Lilian Varanda Pereira

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.

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.

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.

Categorization of postoperative pain descriptors in the sensitive, affective and evaluative dimensions of painful experiences

The main purpose of this study was categorizing 20 descriptors of post-operative pain sensory, affective and evaluative dimensions. Sixty-one physicians participated. They were between 24 and 63 years old and categorized 20 descriptors by considering their level of attribution in the description of post-operative pain sensory, affective and evaluative qualities. The categorization showed that the most frequently attributed descriptors of sensitive pain qualities were: lacerating, unbearable, fulminating, intense and deep; and, for the affective qualities: hallucinating, annihilating, maddening, despairing, inhuman, blinding, terrible, monstrous and dreadful; whereas for the evaluative qualities, they were: unbearable, strong, intense and violent. The most frequently attributed descriptors in the description of post-operative pain are those mostly judged adequate to describe the affective qualities of this experience.The main purpose of this study was categorizing 20 descriptors of post-operative pain sensory, affective and evaluative dimensions. Sixty-one physicians participated. They were between 24 and 63 years old and categorized 20 descriptors by considering their level of attribution in the description of post-operative pain sensory, affective and evaluative qualities. The categorization showed that the most frequently attributed descriptors of sensitive pain qualities were: lacerating, unbearable, fulminating, intense and deep; and, for the affective qualities: hallucinating, annihilating, maddening, despairing, inhuman, blinding, terrible, monstrous and dreadful; whereas for the evaluative qualities, they were: unbearable, strong, intense and violent. The most frequently attributed descriptors in the description of post-operative pain are those mostly judged adequate to describe the affective qualities of this experience.O objetivo do estudo foi categorizar 20 descritores da dor pos-operatoria, considerando a adequacao deles para descrever a experiencia dolorosa em suas dimensoes sensitiva, afetiva e avaliativa. Participaram 61 cirurgioes e anestesistas, de ambos os sexos, com idades de 24 a 63 anos, os quais julgaram os descritores pelo metodo de Estimacao de Categorias, utilizando Escala Numerica de 7 pontos. Os descritores julgados como os mais adequados para descrever a dor pos-operatoria na dimensao sensitiva, considerando a mediana dos escores, foram: dilacerante, insuportavel, fulminante, intensa e profunda; na dimensao afetiva foram: alucinante, aniquiladora, enlouquecedora, desesperadora, desumana, que cega, terrivel, monstruosa e pavorosa e aqueles com maior mediana na dimensao avaliativa: insuportavel, forte, intensa e violenta. Os descritores de maior atribuicao na descricao da dor pos-operatoria foram, em sua maioria, julgados como adequados para descrever a dimensao afetiva dessa experiencia.

Prevalência de dor crônica em estudantes universitários de enfermagem

A dor cronica e uma das principais causas de incapacidade entre os individuos. O objetivo do estudo foi estimar a prevalencia deste tipo de dor em estudantes universitarios de enfermagem e caracteriza-la segundo a ocorrencia, localizacao, duracao, intensidade e qualidade. Estudo transversal, desenvolvido em uma Faculdade de Enfermagem de Goias, entre maio e junho de 2008, com 211 estudantes. A prevalencia de dor cronica autorrelatada foi de 59,7%, frequentemente localizada na cabeca (38,1%), regiao lombar (11,9%) e ombros/ membros superiores (11,9%). Em 46% dos casos, o convivio com a dor variou de um a cinco anos; a intensidade foi caracterizada como forte (Mediana do escore de dor=7,0) e descrita como latejante, pontada, cansativa, enjoada, que incomoda e aperto. A alta prevalencia de dor entre jovens universitarios de enfermagem aponta o futuro da saude dessa populacao, a necessidade de intervencoes para reducao de agravos e adequado alivio dessa experiencia.Chronic pain is one of the major causes of disability among individuals. This study aims to estimate the prevalence of this type of self-reported pain by undergraduate nursing students and characterize it concerning its occurrence, location, duration, intensity, and quality. This cross-sectional study was developed at a Nursing College in Goiás, Brazil, between May and June of 2008 with 211 students. The prevalence of self-reported chronic pain was 59.7%, frequently located in the head (38.1%), lower back (11.9%) and shoulder/upper members (11.9%). In 46% of the cases, living with the pain ranged from one to five years with a strong intensity (Median pain scores=7) and was described as throbbing, stabbing, tiring, sickening, that bothers, and tight. The prevalence of pain is higher than that estimated in similar studies, pointing to the future health of this generation and the need for disease prevention and health promotion programs for adequate relief among this population. DESCRIPTORS: Pain. Students, nursing. Prevalence. LA PREVALENCIA DEL DOLOR CRÓNICO EN ESTUDIANTES DE ENFERMERÍA RESUMEN: El dolor crónico es una de las principales causas de discapacidad entre las personas. Los objetivos de este estudio: estimar la prevalencia este tipo de dolor en los estudiantes universitarios de enfermería, caracterizar el dolor según la aparición, localización, duración, intensidad y calidad. Se trata de un estudio transversal desarrollado en un Facultad de Enfermería de Goiás, de mayo a junio de 2008, con 211 estudiantes. La prevalencia del dolor crónico informado fue del 59,7%, localizado a menudo en la cabeza (38,1%), en la región lumbar (11,9%) y en el hombro/extremidades superiores (11,9%). En el 46% de los casos, la convivencia con el dolor varió de uno a cinco años, la intensidad se caracterizó por ser muy fuerte (puntación de dolor media=7,0) y se describe como palpitante, agudo, agotador, repugnante, y que incomoda y aprieta. La alta prevalencia de dolor entre los estudiantes de enfermería indica la salud futura de esta población, la necesidad de intervenciones para reducir las lesiones y el alivio adecuado de esta experiencia. DESCRIPTORES: Dolor. Estudiantes de enfermería. Prevalencia. 519El dolor cronico es una de las principales causas de discapacidad entre las personas. Los objetivos de este estudio: estimar la prevalencia este tipo de dolor en los estudiantes universitarios de enfermeria, caracterizar el dolor segun la aparicion, localizacion, duracion, intensidad y calidad. Se trata de un estudio transversal desarrollado en un Facultad de Enfermeria de Goias, de mayo a junio de 2008, con 211 estudiantes. La prevalencia del dolor cronico informado fue del 59,7%, localizado a menudo en la cabeza (38,1%), en la region lumbar (11,9%) y en el hombro/extremidades superiores (11,9%). En el 46% de los casos, la convivencia con el dolor vario de uno a cinco anos, la intensidad se caracterizo por ser muy fuerte (puntacion de dolor media=7,0) y se describe como palpitante, agudo, agotador, repugnante, y que incomoda y aprieta. La alta prevalencia de dolor entre los estudiantes de enfermeria indica la salud futura de esta poblacion, la necesidad de intervenciones para reducir las lesiones y el alivio adecuado de esta experiencia.

