Louise Amália de Moura

Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors

OBJETIVOCorrelacionar duas escalas unidimensionais de mensuracao da intensidade da dor autorreferida por idosos e identificar a preferencia por uma das escalas.METODOEstudo conduzido com 101 idosos residentes em Instituicoes de Longa Permanencia para Idosos que referiram algum tipo de dor e alcancaram escores ( 13 no Miniexame do Estado Mental. A Escala Numerica (EN) de 11 pontos e a Escala de Descritores Verbais (EDV), de cinco pontos foram comparadas em tres avaliacoes: global, ao repouso e ao movimento.RESULTADOSAs mulheres foram as mais representadas (61,4%) e a media de idade igual a 77,0±9,1 anos. A EN foi preenchida por 94,8% dos idosos e a EDV por 100%. A associacao entre os escores medios da EN com as categorias da EDV foi significativa, apontando validade convergente e metrica semelhante entre as escalas.CONCLUSAOA mensuracao da dor em idosos institucionalizados pode ser feita por meio da EN e da EDV, no entanto, a escala preferida pelos idosos foi a EDV, independentemente do sexo.OBJECTIVE Correlating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales. METHOD A study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS) of 11 points and a Verbal Descriptor Scale (VDS) of five points were compared in three evaluations: overall, at rest and during movement. RESULTS Women were more representative (61.4%) and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales. CONCLUSION Pain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.

Postoperative pain in children: a gender approach

The objective of this study was to verify and describe, from a gender focus, the associations between gender and specific postoperative pain variables in pediatrics. This is a cross-sectional study of 77 children between 6 and 13 years of age (M=9 years; sd=2.2 years), ASA I and II, 77.9% from low-income classes, 68.8% boys and 32.8% girls. Data were collected on the first postoperative (1st PO) day through semi-structured interviews and four measurement scales. The main baseline diseases were adenotonsillitis and fractures. Prevalence of pain on the 1st PO was 91.7% for girls and 75.5% for boys (p>0.05). No association was found between pain intensity and gender. The most used pain descriptors were it cuts and it squeezes. The preferred scale was the EFMC (with faces from a Brazilian cartoon: Monicas Gang). Pediatric pain management is still inadequate and gender may influence the pain response.The objective of this study was to verify and describe, from a gender focus, the associations between gender and specific postoperative pain variables in pediatrics. This is a cross-sectional study of 77 children between 6 and 13 years of age (M=9 years; sd=2.2 years), ASA I and II, 77.9% from low-income classes, 68.8% boys and 32.8% girls. Data were collected on the first postoperative (1st PO) day through semi-structured interviews and four measurement scales. The main baseline diseases were adenotonsillitis and fractures. Prevalence of pain on the 1st PO was 91.7% for girls and 75.5% for boys (p>0.05). No association was found between pain intensity and gender. The most used pain descriptors were it cuts and it squeezes. The preferred scale was the EFMC (with faces from a Brazilian cartoon: Monicas Gang). Pediatric pain management is still inadequate and gender may influence the pain response.

Dor pós-operatória em crianças: uma abordagem de gênero

The objective of this study was to verify and describe, from a gender focus, the associations between gender and specific postoperative pain variables in pediatrics. This is a cross-sectional study of 77 children between 6 and 13 years of age (M=9 years; sd=2.2 years), ASA I and II, 77.9% from low-income classes, 68.8% boys and 32.8% girls. Data were collected on the first postoperative (1st PO) day through semi-structured interviews and four measurement scales. The main baseline diseases were adenotonsillitis and fractures. Prevalence of pain on the 1st PO was 91.7% for girls and 75.5% for boys (p>0.05). No association was found between pain intensity and gender. The most used pain descriptors were it cuts and it squeezes. The preferred scale was the EFMC (with faces from a Brazilian cartoon: Monicas Gang). Pediatric pain management is still inadequate and gender may influence the pain response.The objective of this study was to verify and describe, from a gender focus, the associations between gender and specific postoperative pain variables in pediatrics. This is a cross-sectional study of 77 children between 6 and 13 years of age (M=9 years; sd=2.2 years), ASA I and II, 77.9% from low-income classes, 68.8% boys and 32.8% girls. Data were collected on the first postoperative (1st PO) day through semi-structured interviews and four measurement scales. The main baseline diseases were adenotonsillitis and fractures. Prevalence of pain on the 1st PO was 91.7% for girls and 75.5% for boys (p>0.05). No association was found between pain intensity and gender. The most used pain descriptors were it cuts and it squeezes. The preferred scale was the EFMC (with faces from a Brazilian cartoon: Monicas Gang). Pediatric pain management is still inadequate and gender may influence the pain response.

