BACKGROUND AND OBJECTIVES: The incidence of malignant melanoma is increasing worldwide. This is a... more BACKGROUND AND OBJECTIVES: The incidence of malignant melanoma is increasing worldwide. This is a tumor with high morbidity and mortality. Most common symptom of cancer patients is pain, which is complex, multifactorial and directly impacts patients' quality of life. However, there is little information about the prevalence of pain in this population. This study aimed at observing the prevalence of pain among melanoma patients in a reference center, in addition to obtaining information about treatments and pain-related incapacity. METHODS: Descriptive, retrospective, exploratory study level I, with quantitative approach, carried out by means of the analysis of 306 medical records of melanoma patients. RESULTS: The prevalence of pain was 38.2%. Among those with pain complaints, its location was the same as the injury in 20.5% of cases, in 8% of cases it was at the same site of malignant melanoma metastases and 55.8% have stated that pain was related to lymphadenectomy. Among such patients, 70% were treated to control pain, 2% were referred to specialized treatment and 75% have reported pain-related incapacity. CONCLUSION: Persistent pain is a prevalent and disabling melanoma-related symptom which is related both to the surgical procedure and the staging, requiring early prevention and treatment actions.
Cadernos de Naturologia e Terapias Complementares, 2017
Introdução: A cervicalgia é uma condição clínica caracterizada por dor na região posterior ou pós... more Introdução: A cervicalgia é uma condição clínica caracterizada por dor na região posterior ou póstero-lateral do pescoço, podendo ser local ou irradiada para os membros superiores nos determinados der¬mátomos correspondentes. Nesse sentido, pesquisas atuais indicam que o uso da acupuntura dentro do processo de reabilitação possui efi¬cácia comprovada. A acupuntura atualmente é amplamente utilizada no arsenal de tratamento de vários profissionais devido a seus ótimos resultados. Objetivo: Nesse sentido, o trabalho apresenta como objeti¬vo identificar na literatura os tratamentos usuais para as cervicalgias através da acupuntura, além de levantar os protocolos mais usuais no tratamento das cervicalgias segundo a Medicina Tradicional Chinesa. Materiais e métodos: Este trabalho de pesquisa foi embasado na me¬todologia de revisão integrativa que apresenta como um método que proporciona síntese de conhecimento e a incorporação da aplicabili¬dade de resultados de estudos significativos na ...
DOI http://dx.doi.org/10.1590/19820194201800093 Escola de Enfermagem Aurora Afonso Costa, Univers... more DOI http://dx.doi.org/10.1590/19820194201800093 Escola de Enfermagem Aurora Afonso Costa, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil. Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Confl ict of interest: none known. Abstract Objective: To know the benefi ts of nursing practices to patients with pain followed-up in the pain clinic. Methods: Integrative literature review, using the electronic portal SCIELO, CINAHL and PubMed Central databases, with time cut from 2008 to 2018 and data collection period between June and July 2018. The Health Science Descriptors (DeCs) and Medical Subject Heading (MeSH) were: Patients, Chronic pain, Nurse Care, Pain clinic. Results: It was evidenced...
INTRODUÇÃO: A síndrome descrito pela primeira vez em início insidioso de achados rigidez muscular... more INTRODUÇÃO: A síndrome descrito pela primeira vez em início insidioso de achados rigidez muscular axial, progredindo A hiperlordose dolorosa devido Prof. Dr. Fabiano de Abreu Bruno José de Pinho Person Syndrome (SPS) is a rare neurological Moersch and Woltman. The clinical picture has an episodic painful spasms, hyperreflexia, axial proximal limb muscles. Painful hyperlordosis diagnostic characteristic of SPS. CASE REPORT:Male, referred by the neurologist to the spine surgeon because management of chronic low back pain, progressively acute examination is difficult to perform in SPS because zygoapophyseal joint, intervertebral discs L4L5 cranial migrated herniated disc. Once there his axial and radicular pain, it was decided transforaminal endoscopic discectomy for L4L5 decompression, branch ablative radiofrequency rhizotomy to ganglion pulsed radiofrequency rhizotomy for One year postoperative follow up, the patient and SF-36. CONCLUSION: Chronic pain reported biological, psychological and social dimensions. the factors involved with pain allows planning strategies in uncommon and off label patients, as in the Syndrome, Stiff-Person, Chronic Pain, endoscopic rhizotomy, minimally invasive treatment. ndrome da pessoa rígida (SPR) é um distúrbio em 1956 por Moersch e Woltman. O quadro achados clássicos de espasmos dolorosos episódicos, progredindo lentamente para os músculos proximais devido à rigidez da coluna lombar é uma
In this study, we assessed resilience, depression, and quality of life in a group of elderly indi... more In this study, we assessed resilience, depression, and quality of life in a group of elderly individuals with or without chronic pain. Patients and methods: A cross-sectional study assessing elderly individuals followed up at a geriatrics outpatient clinic and divided into two groups: 54 elderly patients with chronic pain and 54 elderly with no chronic pain. Results: The sample comprised mainly women (67.6%), with mean age 79.9 years. The mean resilience index in the group with pain was 69.4 and, in the group with no pain, 80.1 (P<0.001). Depression was observed in 35.2% of patients with chronic pain; there was no case of depression in those without chronic pain. Quality of life of the elderly with chronic pain was worse in all the domains assessed: physical, mental, emotional, social, vitality, and pain. Conclusion: In the study sample, resilience was lower, depression was more frequent, and quality of life was worse in the group of elderly with chronic pain.
Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanha... more Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanhados na clinica de dor. Métodos Revisão integrativa de literatura, sendo utilizado o portal eletrônico SCIELO, e base de dados CINAHL e PubMed Central, com recorte temporal de 2008 a 2018 e período de coleta de dados entre junho e julho de 2018. Como descritores em saúde (DeCs): Pacientes, Dor crônica, Cuidados de Enfermagem, Clínicas de dor; e, o Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Evidenciou-se que a produção analisada é, majoritariamente, sobre práticas de enfermagem não farmacológica a pacientes com dor crônica, com publicações reduzidas no Brasil e tendem a se concentrar nos últimos cinco anos. O paciente com este tipo de agravo, vivencia condições multifatoriais que influenciam diretamente na condição de saúde, e necessitando de acompanhamento integral por equipe interprofissional, com inclusão da rede cuidadora, através interv...
Objective: To evaluate the behavior of children before and after a therapeutic play session. Meth... more Objective: To evaluate the behavior of children before and after a therapeutic play session. Methods: A quantitative and descriptive study was carried out in a major hospital of the city of Santos, State of São Paulo, involving 30 preschool children recently admitted to a pediatric ward. A behavior scale was applied before and after a therapeutic play session. This scale comprises six categories: moving, gazing, expressing feelings, talking, playing, and not responding to stimuli or requests. Each category is scored from 1 to 3, the lowest score representing the least interaction. Results: Before therapeutic play sessions, children showed no interest and were scored 1 and 2: moving parts of their bodies and expressing emotions, such as seriousness, and gazing rapidly to a place as if expecting something. After therapeutic play, the children progressed to level 3: changing position, moving with a purpose, observing attentively to what they saw, and expressing emotions such as joy. Co...
The objective of this study was to translate and culturally adapt the Behavioral Pain Scale to Br... more The objective of this study was to translate and culturally adapt the Behavioral Pain Scale to Brazilian Portuguese and to evaluate the psychometric properties of this scale. Method: This study was conducted in two phases: the Behavioral Pain Scale was translated and culturally adapted to Brazilian Portuguese and the psychometric properties of this scale were subsequently assessed (reliability and clinical utility). The study sample consisted of 100 patients who were older than 18 years of age, admitted to an intensive care unit, intubated, mechanically ventilated, and subjected or not to sedation and analgesia from July 2012 to December 2012. Pediatric and non-intubated patients were excluded. The study was conducted at a large private hospital that was situated in the city of São Paulo (SP).
BACKGROUND AND OBJECTIVES: Low back pain treatment may be either conservative or surgical. Curren... more BACKGROUND AND OBJECTIVES: Low back pain treatment may be either conservative or surgical. Current guidelines recommend conservative treatment for most cases, with drugs and rehabilitation, including physical medicine and psychological assistance. Invasive procedures may be justified if there are evidences of short and long term benefits, and minimally invasive techniques, such as radiofrequency, are modern and effective to relieve this pain. This study aimed at searching Brazilian literature about the use of pulsed radiofrequency to treat low back pain. CONTENTS: A literature survey was carried out with articles published from 2004 to 2010 in Portuguese and Spanish in LILACS, Scielo and Cochrane, Cinahl and Medline databases. CONCLUSION: Pulsed radiofrequency is an effective method to treat chronic low back pain, with low incidence of complications.
