Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170030
A. Carvalho, W. R. Bertor, Ricardo Massao Abico, Lana Brandl, Thiago Fernando Mattjie, A. Andrade, L. A. Peyré-Tartaruga
BACKGROUND AND OBJECTIVES: Chronic low back pain syndrome promotes several functional losses which impact quality of life of patients, and walking is one of the most impaired functions. Being chronic low back pain a syndrome with multiple etiologies, efforts to understand the relation between functional losses and etiologic factors are justified. This study aimed at correlating walking speed with pain perception, incapacity level (I) and condition of having or not chronic low back pain (group). METHODS: Sample was made up of volunteers with nonspecific low back pain (LG/n=8) and healthy subjects (CG/n=8). Incapacity level was obtained by Oswestry Incapacity Index during evaluation. Tests battery was divided in three sessions according to walking intensity, as follows: preferred self-selected speed (VP) and faster and slower speeds as compared to VP. In each session, volunteers walked for five minutes and at every minute pain was quantified by the analog scale. Kendal Tau test was used with p=0.05. RESULTS: Walking speed was not correlated with pain intensity, with incapacity level or with the group. However, group versus incapacity level, group versus pain, incapacity level versus pain were correlated with one another. CONCLUSION: Walking performance was not influenced by nonspecific chronic low back pain and by incapacity level.
{"title":"Nonspecific chronic low back pain and incapacity level: influence of walking performance","authors":"A. Carvalho, W. R. Bertor, Ricardo Massao Abico, Lana Brandl, Thiago Fernando Mattjie, A. Andrade, L. A. Peyré-Tartaruga","doi":"10.5935/1806-0013.20170030","DOIUrl":"https://doi.org/10.5935/1806-0013.20170030","url":null,"abstract":"BACKGROUND AND OBJECTIVES: Chronic low back pain syndrome promotes several functional losses which impact quality of life of patients, and walking is one of the most impaired functions. Being chronic low back pain a syndrome with multiple etiologies, efforts to understand the relation between functional losses and etiologic factors are justified. This study aimed at correlating walking speed with pain perception, incapacity level (I) and condition of having or not chronic low back pain (group). METHODS: Sample was made up of volunteers with nonspecific low back pain (LG/n=8) and healthy subjects (CG/n=8). Incapacity level was obtained by Oswestry Incapacity Index during evaluation. Tests battery was divided in three sessions according to walking intensity, as follows: preferred self-selected speed (VP) and faster and slower speeds as compared to VP. In each session, volunteers walked for five minutes and at every minute pain was quantified by the analog scale. Kendal Tau test was used with p=0.05. RESULTS: Walking speed was not correlated with pain intensity, with incapacity level or with the group. However, group versus incapacity level, group versus pain, incapacity level versus pain were correlated with one another. CONCLUSION: Walking performance was not influenced by nonspecific chronic low back pain and by incapacity level.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"150-155"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42598248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170021
A. Leite, Amaurilio O Nogueira, Luis Gustavo Oliveira Farias
BACKGROUND AND OBJECTIVES: Chest pain is a major reason for hospitalization in the public network due to its subjectivity, non-specificity, lack of nurses and physicians’ qualification, quality of assistance and the fact that chest pain patients satisfaction is still far away from ideal. This study aimed at evaluating the quality of assistance of acute chest pain patients in the State of Ceará, Brazil. METHODS: This is a descriptive, exploratory and analytical study. After applying a form, a sample of 430 patients and 50 professionals of a reference hospital was obtained. Non-parametric statistics was used for analysis and discussion. Dependent variables and users’ satisfaction were correlated for the development of tables and simple descriptive statistical analysis. RESULTS: Three hundred and eighty-one patients (65.65%) have looked for assistance more than once, returning for several reasons, even when there were other units for health follow up in their respective region. Most users (n=422) have not noticed assistance barriers with regard to materials and human resources (83.17). However, delay in assistance (9.0%) was the most important barrier perceived by those referring difficulties (n=38). CONCLUSION: The complex assistance to acute chest pain patients affects the analysis of the quality of assistance provided to users. The high number of patients makes the service chaotic because the relationship between health professionals and structure is not satisfactory, requiring the insertion of more professionals and improvement in assistance time.