Prevalence and factors associated with preoperative anxiety in children aged 5-12 years

Abstract Objective: to estimate the prevalence and factors associated with preoperative anxiety in children who wait for outpatient surgery. Method: cross-sectional analysis of baseline data of a prospective cohort study that investigates the predictors of postoperative pain in children aged 5-12 years submitted to inguinal and umbilical hernia repair. It was selected 210 children, which were interviewed in the preoperative holding area of a general hospital. Anxiety was evaluated using the modified Yale Preoperative Anxiety Scale (mYPAS). Sociodemographic and clinical variables were analyzed as exposure and anxiety (mYPAS final score>30) as outcome. Logistic regression was used to identify factors associated with preoperative anxiety. Results: forty-two percent (42.0%) of children presented preoperative anxiety (CI95%: 35.7%-48.6%), with mean scores equal to 30.1 (SD=8.4). Factors associated with preoperative anxiety were: age group of 5-6 years (OR=2.28; p=0.007) and socioeconomic status classified as class C (OR=2.39; p=0.016). Conclusion: the evaluation of children who wait for outpatient surgery should be multidimensional and comprise information on age and socioeconomic status, in order to help in the identification and early treatment of preoperative anxiety.Objetivo: estimar la prevalencia y los factores asociados con la ansiedad preoperatoria en ninos que aguardan cirugia ambulatoria. Metodo: analisis transversal de los datos de referencia de un estudio de cohorte prospectivo que investiga los predictores de dolor postoperatorio en ninos de 5-12 anos, sometidos a reparacion de hernia inguinal y umbilical. Se seleccionaron 210 ninos, entrevistados en la sala de espera de un hospital general. La ansiedad se evaluo por medio de la Escala de Ansiedad Preoperatoria de Yale Modificada (EAPY-m). Se analizaron variables sociodemograficas y clinicas, como exposicion y ansiedad (suma de las puntuaciones de la EAPY-m>30) como resultado. Se utilizo regresion logistica para identificar factores asociados con la ansiedad preoperatoria. Resultados: cuarenta y dos por ciento (42.0%) de los ninos presentaron ansiedad preoperatoria (IC95%: 35,7%-48,6%), con una puntuacion media igual a 30,1 (DE=8,4). Los factores asociados con la ansiedad preoperatoria fueron grupo de edad de 5-6 anos (OR=2,28; p=0,007) y clase socioeconomica C (OR=2,39; p=0,016). Conclusion: la evaluacion de los ninos que aguardan cirugia ambulatoria debe ser multidimensional y contener informacion sobre la edad y el nivel socioeconomico, con el fin de ayudar a la identificacion y el tratamiento precoz de la ansiedad preoperatoria.

Prevalência e fatores associados à ansiedade pré-operatória em crianças de 5 a 12 anos

Abstract Objective: to estimate the prevalence and factors associated with preoperative anxiety in children who wait for outpatient surgery. Method: cross-sectional analysis of baseline data of a prospective cohort study that investigates the predictors of postoperative pain in children aged 5-12 years submitted to inguinal and umbilical hernia repair. It was selected 210 children, which were interviewed in the preoperative holding area of a general hospital. Anxiety was evaluated using the modified Yale Preoperative Anxiety Scale (mYPAS). Sociodemographic and clinical variables were analyzed as exposure and anxiety (mYPAS final score>30) as outcome. Logistic regression was used to identify factors associated with preoperative anxiety. Results: forty-two percent (42.0%) of children presented preoperative anxiety (CI95%: 35.7%-48.6%), with mean scores equal to 30.1 (SD=8.4). Factors associated with preoperative anxiety were: age group of 5-6 years (OR=2.28; p=0.007) and socioeconomic status classified as class C (OR=2.39; p=0.016). Conclusion: the evaluation of children who wait for outpatient surgery should be multidimensional and comprise information on age and socioeconomic status, in order to help in the identification and early treatment of preoperative anxiety.Objetivo: estimar la prevalencia y los factores asociados con la ansiedad preoperatoria en ninos que aguardan cirugia ambulatoria. Metodo: analisis transversal de los datos de referencia de un estudio de cohorte prospectivo que investiga los predictores de dolor postoperatorio en ninos de 5-12 anos, sometidos a reparacion de hernia inguinal y umbilical. Se seleccionaron 210 ninos, entrevistados en la sala de espera de un hospital general. La ansiedad se evaluo por medio de la Escala de Ansiedad Preoperatoria de Yale Modificada (EAPY-m). Se analizaron variables sociodemograficas y clinicas, como exposicion y ansiedad (suma de las puntuaciones de la EAPY-m>30) como resultado. Se utilizo regresion logistica para identificar factores asociados con la ansiedad preoperatoria. Resultados: cuarenta y dos por ciento (42.0%) de los ninos presentaron ansiedad preoperatoria (IC95%: 35,7%-48,6%), con una puntuacion media igual a 30,1 (DE=8,4). Los factores asociados con la ansiedad preoperatoria fueron grupo de edad de 5-6 anos (OR=2,28; p=0,007) y clase socioeconomica C (OR=2,39; p=0,016). Conclusion: la evaluacion de los ninos que aguardan cirugia ambulatoria debe ser multidimensional y contener informacion sobre la edad y el nivel socioeconomico, con el fin de ayudar a la identificacion y el tratamiento precoz de la ansiedad preoperatoria.