JUSTIFICATIVA E OBJETIVOS: Buscar publicações na literatura nacional sobre instrumentos para aval... more JUSTIFICATIVA E OBJETIVOS: Buscar publicações na literatura nacional sobre instrumentos para avaliação de dor em pacientes oncológicos e propor um instrumento de avaliação inicial de dor nesses pacientes. CONTEÚDO: Foram utilizadas as bases de dados LILACS , Bibliográficos da USP, Catálogo on-line Global (Dedalus), SciElo, MedLine, Cochrane e o Cumulative Index to Nursing and Allied Health Literature (CINAHL). CONCLUSÃO: O presente estudo comprovou que as escalas unidimensionais são mais frequentemente utilizadas, no entanto evidenciou a importância de utilizar instrumento multidimensional para avaliar a dor do paciente oncológico. Descritores: Avaliação da dor, dor, oncologia, paciente. SUMMARY BACKGROUND AND OBJECTIVES: To look for publications in the Brazilian literature about tools for pain evaluation in cancer patients and to propose an initial pain evaluation tool for cancer patients. CONTENTS: The following databases were searched: LILACS , Bibliográficos da USP, On-line Global Catalogue (Dedalus), SciElo, MedLine, Cochrane and Cumulative Index to Nursing and Allied Health Literature (CINAHL). CONCLUSION: This study has shown that one-dimension scales are more often used, however it has stressed
Objective: To identify knowledge of caretakers about pain in longstay patients with cognitive imp... more Objective: To identify knowledge of caretakers about pain in longstay patients with cognitive impairment and to understand the importance of caretakers in assessing pain in these patients. Methods: A descriptive exploratory survey conducted at the longstay inpatients unit with nineteen caretakers of patients with cognitive impairment. Result: As to signs suggesting pain in these patients, in the item vocalization, 75% of the caregivers reported moan as the sign most often related to pain, followed by groan (50%) and cry 37.5%; however, 75% disagreed that yell is a sign of pain. Regarding facial expression, 75% said that closing eyes and frowning are signs of pain; nevertheless, 62.5% disagreed that opening the mouth, clenching teeth and squeezing eyes are signs suggesting pain. As to body movements, 62.5% reported that when patients are immobile and tense, or agitated (50%) could be due to pain, and positions of protection and curling are not considered as signs of pain. Of the caretakers studied, all agreed that it is important to pay attention to pain, to call the nursing team when patients may feel pain, and 62.5% of them suggested actions that can bring relief to pain. Conclusion: The survey showed that information about pain provided by caretakers of chronic patients are fundamental sources that should be valued; however they require more knowledge on signs suggesting pain that could help them identifying signs of suffering. Some studies demonstrated a high incidence of pain in institutionalized patients; very often their pain is underevaluated and therefore undertreated.
Objective: To identify the occurrence of overweight and obesity in preschool children (two to fiv... more Objective: To identify the occurrence of overweight and obesity in preschool children (two to five years) in a day-care center in the city of São Paulo, using the weight/height ratio. Methods: This is a descriptive study, with exploratory quantitative approach, conducted in a day-care center in São Paulo. The sample consisted of 29 children, aged from two to five years and the data were collected through questionnaires. results: As for the nutritional assessment of children according to the Waterlow criteria, 12 (41%) were normal, 7 (24%) obese, 5 (17%) overweight, 3 (10%) had grade 1 malnutrition, 1 (4%), morbid obesity and 1 (4%), grade 3 malnutrition. conclusions: It is concluded that a significant proportion of the children assessed is above the appropriate weight range, requiring the implementation of preventive actions aimed to guide habits of good nutrition, encouraging physical activity, thereby decreasing the rates of child obesity and impacting their health at adulthood.
Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portugues... more Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement). Methods Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain. Results Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were “Facial expression”, “Body language” and “Consolability”. The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibilit...