{"title":"Quality of assistance of acute chest pain patients in the State of Ceará, Brazil","authors":"A. Leite, Amaurilio O Nogueira, Luis Gustavo Oliveira Farias","doi":"10.5935/1806-0013.20170021","DOIUrl":"https://doi.org/10.5935/1806-0013.20170021","url":null,"abstract":"BACKGROUND AND OBJECTIVES: Chest pain is a major reason for hospitalization in the public network due to its subjectivity, non-specificity, lack of nurses and physicians’ qualification, quality of assistance and the fact that chest pain patients satisfaction is still far away from ideal. This study aimed at evaluating the quality of assistance of acute chest pain patients in the State of Ceará, Brazil. METHODS: This is a descriptive, exploratory and analytical study. After applying a form, a sample of 430 patients and 50 professionals of a reference hospital was obtained. Non-parametric statistics was used for analysis and discussion. Dependent variables and users’ satisfaction were correlated for the development of tables and simple descriptive statistical analysis. RESULTS: Three hundred and eighty-one patients (65.65%) have looked for assistance more than once, returning for several reasons, even when there were other units for health follow up in their respective region. Most users (n=422) have not noticed assistance barriers with regard to materials and human resources (83.17). However, delay in assistance (9.0%) was the most important barrier perceived by those referring difficulties (n=38). CONCLUSION: The complex assistance to acute chest pain patients affects the analysis of the quality of assistance provided to users. The high number of patients makes the service chaotic because the relationship between health professionals and structure is not satisfactory, requiring the insertion of more professionals and improvement in assistance time.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42374521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170036
F. Nascimento, C. Folchini, P. Kowacs
BACKGROUND AND OBJECTIVES: Chronic pelvic pain is a condition that lacks specific treatment and often is refractory to several therapeutic approaches. This study aims to report two patients in whom chronic pelvic pain was nearly completely controlled with thalidomide as an add-on therapy. CASES REpORT: The response to therapy of two postmenopausal women who presented to our service with a longstanding history of refractory chronic pelvic pain secondary to interstitial cystitis is reported. Due to their uncontrolled pain and consequent poor quality of life, these women were started on thalidomide at 25 mg/day as an add-on therapy. At one-month followup, the patients’ pain was reduced in 80% and 70%, respectively. Subsequently, their pain increased, but was again relieved with higher doses of thalidomide. Notably, this medication was well tolerated by both patients. At one-year follow-up and elevenmonth follow-up (respectively), their pain has remained controlled and their quality of life is significantly improved. CONClUSIONS: These results suggest that thalidomide may have therapeutic value for chronic pelvic pain/interstitial cystitis. Based on previously published data, we hypothesize that suppression of TNF-alpha may be one of the mechanisms by which thalidomide controls pelvic pain. Our study may lead to a better understanding of the currently unclear pathogenesis of chronic pelvic pain. Lastly, we hope to encourage further studies to establish the efficacy and safety of thalidomide for CPP and other chronic pain conditions.