Prevalencia y factores asociados con la ansiedad preoperatoria en niños de 5 a 12 años

Abstract Objective: to estimate the prevalence and factors associated with preoperative anxiety in children who wait for outpatient surgery. Method: cross-sectional analysis of baseline data of a prospective cohort study that investigates the predictors of postoperative pain in children aged 5-12 years submitted to inguinal and umbilical hernia repair. It was selected 210 children, which were interviewed in the preoperative holding area of a general hospital. Anxiety was evaluated using the modified Yale Preoperative Anxiety Scale (mYPAS). Sociodemographic and clinical variables were analyzed as exposure and anxiety (mYPAS final score>30) as outcome. Logistic regression was used to identify factors associated with preoperative anxiety. Results: forty-two percent (42.0%) of children presented preoperative anxiety (CI95%: 35.7%-48.6%), with mean scores equal to 30.1 (SD=8.4). Factors associated with preoperative anxiety were: age group of 5-6 years (OR=2.28; p=0.007) and socioeconomic status classified as class C (OR=2.39; p=0.016). Conclusion: the evaluation of children who wait for outpatient surgery should be multidimensional and comprise information on age and socioeconomic status, in order to help in the identification and early treatment of preoperative anxiety.Objetivo: estimar la prevalencia y los factores asociados con la ansiedad preoperatoria en ninos que aguardan cirugia ambulatoria. Metodo: analisis transversal de los datos de referencia de un estudio de cohorte prospectivo que investiga los predictores de dolor postoperatorio en ninos de 5-12 anos, sometidos a reparacion de hernia inguinal y umbilical. Se seleccionaron 210 ninos, entrevistados en la sala de espera de un hospital general. La ansiedad se evaluo por medio de la Escala de Ansiedad Preoperatoria de Yale Modificada (EAPY-m). Se analizaron variables sociodemograficas y clinicas, como exposicion y ansiedad (suma de las puntuaciones de la EAPY-m>30) como resultado. Se utilizo regresion logistica para identificar factores asociados con la ansiedad preoperatoria. Resultados: cuarenta y dos por ciento (42.0%) de los ninos presentaron ansiedad preoperatoria (IC95%: 35,7%-48,6%), con una puntuacion media igual a 30,1 (DE=8,4). Los factores asociados con la ansiedad preoperatoria fueron grupo de edad de 5-6 anos (OR=2,28; p=0,007) y clase socioeconomica C (OR=2,39; p=0,016). Conclusion: la evaluacion de los ninos que aguardan cirugia ambulatoria debe ser multidimensional y contener informacion sobre la edad y el nivel socioeconomico, con el fin de ayudar a la identificacion y el tratamiento precoz de la ansiedad preoperatoria.

Predictors for Moderate to Severe Acute Postoperative Pain after Cesarean Section

Background. Moderate to severe postoperative pain affects performance of daily activities and it contributes to persistent postoperative pain. In patients submitted to cesarean section, this pain can also interfere with womens ability to care for their babies, to effectively breastfeed, and to satisfactorily interact with their children. Factors influencing the pain perception during the immediate postoperative period have not been widely pursued. Objective. To investigate the incidence and predicting factors of postoperative pain after cesarean section. Methods. A prospective longitudinal study with 1,062 women submitted to cesarean section. We collected sociodemographic, clinical, surgical, and health behavior data. We used the 11-point Numerical Pain and the Hospital Anxiety and Depression Scales. We performed logistic analysis to identify predictors of moderate to severe postoperative pain. Results. The incidence of moderate-severe postoperative pain was 78.4% (CI: 95%: 75.9%–80.8%). The preoperative anxiety (OR = 1.60; CI 95%: 1.22–2.30) and intrathecal morphine with fentanyl (OR = 0,23; CI 95%: 0.08–0.66) were significantly associated with moderate-severe postoperative pain report. Conclusion. The preoperative anxiety increases the risk of moderate-severe postoperative pain in women submitted to cesarean section. The intrathecal morphine with fentanyl added to bupivacaine was a protective factor against this pain.