RESUMO JUSTIFICATIVA E OBJETIVOS: A criança interna-da, na maioria das vezes, é submetida à punçã... more RESUMO JUSTIFICATIVA E OBJETIVOS: A criança interna-da, na maioria das vezes, é submetida à punção venosa e talvez essa seja a experiência mais estressante percebida no decorrer da sua internação. O objetivo deste estudo foi avaliar a intensidade da dor da criança em idade es-colar quando submetida á punção venosa periférica. MÉTODO: Após aprovação pelo Comitê de Ética em Pesquisa da Instituição, usando a escala de faces e a es-cala visual numérica para a avaliação da dor no momento da punção venosa, foram estudadas 31 crianças em idade escolar submetidas à punção venosa, sendo que 67,74% delas já haviam sido internadas e vivenciadas o procedi-mento anteriormente. RESULTADOS: Em relação à intensidade da dor 48,39% das crianças informaram que foi de intensida-de leve, 32,27% sentiram dor moderada, 9,67% dor in-suportável, sendo que 9,67% das crianças informaram não ter sentido nenhuma dor no momento da punção venosa. Analisando as etapas do procedimento verifi-cou-se que o uso do gar...
Background and Aims: Although it has been recognized that most of the pain experienced by the new... more Background and Aims: Although it has been recognized that most of the pain experienced by the newborn can be prevented or substantially relieved. This study aimed to determine the prevalence and severity of the pain experienced by newborns receiving intensive care, as well as the effectiveness of the non-pharmacological therapeutic measures. Methods: At a Neonatal Intensive Care Unit, 170 newborns were studied during one year, resulting in 844 observations. Data were collected based on newborn observation, an interview with parents and nurses who provide care, and a retrospective analysis of the clinical records. Pain intensity was measured using the Echelle Douleur et d'Inconfort du Nouveau-Né. Results: During 8 hours of observation, 94.8% of the 844 observations showed a high prevalence of pain, mostly mild pain (72.7%). Non-pharmacological interventions were applied to 88.7% of the observations, especially related to positioning, massage and comfort techniques. The prevalence of the daily assessment of pain intensity was 21.7%, and the intensity of the pain experienced by the newborn was not influenced by the frequency of pain assessment or its treatment. Conclusions: Despite the high prevalence of pain, about 3 / 4 of the observations show that newborns experience mild pain or no pain at all. The assessment of pain intensity should be promoted and considered when deciding on the treatment. Nurses use nonpharmacological measures of comfort, massage and positioning often and effectively, but other techniques should also be promoted, such as the use of sucrose, glucose or maternal breastfeeding.
Background and Aims: Catechol-O-methyltransferase (COMT) is an enzyme metabolizing catecholamines... more Background and Aims: Catechol-O-methyltransferase (COMT) is an enzyme metabolizing catecholamines in different tissues. Polymorphisms in COMT-gene can attenuate COMT-activity and increase sensitivity to pain and opioid response. Clinical significance of those polymorphisms, remains to be verified as clinical studies exploring the effect of COMT polymorphisms on pain have mostly had small and/or heterogeneous patient samples and excluded several important SNPs. In the current study we define the effect of the COMT-gene on experimental and clinical pain phenotypes in a large group of female patients of homogenous ethnic origin. Methods: Intensity and unpleasantness of cold (3°C) and heat (43°C and 48°C, 5 s) pain and tolerance to cold pain were assessed in 640 breast cancer patients undergoing surgery. In total 22 SNPs from COMT-gene were genotyped. After the surgery the oxycodone dose required to achieve adequate analgesia, total amount of oxycodone consumed within 24 h, and acute postoperative pain were recorded. Results: Several SNPs showed significant associations with experimental heat (43°C: rs165774, rs9306235, rs2518824; 48°C: rs737866, rs737865, rs8185002, rs165774) or cold (rs1544325, rs2518824) pain. Clinical postoperative pain was associated with SNPs rs4646312, rs2239393 and rs4818 whereas rs4680 did not reach the level of statistical significance (P = 0.08). In oxycodone consumption, no statistically significant associations were found although SNPs rs4633 and rs4680 showed borderline association results (P-values 0.05-0.07). Conclusions: Several COMT SNPs were associated with sensitivity to experimental and clinical pain. SNPs other than rs4680 seem to play a major role in all of the traits.