{"title":"Potential role of thalidomide in the management of chronic pelvic pain. Cases report","authors":"F. Nascimento, C. Folchini, P. Kowacs","doi":"10.5935/1806-0013.20170036","DOIUrl":"https://doi.org/10.5935/1806-0013.20170036","url":null,"abstract":"BACKGROUND AND OBJECTIVES: Chronic pelvic pain is a condition that lacks specific treatment and often is refractory to several therapeutic approaches. This study aims to report two patients in whom chronic pelvic pain was nearly completely controlled with thalidomide as an add-on therapy. CASES REpORT: The response to therapy of two postmenopausal women who presented to our service with a longstanding history of refractory chronic pelvic pain secondary to interstitial cystitis is reported. Due to their uncontrolled pain and consequent poor quality of life, these women were started on thalidomide at 25 mg/day as an add-on therapy. At one-month followup, the patients’ pain was reduced in 80% and 70%, respectively. Subsequently, their pain increased, but was again relieved with higher doses of thalidomide. Notably, this medication was well tolerated by both patients. At one-year follow-up and elevenmonth follow-up (respectively), their pain has remained controlled and their quality of life is significantly improved. CONClUSIONS: These results suggest that thalidomide may have therapeutic value for chronic pelvic pain/interstitial cystitis. Based on previously published data, we hypothesize that suppression of TNF-alpha may be one of the mechanisms by which thalidomide controls pelvic pain. Our study may lead to a better understanding of the currently unclear pathogenesis of chronic pelvic pain. Lastly, we hope to encourage further studies to establish the efficacy and safety of thalidomide for CPP and other chronic pain conditions.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"181-183"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5935/1806-0013.20170036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44966144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170023
Elen Soares Marques, N. M. Filho, Marcia Elena Rabelo Gouvea, Paula dos Santos Ferreira, L. Nogueira
JUSTIFICATIVA E OBJETIVOS: Dor cronica e o principal motivo para consultas de profissionais de saude e tem sido considerada como um problema de saude publica. Varios pacientes com dor cronica devem desenvolver o predominio de sensibilizacao central. Pacientes com sensibilizacao central devem ser avaliados atraves do modelo biopsicossocial. O objetivo deste estudo foi avaliar o comprometimento fisico e psicossocial de mulheres com dor cronica que apresentam predominio de sensibilizacao central. METODOS: Um estudo transversal foi conduzido com mulheres com dor cronica que apresentam predominio de sensibilizacao central. Cinquenta e sete pacientes com dores musculoesqueleticas participaram da triagem. Mulheres com dor cronica de natureza neuropatica e com dor localizada em mais de tres locais, incluindo tronco, membro superior e inferior tambem foram incluidas. Sensibilizacao central foi definida pela classificacao da dor baseada em seu mecanismo. Dezoito pacientes foram identificados e preencheram um questionario com caracteristicas socio-demograficas, intensidade de dor, funcionalidade, qualidade de vida, cinesiofobia e catastrofizacao. Foi realizada a analise estatistica descritiva e a correlacao entre as variaveis. RESULTADOS: Todos as participantes apresentavam dor sete vezes por semana e 88,9% foram classificadas como dor intensa. Foi observado elevado nivel de catastrofizacao e cinesiofobia. Houve uma forte correlacao entre catastrofizacao e cinesiofobia (Rho=0,864, p<0,01). O componente mental do questionario de qualidade de vida evidenciou moderada correlacao com catastrofizacao (Rho=-0,611, p<0,01) e cinesiofobia (Rho=-0,646, p<0,01). Houve moderada correlacao entre a intensidade de dor e a catastrofizacao (Rho=0,628, p<0,01) e cinesiofobia (Rho=0,581, p=0,01). Nenhuma correlacao entre idade, componente fisico da qualidade de vida, funcionalidade e duracao da dor foi observada. CONCLUSAO: A qualidade de vida e a intensidade da dor estiveram mais relacionadas com os fatores psicossociais do que a funcionalidade em mulheres com dor musculoesqueletica cronica com predominio de sensibilizacao central.