Intensidade da dor em idosos institucionalizados: comparação entre as escalas numérica e de descritores verbais

OBJETIVOCorrelacionar duas escalas unidimensionais de mensuracao da intensidade da dor autorreferida por idosos e identificar a preferencia por uma das escalas.METODOEstudo conduzido com 101 idosos residentes em Instituicoes de Longa Permanencia para Idosos que referiram algum tipo de dor e alcancaram escores ( 13 no Miniexame do Estado Mental. A Escala Numerica (EN) de 11 pontos e a Escala de Descritores Verbais (EDV), de cinco pontos foram comparadas em tres avaliacoes: global, ao repouso e ao movimento.RESULTADOSAs mulheres foram as mais representadas (61,4%) e a media de idade igual a 77,0±9,1 anos. A EN foi preenchida por 94,8% dos idosos e a EDV por 100%. A associacao entre os escores medios da EN com as categorias da EDV foi significativa, apontando validade convergente e metrica semelhante entre as escalas.CONCLUSAOA mensuracao da dor em idosos institucionalizados pode ser feita por meio da EN e da EDV, no entanto, a escala preferida pelos idosos foi a EDV, independentemente do sexo.OBJECTIVE Correlating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales. METHOD A study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS) of 11 points and a Verbal Descriptor Scale (VDS) of five points were compared in three evaluations: overall, at rest and during movement. RESULTS Women were more representative (61.4%) and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales. CONCLUSION Pain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.

Intensidad del dolor en ancianos institucionalizados: comparación entre la escala numérica y los descriptores verbales

OBJETIVOCorrelacionar duas escalas unidimensionais de mensuracao da intensidade da dor autorreferida por idosos e identificar a preferencia por uma das escalas.METODOEstudo conduzido com 101 idosos residentes em Instituicoes de Longa Permanencia para Idosos que referiram algum tipo de dor e alcancaram escores ( 13 no Miniexame do Estado Mental. A Escala Numerica (EN) de 11 pontos e a Escala de Descritores Verbais (EDV), de cinco pontos foram comparadas em tres avaliacoes: global, ao repouso e ao movimento.RESULTADOSAs mulheres foram as mais representadas (61,4%) e a media de idade igual a 77,0±9,1 anos. A EN foi preenchida por 94,8% dos idosos e a EDV por 100%. A associacao entre os escores medios da EN com as categorias da EDV foi significativa, apontando validade convergente e metrica semelhante entre as escalas.CONCLUSAOA mensuracao da dor em idosos institucionalizados pode ser feita por meio da EN e da EDV, no entanto, a escala preferida pelos idosos foi a EDV, independentemente do sexo.OBJECTIVE Correlating two unidimensional scales for measurement of self-reported pain intensity for elderly and identifying a preference for one of the scales. METHOD A study conducted with 101 elderly people living in Nursing Home who reported any pain and reached ( 13 the scores on the Mini-Mental State Examination. A Numeric Rating Scale - (NRS) of 11 points and a Verbal Descriptor Scale (VDS) of five points were compared in three evaluations: overall, at rest and during movement. RESULTS Women were more representative (61.4%) and the average age was 77.0±9.1 years. NRS was completed by 94.8% of the elderly while VDS by 100%. The association between the mean scores of NRS with the categories of VDS was significant, indicating convergent validity and a similar metric between the scales. CONCLUSION Pain measurements among institutionalized elderly can be made by NRS and VDS; however, the preferred scale for the elderly was the VDS, regardless of gender.

Dolor post-operatorio en niños: un abordaje de género

The objective of this study was to verify and describe, from a gender focus, the associations between gender and specific postoperative pain variables in pediatrics. This is a cross-sectional study of 77 children between 6 and 13 years of age (M=9 years; sd=2.2 years), ASA I and II, 77.9% from low-income classes, 68.8% boys and 32.8% girls. Data were collected on the first postoperative (1st PO) day through semi-structured interviews and four measurement scales. The main baseline diseases were adenotonsillitis and fractures. Prevalence of pain on the 1st PO was 91.7% for girls and 75.5% for boys (p>0.05). No association was found between pain intensity and gender. The most used pain descriptors were it cuts and it squeezes. The preferred scale was the EFMC (with faces from a Brazilian cartoon: Monicas Gang). Pediatric pain management is still inadequate and gender may influence the pain response.The objective of this study was to verify and describe, from a gender focus, the associations between gender and specific postoperative pain variables in pediatrics. This is a cross-sectional study of 77 children between 6 and 13 years of age (M=9 years; sd=2.2 years), ASA I and II, 77.9% from low-income classes, 68.8% boys and 32.8% girls. Data were collected on the first postoperative (1st PO) day through semi-structured interviews and four measurement scales. The main baseline diseases were adenotonsillitis and fractures. Prevalence of pain on the 1st PO was 91.7% for girls and 75.5% for boys (p>0.05). No association was found between pain intensity and gender. The most used pain descriptors were it cuts and it squeezes. The preferred scale was the EFMC (with faces from a Brazilian cartoon: Monicas Gang). Pediatric pain management is still inadequate and gender may influence the pain response.