BACKGROUND AND OBJECTIVES: The incidence of malignant melanoma is increasing worldwide. This is a... more BACKGROUND AND OBJECTIVES: The incidence of malignant melanoma is increasing worldwide. This is a tumor with high morbidity and mortality. Most common symptom of cancer patients is pain, which is complex, multifactorial and directly impacts patients' quality of life. However, there is little information about the prevalence of pain in this population. This study aimed at observing the prevalence of pain among melanoma patients in a reference center, in addition to obtaining information about treatments and pain-related incapacity. METHODS: Descriptive, retrospective, exploratory study level I, with quantitative approach, carried out by means of the analysis of 306 medical records of melanoma patients. RESULTS: The prevalence of pain was 38.2%. Among those with pain complaints, its location was the same as the injury in 20.5% of cases, in 8% of cases it was at the same site of malignant melanoma metastases and 55.8% have stated that pain was related to lymphadenectomy. Among such patients, 70% were treated to control pain, 2% were referred to specialized treatment and 75% have reported pain-related incapacity. CONCLUSION: Persistent pain is a prevalent and disabling melanoma-related symptom which is related both to the surgical procedure and the staging, requiring early prevention and treatment actions.
Cadernos de Naturologia e Terapias Complementares, 2017
Introdução: A cervicalgia é uma condição clínica caracterizada por dor na região posterior ou pós... more Introdução: A cervicalgia é uma condição clínica caracterizada por dor na região posterior ou póstero-lateral do pescoço, podendo ser local ou irradiada para os membros superiores nos determinados der¬mátomos correspondentes. Nesse sentido, pesquisas atuais indicam que o uso da acupuntura dentro do processo de reabilitação possui efi¬cácia comprovada. A acupuntura atualmente é amplamente utilizada no arsenal de tratamento de vários profissionais devido a seus ótimos resultados. Objetivo: Nesse sentido, o trabalho apresenta como objeti¬vo identificar na literatura os tratamentos usuais para as cervicalgias através da acupuntura, além de levantar os protocolos mais usuais no tratamento das cervicalgias segundo a Medicina Tradicional Chinesa. Materiais e métodos: Este trabalho de pesquisa foi embasado na me¬todologia de revisão integrativa que apresenta como um método que proporciona síntese de conhecimento e a incorporação da aplicabili¬dade de resultados de estudos significativos na ...
DOI http://dx.doi.org/10.1590/19820194201800093 Escola de Enfermagem Aurora Afonso Costa, Univers... more DOI http://dx.doi.org/10.1590/19820194201800093 Escola de Enfermagem Aurora Afonso Costa, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil. Faculdade de Enfermagem, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Confl ict of interest: none known. Abstract Objective: To know the benefi ts of nursing practices to patients with pain followed-up in the pain clinic. Methods: Integrative literature review, using the electronic portal SCIELO, CINAHL and PubMed Central databases, with time cut from 2008 to 2018 and data collection period between June and July 2018. The Health Science Descriptors (DeCs) and Medical Subject Heading (MeSH) were: Patients, Chronic pain, Nurse Care, Pain clinic. Results: It was evidenced...
INTRODUÇÃO: A síndrome descrito pela primeira vez em início insidioso de achados rigidez muscular... more INTRODUÇÃO: A síndrome descrito pela primeira vez em início insidioso de achados rigidez muscular axial, progredindo A hiperlordose dolorosa devido Prof. Dr. Fabiano de Abreu Bruno José de Pinho Person Syndrome (SPS) is a rare neurological Moersch and Woltman. The clinical picture has an episodic painful spasms, hyperreflexia, axial proximal limb muscles. Painful hyperlordosis diagnostic characteristic of SPS. CASE REPORT:Male, referred by the neurologist to the spine surgeon because management of chronic low back pain, progressively acute examination is difficult to perform in SPS because zygoapophyseal joint, intervertebral discs L4L5 cranial migrated herniated disc. Once there his axial and radicular pain, it was decided transforaminal endoscopic discectomy for L4L5 decompression, branch ablative radiofrequency rhizotomy to ganglion pulsed radiofrequency rhizotomy for One year postoperative follow up, the patient and SF-36. CONCLUSION: Chronic pain reported biological, psychological and social dimensions. the factors involved with pain allows planning strategies in uncommon and off label patients, as in the Syndrome, Stiff-Person, Chronic Pain, endoscopic rhizotomy, minimally invasive treatment. ndrome da pessoa rígida (SPR) é um distúrbio em 1956 por Moersch e Woltman. O quadro achados clássicos de espasmos dolorosos episódicos, progredindo lentamente para os músculos proximais devido à rigidez da coluna lombar é uma
In this study, we assessed resilience, depression, and quality of life in a group of elderly indi... more In this study, we assessed resilience, depression, and quality of life in a group of elderly individuals with or without chronic pain. Patients and methods: A cross-sectional study assessing elderly individuals followed up at a geriatrics outpatient clinic and divided into two groups: 54 elderly patients with chronic pain and 54 elderly with no chronic pain. Results: The sample comprised mainly women (67.6%), with mean age 79.9 years. The mean resilience index in the group with pain was 69.4 and, in the group with no pain, 80.1 (P<0.001). Depression was observed in 35.2% of patients with chronic pain; there was no case of depression in those without chronic pain. Quality of life of the elderly with chronic pain was worse in all the domains assessed: physical, mental, emotional, social, vitality, and pain. Conclusion: In the study sample, resilience was lower, depression was more frequent, and quality of life was worse in the group of elderly with chronic pain.
Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanha... more Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanhados na clinica de dor. Métodos Revisão integrativa de literatura, sendo utilizado o portal eletrônico SCIELO, e base de dados CINAHL e PubMed Central, com recorte temporal de 2008 a 2018 e período de coleta de dados entre junho e julho de 2018. Como descritores em saúde (DeCs): Pacientes, Dor crônica, Cuidados de Enfermagem, Clínicas de dor; e, o Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Evidenciou-se que a produção analisada é, majoritariamente, sobre práticas de enfermagem não farmacológica a pacientes com dor crônica, com publicações reduzidas no Brasil e tendem a se concentrar nos últimos cinco anos. O paciente com este tipo de agravo, vivencia condições multifatoriais que influenciam diretamente na condição de saúde, e necessitando de acompanhamento integral por equipe interprofissional, com inclusão da rede cuidadora, através interv...
Objective: To evaluate the behavior of children before and after a therapeutic play session. Meth... more Objective: To evaluate the behavior of children before and after a therapeutic play session. Methods: A quantitative and descriptive study was carried out in a major hospital of the city of Santos, State of São Paulo, involving 30 preschool children recently admitted to a pediatric ward. A behavior scale was applied before and after a therapeutic play session. This scale comprises six categories: moving, gazing, expressing feelings, talking, playing, and not responding to stimuli or requests. Each category is scored from 1 to 3, the lowest score representing the least interaction. Results: Before therapeutic play sessions, children showed no interest and were scored 1 and 2: moving parts of their bodies and expressing emotions, such as seriousness, and gazing rapidly to a place as if expecting something. After therapeutic play, the children progressed to level 3: changing position, moving with a purpose, observing attentively to what they saw, and expressing emotions such as joy. Co...
The objective of this study was to translate and culturally adapt the Behavioral Pain Scale to Br... more The objective of this study was to translate and culturally adapt the Behavioral Pain Scale to Brazilian Portuguese and to evaluate the psychometric properties of this scale. Method: This study was conducted in two phases: the Behavioral Pain Scale was translated and culturally adapted to Brazilian Portuguese and the psychometric properties of this scale were subsequently assessed (reliability and clinical utility). The study sample consisted of 100 patients who were older than 18 years of age, admitted to an intensive care unit, intubated, mechanically ventilated, and subjected or not to sedation and analgesia from July 2012 to December 2012. Pediatric and non-intubated patients were excluded. The study was conducted at a large private hospital that was situated in the city of São Paulo (SP).
BACKGROUND AND OBJECTIVES: Low back pain treatment may be either conservative or surgical. Curren... more BACKGROUND AND OBJECTIVES: Low back pain treatment may be either conservative or surgical. Current guidelines recommend conservative treatment for most cases, with drugs and rehabilitation, including physical medicine and psychological assistance. Invasive procedures may be justified if there are evidences of short and long term benefits, and minimally invasive techniques, such as radiofrequency, are modern and effective to relieve this pain. This study aimed at searching Brazilian literature about the use of pulsed radiofrequency to treat low back pain. CONTENTS: A literature survey was carried out with articles published from 2004 to 2010 in Portuguese and Spanish in LILACS, Scielo and Cochrane, Cinahl and Medline databases. CONCLUSION: Pulsed radiofrequency is an effective method to treat chronic low back pain, with low incidence of complications.