{"title":"Functionality, psychosocial factors and quality of life in women with predominance of central sensitization","authors":"Elen Soares Marques, N. M. Filho, Marcia Elena Rabelo Gouvea, Paula dos Santos Ferreira, L. Nogueira","doi":"10.5935/1806-0013.20170023","DOIUrl":"https://doi.org/10.5935/1806-0013.20170023","url":null,"abstract":"JUSTIFICATIVA E OBJETIVOS: Dor cronica e o principal motivo para consultas de profissionais de saude e tem sido considerada como um problema de saude publica. Varios pacientes com dor cronica devem desenvolver o predominio de sensibilizacao central. Pacientes com sensibilizacao central devem ser avaliados atraves do modelo biopsicossocial. O objetivo deste estudo foi avaliar o comprometimento fisico e psicossocial de mulheres com dor cronica que apresentam predominio de sensibilizacao central. METODOS: Um estudo transversal foi conduzido com mulheres com dor cronica que apresentam predominio de sensibilizacao central. Cinquenta e sete pacientes com dores musculoesqueleticas participaram da triagem. Mulheres com dor cronica de natureza neuropatica e com dor localizada em mais de tres locais, incluindo tronco, membro superior e inferior tambem foram incluidas. Sensibilizacao central foi definida pela classificacao da dor baseada em seu mecanismo. Dezoito pacientes foram identificados e preencheram um questionario com caracteristicas socio-demograficas, intensidade de dor, funcionalidade, qualidade de vida, cinesiofobia e catastrofizacao. Foi realizada a analise estatistica descritiva e a correlacao entre as variaveis. RESULTADOS: Todos as participantes apresentavam dor sete vezes por semana e 88,9% foram classificadas como dor intensa. Foi observado elevado nivel de catastrofizacao e cinesiofobia. Houve uma forte correlacao entre catastrofizacao e cinesiofobia (Rho=0,864, p<0,01). O componente mental do questionario de qualidade de vida evidenciou moderada correlacao com catastrofizacao (Rho=-0,611, p<0,01) e cinesiofobia (Rho=-0,646, p<0,01). Houve moderada correlacao entre a intensidade de dor e a catastrofizacao (Rho=0,628, p<0,01) e cinesiofobia (Rho=0,581, p=0,01). Nenhuma correlacao entre idade, componente fisico da qualidade de vida, funcionalidade e duracao da dor foi observada. CONCLUSAO: A qualidade de vida e a intensidade da dor estiveram mais relacionadas com os fatores psicossociais do que a funcionalidade em mulheres com dor musculoesqueletica cronica com predominio de sensibilizacao central.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"112-118"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44694275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170034
D. C. Almeida, D. Kraychete
JUSTIFICATIVA E OBJETIVOS: A dor lombar e um problema que afeta 80% dos adultos em algum momento da vida, esta entre as 10 primeiras causas de consultas a internistas e, em cada ano, trabalhadores se ausentam de suas atividades por mais de sete dias em razao dessa doenca com grande impacto na produtividade e reducao da economia. O objetivo deste estudo foi fornecer ao clinico que trabalha no atendimento primario uma maneira de abordagem adequada do paciente com dor lombar cronica, enfatizando o diagnostico diferencial dessa doenca. CONTEUDO: A caracterizacao etiologica da dor lombar e um processo que exige uma abordagem propedeutica que inclua historia clinica, exame fisico e exames complementares. Foi desenvolvido, baseado na literatura, abordagem de dor lombar de origem mecânica, e outras menos comuns, como as que cursam com componente neuropatico ou decorrentes de inflamacao, infeccao ou neoplasia. CONCLUSAO: O diagnostico da dor lombar e essencial, porem desafiador, para o medico no atendimento primario. A maioria dos pacientes portadores de lombalgia pode ser tratado no ambiente de atendimento primario, desde que o medico assistente tenha conhecimento apropriado da forma como elaborar o diagnostico diferencial dessa doenca.
