem decrescente, foram: intensa, forte, aguda insuportavel e continua e os de menor atribuicao foram: circulante, assaltante, circular, vagarosa e formidavel.

[Pain measurement in the elderly: a review].

This study revised and examined the theoretical and practical base of pain measurement in elderly persons through clinical studies and bibliographical reviews. We discussed the advantages and limitations of the ordinal instruments more frequently used in situations in which alterations characteristic of aging coexist, whose actions in feelings of pain have not been clarified yet. Moreover, we indicated the factors that intervene in the evaluation process of painful experiences leading to underestimation and inadequate control of pain in elderly persons.A base teorica e pratica da mensuracao de dor em idosos foi revisada e examinada atraves de estudos clinicos e revisoes bibliograficas. As vantagens e limitacoes dos instrumentos ordinais mais frequentemente utilizados foram discutidas em situacoes nas quais coexistem alteracoes proprias do envelhecimento, cuja acao na sensacao dolorosa ainda nao esta bem esclarecida. Os fatores que interferem no processo de avaliacao da experiencia dolorosa, levando a subestimacao e controle inadequados da dor em individuos idosos, foram apontados.La base teorica y practica de la mensuracion del dolor en los ancianos fue revisada y examinada a traves de estudios clinicos y revisiones bibliograficas. Las ventajas y limitaciones de los instrumentos ordinales mas frecuentemente utilizados fueron discutidas en situaciones en las cuales coexisten alteraciones propias del envejecimiento, cuya accion dolorosa todavia no esta bien aclarada. Los factores que interfieren en el proceso de evaluacion de la experiencia dolorosa, llevando a la desvalorizacion y control inadecuados del dolor en ancianos, fueron apuntados.

PRESTÍGIO PROFISSIONAL DO ENFERMEIRO: ESTIMAÇÃO DE MAGNITUDES E DE CATEGORIAS EXPANDIDAS

El prestigio social de profesiones de nivel superior ejercidas por: asistentes sociales, biologos, dentistas, enfermeros, ingenieros, farmaceuticos, fisicos, fisioterapeutas, fonoaudiologos, medicos, psicologos, quimicos y sociologos fue escalonado por el metodo psicofisico de estimacion de magnitudes y de categorias expandidas. Los resultados mostraron que: 1) cuando aumentamos la amplitud limitada de las categorias, ese metodo pasa a tener las mismas caracteristicas de la estimacion de magnitudes. 2) la relacion entre las estimativas de magnitud y las estimativas de categorias expandidas es una funcion de potencia con exponente no significativamente diferente de 1.0 En funcion de estos datos, podemos concluir que: 1- la profesion de enfermero ocupa la septima o la octava posicion en terminos de prestigio de las 13 profesiones, mientras que la de medico ocupa la primera posicion en las escalas obtenidas por los metodos utilizados; 2- las ordenaciones resultantes de los metodos producen posiciones de prestigio altamente semejantes para las diferentes profesiones.The prestige of professionals such as social workers, biologists, dentists, nurses, engineers, pharmacists, physicists, physical therapists, speech-language pathologists, physicians, psychologists, chemists and sociologists was scaled by the psychophysical methods of estimation of magnitudes and expanded categories. Results showed that: 1) when we increase the limited amplitude of categories, this method has the same characteristics as those of the estimation of magnitudes. 2) the relationship between the estimations of magnitudes and estimations of expanded categories is a power function with an exponent that is not significantly different from 1.0. These data enabled the following conclusions: 1--The nursing profession is in the seventh or eighth position regarding the prestige of the 13 professions whereas physicians are in the first position in the scale obtained by the used methods; 2--the orders resulting from the methods produce positions of prestige that highly agree for the different professions.

Estimação de magnitude do estresse, pelos alunos de graduação, quanto ao cuidado de enfermagem

Stress is defined as the physiological, psychological and behavioral response of an individual attempting to adapt to internal and external pressure. This study aimed at observing how nursing students perceive stress in view of the care delivered in hospitals. Direct psychophysical methods, ratio scale and cross-modality matching were used. The sample consisted of 15 students registered in the third term of a nursing program. The ratio scale for nursing care was subject to psychophysical validation through the cross-modality matching method. Data were collected by means of a questionnaire containing 15 types of nursing care delivered at hospitals, in which the task consisted in estimating a number for each type, which would be proportional to the amount of stress caused during its performance. Results showed that permanent vesical probing is considered the most stressful type of care, followed by relief vesical probing, and that temperature taking was regarded as the least stressful technique. There is a need for further study, through other comparisons and with other population samples.