JUSTIFICATIVA E OBJETIVOS: Buscar publicações na literatura nacional sobre instrumentos para aval... more JUSTIFICATIVA E OBJETIVOS: Buscar publicações na literatura nacional sobre instrumentos para avaliação de dor em pacientes oncológicos e propor um instrumento de avaliação inicial de dor nesses pacientes. CONTEÚDO: Foram utilizadas as bases de dados LILACS , Bibliográficos da USP, Catálogo on-line Global (Dedalus), SciElo, MedLine, Cochrane e o Cumulative Index to Nursing and Allied Health Literature (CINAHL). CONCLUSÃO: O presente estudo comprovou que as escalas unidimensionais são mais frequentemente utilizadas, no entanto evidenciou a importância de utilizar instrumento multidimensional para avaliar a dor do paciente oncológico. Descritores: Avaliação da dor, dor, oncologia, paciente. SUMMARY BACKGROUND AND OBJECTIVES: To look for publications in the Brazilian literature about tools for pain evaluation in cancer patients and to propose an initial pain evaluation tool for cancer patients. CONTENTS: The following databases were searched: LILACS , Bibliográficos da USP, On-line Global Catalogue (Dedalus), SciElo, MedLine, Cochrane and Cumulative Index to Nursing and Allied Health Literature (CINAHL). CONCLUSION: This study has shown that one-dimension scales are more often used, however it has stressed
Objective: To identify knowledge of caretakers about pain in longstay patients with cognitive imp... more Objective: To identify knowledge of caretakers about pain in longstay patients with cognitive impairment and to understand the importance of caretakers in assessing pain in these patients. Methods: A descriptive exploratory survey conducted at the longstay inpatients unit with nineteen caretakers of patients with cognitive impairment. Result: As to signs suggesting pain in these patients, in the item vocalization, 75% of the caregivers reported moan as the sign most often related to pain, followed by groan (50%) and cry 37.5%; however, 75% disagreed that yell is a sign of pain. Regarding facial expression, 75% said that closing eyes and frowning are signs of pain; nevertheless, 62.5% disagreed that opening the mouth, clenching teeth and squeezing eyes are signs suggesting pain. As to body movements, 62.5% reported that when patients are immobile and tense, or agitated (50%) could be due to pain, and positions of protection and curling are not considered as signs of pain. Of the caretakers studied, all agreed that it is important to pay attention to pain, to call the nursing team when patients may feel pain, and 62.5% of them suggested actions that can bring relief to pain. Conclusion: The survey showed that information about pain provided by caretakers of chronic patients are fundamental sources that should be valued; however they require more knowledge on signs suggesting pain that could help them identifying signs of suffering. Some studies demonstrated a high incidence of pain in institutionalized patients; very often their pain is underevaluated and therefore undertreated.
Objective: To identify the occurrence of overweight and obesity in preschool children (two to fiv... more Objective: To identify the occurrence of overweight and obesity in preschool children (two to five years) in a day-care center in the city of São Paulo, using the weight/height ratio. Methods: This is a descriptive study, with exploratory quantitative approach, conducted in a day-care center in São Paulo. The sample consisted of 29 children, aged from two to five years and the data were collected through questionnaires. results: As for the nutritional assessment of children according to the Waterlow criteria, 12 (41%) were normal, 7 (24%) obese, 5 (17%) overweight, 3 (10%) had grade 1 malnutrition, 1 (4%), morbid obesity and 1 (4%), grade 3 malnutrition. conclusions: It is concluded that a significant proportion of the children assessed is above the appropriate weight range, requiring the implementation of preventive actions aimed to guide habits of good nutrition, encouraging physical activity, thereby decreasing the rates of child obesity and impacting their health at adulthood.
Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portugues... more Objective To adapt the Pain Assessment in Advanced Dementia (PAINAD) scale to Brazilian Portuguese with respect to semantic equivalence and cultural aspects, and to evaluate the respective psychometric properties (validity, feasibility, clinical utility and inter-rater agreement). Methods Two-stage descriptive, cross-sectional retrospective study involving cultural and semantic validation of the Brazilian Portuguese version of the scale, and investigation of its psychometric properties (validity, reliability and clinical utility). The sample consisted of 63 inpatients presenting with neurological deficits and unable to self-report pain. Results Semantic and cultural validation of the PAINAD scale was easily achieved. The scale indicators most commonly used by nurses to assess pain were “Facial expression”, “Body language” and “Consolability”. The Brazilian Portuguese version of the scale has proved to be valid and accurate; good levels of inter-rater agreement assured reproducibilit...