Prevalência e caracterização da prática de automedicação para alívio da dor entre estudantes universitários de enfermagem

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.

Categorização de descritores da dor pós-operatória nas dimensões sensitiva, afetiva e avaliativa da experiência dolorosa

The main purpose of this study was categorizing 20 descriptors of post-operative pain sensory, affective and evaluative dimensions. Sixty-one physicians participated. They were between 24 and 63 years old and categorized 20 descriptors by considering their level of attribution in the description of post-operative pain sensory, affective and evaluative qualities. The categorization showed that the most frequently attributed descriptors of sensitive pain qualities were: lacerating, unbearable, fulminating, intense and deep; and, for the affective qualities: hallucinating, annihilating, maddening, despairing, inhuman, blinding, terrible, monstrous and dreadful; whereas for the evaluative qualities, they were: unbearable, strong, intense and violent. The most frequently attributed descriptors in the description of post-operative pain are those mostly judged adequate to describe the affective qualities of this experience.The main purpose of this study was categorizing 20 descriptors of post-operative pain sensory, affective and evaluative dimensions. Sixty-one physicians participated. They were between 24 and 63 years old and categorized 20 descriptors by considering their level of attribution in the description of post-operative pain sensory, affective and evaluative qualities. The categorization showed that the most frequently attributed descriptors of sensitive pain qualities were: lacerating, unbearable, fulminating, intense and deep; and, for the affective qualities: hallucinating, annihilating, maddening, despairing, inhuman, blinding, terrible, monstrous and dreadful; whereas for the evaluative qualities, they were: unbearable, strong, intense and violent. The most frequently attributed descriptors in the description of post-operative pain are those mostly judged adequate to describe the affective qualities of this experience.O objetivo do estudo foi categorizar 20 descritores da dor pos-operatoria, considerando a adequacao deles para descrever a experiencia dolorosa em suas dimensoes sensitiva, afetiva e avaliativa. Participaram 61 cirurgioes e anestesistas, de ambos os sexos, com idades de 24 a 63 anos, os quais julgaram os descritores pelo metodo de Estimacao de Categorias, utilizando Escala Numerica de 7 pontos. Os descritores julgados como os mais adequados para descrever a dor pos-operatoria na dimensao sensitiva, considerando a mediana dos escores, foram: dilacerante, insuportavel, fulminante, intensa e profunda; na dimensao afetiva foram: alucinante, aniquiladora, enlouquecedora, desesperadora, desumana, que cega, terrivel, monstruosa e pavorosa e aqueles com maior mediana na dimensao avaliativa: insuportavel, forte, intensa e violenta. Os descritores de maior atribuicao na descricao da dor pos-operatoria foram, em sua maioria, julgados como adequados para descrever a dimensao afetiva dessa experiencia.