{"title":"Low back pain - a diagnostic approach","authors":"D. C. Almeida, D. Kraychete","doi":"10.5935/1806-0013.20170034","DOIUrl":"https://doi.org/10.5935/1806-0013.20170034","url":null,"abstract":"JUSTIFICATIVA E OBJETIVOS: A dor lombar e um problema que afeta 80% dos adultos em algum momento da vida, esta entre as 10 primeiras causas de consultas a internistas e, em cada ano, trabalhadores se ausentam de suas atividades por mais de sete dias em razao dessa doenca com grande impacto na produtividade e reducao da economia. O objetivo deste estudo foi fornecer ao clinico que trabalha no atendimento primario uma maneira de abordagem adequada do paciente com dor lombar cronica, enfatizando o diagnostico diferencial dessa doenca. CONTEUDO: A caracterizacao etiologica da dor lombar e um processo que exige uma abordagem propedeutica que inclua historia clinica, exame fisico e exames complementares. Foi desenvolvido, baseado na literatura, abordagem de dor lombar de origem mecânica, e outras menos comuns, como as que cursam com componente neuropatico ou decorrentes de inflamacao, infeccao ou neoplasia. CONCLUSAO: O diagnostico da dor lombar e essencial, porem desafiador, para o medico no atendimento primario. A maioria dos pacientes portadores de lombalgia pode ser tratado no ambiente de atendimento primario, desde que o medico assistente tenha conhecimento apropriado da forma como elaborar o diagnostico diferencial dessa doenca.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5935/1806-0013.20170034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45807481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170022
André Lopes e Silva, Khalil Smaidi, Marta Helena Rovani Pires, O. Pires
BACKGROUND AND OBJECTIVES: Pain is a major complaint of individuals looking for healthcare services. The high prevalence of both acute and chronic pain makes it a public health problem, due to high costs imposed to society and healthcare services, in addition to the negative impact on daily activities of those living with such experience. This study aimed at identifying the prevalence of chronic pain among medical students of a University in the countryside of São Paulo. METHODS: Cross-sectional study carried out with 395 students of all grades of the medicine course of the Universidade de Taubaté. Investigated variables were: pain incidence and duration, presence or not of triggering factor(s), use or not of painkillers, pain location and dimension according to McGill questionnaire. RESULTS: There has been predominance of females with 253 participants (64.05%), prevailing the age group between 21 to 25 years with 217 students (54.93%). Among participants, 219 (55.44%) reported some type of pain and among them, 141 (64.38%) have reported chronic pain, that is, for more than six months, in a total of 35.69%. CONCLUSION: In our study, chronic pain prevalence was 35.69%, especially among females. With regard to pain location, there has been more prevalence of lumbar and sacrococcygeal regions, followed by knees and headache, face and mouth and finally widespread pain.
{"title":"Prevalence of chronic pain and associated factors among medical students","authors":"André Lopes e Silva, Khalil Smaidi, Marta Helena Rovani Pires, O. Pires","doi":"10.5935/1806-0013.20170022","DOIUrl":"https://doi.org/10.5935/1806-0013.20170022","url":null,"abstract":"BACKGROUND AND OBJECTIVES: Pain is a major complaint of individuals looking for healthcare services. The high prevalence of both acute and chronic pain makes it a public health problem, due to high costs imposed to society and healthcare services, in addition to the negative impact on daily activities of those living with such experience. This study aimed at identifying the prevalence of chronic pain among medical students of a University in the countryside of São Paulo. METHODS: Cross-sectional study carried out with 395 students of all grades of the medicine course of the Universidade de Taubaté. Investigated variables were: pain incidence and duration, presence or not of triggering factor(s), use or not of painkillers, pain location and dimension according to McGill questionnaire. RESULTS: There has been predominance of females with 253 participants (64.05%), prevailing the age group between 21 to 25 years with 217 students (54.93%). Among participants, 219 (55.44%) reported some type of pain and among them, 141 (64.38%) have reported chronic pain, that is, for more than six months, in a total of 35.69%. CONCLUSION: In our study, chronic pain prevalence was 35.69%, especially among females. With regard to pain location, there has been more prevalence of lumbar and sacrococcygeal regions, followed by knees and headache, face and mouth and finally widespread pain.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"108-111"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42354054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170025