RESUMO JUSTIFICATIVA E OBJETIVOS: A criança interna-da, na maioria das vezes, é submetida à punçã... more RESUMO JUSTIFICATIVA E OBJETIVOS: A criança interna-da, na maioria das vezes, é submetida à punção venosa e talvez essa seja a experiência mais estressante percebida no decorrer da sua internação. O objetivo deste estudo foi avaliar a intensidade da dor da criança em idade es-colar quando submetida á punção venosa periférica. MÉTODO: Após aprovação pelo Comitê de Ética em Pesquisa da Instituição, usando a escala de faces e a es-cala visual numérica para a avaliação da dor no momento da punção venosa, foram estudadas 31 crianças em idade escolar submetidas à punção venosa, sendo que 67,74% delas já haviam sido internadas e vivenciadas o procedi-mento anteriormente. RESULTADOS: Em relação à intensidade da dor 48,39% das crianças informaram que foi de intensida-de leve, 32,27% sentiram dor moderada, 9,67% dor in-suportável, sendo que 9,67% das crianças informaram não ter sentido nenhuma dor no momento da punção venosa. Analisando as etapas do procedimento verifi-cou-se que o uso do gar...
Background and Aims: Although it has been recognized that most of the pain experienced by the new... more Background and Aims: Although it has been recognized that most of the pain experienced by the newborn can be prevented or substantially relieved. This study aimed to determine the prevalence and severity of the pain experienced by newborns receiving intensive care, as well as the effectiveness of the non-pharmacological therapeutic measures. Methods: At a Neonatal Intensive Care Unit, 170 newborns were studied during one year, resulting in 844 observations. Data were collected based on newborn observation, an interview with parents and nurses who provide care, and a retrospective analysis of the clinical records. Pain intensity was measured using the Echelle Douleur et d'Inconfort du Nouveau-Né. Results: During 8 hours of observation, 94.8% of the 844 observations showed a high prevalence of pain, mostly mild pain (72.7%). Non-pharmacological interventions were applied to 88.7% of the observations, especially related to positioning, massage and comfort techniques. The prevalence of the daily assessment of pain intensity was 21.7%, and the intensity of the pain experienced by the newborn was not influenced by the frequency of pain assessment or its treatment. Conclusions: Despite the high prevalence of pain, about 3 / 4 of the observations show that newborns experience mild pain or no pain at all. The assessment of pain intensity should be promoted and considered when deciding on the treatment. Nurses use nonpharmacological measures of comfort, massage and positioning often and effectively, but other techniques should also be promoted, such as the use of sucrose, glucose or maternal breastfeeding.
Background and Aims: Catechol-O-methyltransferase (COMT) is an enzyme metabolizing catecholamines... more Background and Aims: Catechol-O-methyltransferase (COMT) is an enzyme metabolizing catecholamines in different tissues. Polymorphisms in COMT-gene can attenuate COMT-activity and increase sensitivity to pain and opioid response. Clinical significance of those polymorphisms, remains to be verified as clinical studies exploring the effect of COMT polymorphisms on pain have mostly had small and/or heterogeneous patient samples and excluded several important SNPs. In the current study we define the effect of the COMT-gene on experimental and clinical pain phenotypes in a large group of female patients of homogenous ethnic origin. Methods: Intensity and unpleasantness of cold (3°C) and heat (43°C and 48°C, 5 s) pain and tolerance to cold pain were assessed in 640 breast cancer patients undergoing surgery. In total 22 SNPs from COMT-gene were genotyped. After the surgery the oxycodone dose required to achieve adequate analgesia, total amount of oxycodone consumed within 24 h, and acute postoperative pain were recorded. Results: Several SNPs showed significant associations with experimental heat (43°C: rs165774, rs9306235, rs2518824; 48°C: rs737866, rs737865, rs8185002, rs165774) or cold (rs1544325, rs2518824) pain. Clinical postoperative pain was associated with SNPs rs4646312, rs2239393 and rs4818 whereas rs4680 did not reach the level of statistical significance (P = 0.08). In oxycodone consumption, no statistically significant associations were found although SNPs rs4633 and rs4680 showed borderline association results (P-values 0.05-0.07). Conclusions: Several COMT SNPs were associated with sensitivity to experimental and clinical pain. SNPs other than rs4680 seem to play a major role in all of the traits.
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