J. Dantas, M. I. Martins
BACKGROUND AND OBJECTIVES: To evaluate pain symptoms and their influence on quality of life of chronic renal patients submitted to hemodialysis. METHODS: Descriptive, exploratory, comparative and crosssectional study paired by frequency, having as tested group (GI, n=50) chronic renal patients under hemodialysis with hypertension and diabetes mellitus type 2, and as control group (GII, n=50) patients with hypertension or diabetes mellitus type 2, assisted by the Hypertension Ambulatory. Quality of life was evaluated by the Kidney Disease and Quality of Life ShortForm, pain by the Brief Pain Inventory, emotional factors by Beck anxiety and depression scales and neuropathic pain by DN4 questionnaire. RESULTS: Both groups had predominance of males, mean age of 47.3±16.5 years. With regard to labor, the group under hemodialysis (GI) had 80% of inactive patients. Most impaired quality of life domains were job situation and physical function. There has been prevalence of depression and anxiety, neuropathic pain and more pain complaint in GI, significantly interfering with general activities such as sleep and walking ability. There has been significant correlation (p<0.05) between anxiety, physical function and labor situation versus pain. CONCLUSION: Pain is often ignored, but brings significant consequences to quality of life of patients, contributing for relevant worsening of anxious or depressive symptoms. Thus, it is critical the multidisciplinary management of such patients.
{"title":"Correlation between pain and quality of life of patients under hemodialysis","authors":"J. Dantas, M. I. Martins","doi":"10.5935/1806-0013.20170025","DOIUrl":"https://doi.org/10.5935/1806-0013.20170025","url":null,"abstract":"BACKGROUND AND OBJECTIVES: To evaluate pain symptoms and their influence on quality of life of chronic renal patients submitted to hemodialysis. METHODS: Descriptive, exploratory, comparative and crosssectional study paired by frequency, having as tested group (GI, n=50) chronic renal patients under hemodialysis with hypertension and diabetes mellitus type 2, and as control group (GII, n=50) patients with hypertension or diabetes mellitus type 2, assisted by the Hypertension Ambulatory. Quality of life was evaluated by the Kidney Disease and Quality of Life ShortForm, pain by the Brief Pain Inventory, emotional factors by Beck anxiety and depression scales and neuropathic pain by DN4 questionnaire. RESULTS: Both groups had predominance of males, mean age of 47.3±16.5 years. With regard to labor, the group under hemodialysis (GI) had 80% of inactive patients. Most impaired quality of life domains were job situation and physical function. There has been prevalence of depression and anxiety, neuropathic pain and more pain complaint in GI, significantly interfering with general activities such as sleep and walking ability. There has been significant correlation (p<0.05) between anxiety, physical function and labor situation versus pain. CONCLUSION: Pain is often ignored, but brings significant consequences to quality of life of patients, contributing for relevant worsening of anxious or depressive symptoms. Thus, it is critical the multidisciplinary management of such patients.","PeriodicalId":30846,"journal":{"name":"Revista Dor","volume":"18 1","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5935/1806-0013.20170025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47131311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.5935/1806-0013.20170033
A. Ramos, A. Tavares, Susana Mendonça
BACKGROUND AND OBJECTIVES: To outline best practices guidelines to control pain and dyspnea of cancer patients in an urgency setting. CONTENTS: PI[C]O question, with resource to EBSCO (Medline with Full Text, CINAHL, Plus with Full Text, British Nursing Index), retrospectively from September 2009 to 2014 and guidelines issued by reference entities: Oncology Nursing Society (2011), National Comprehensive Cancer Network (2011; 2014) and Cancer Care Ontario (2010), with a total of 15 articles. The first stage for adequate symptoms control is systematized evaluation. Pharmacological pain control should comply with the modified analgesic ladder of the World Health Organization, including titration, equianalgesia, opioid rotation, administration route, difficult to control painful conditions and adverse effects control. Oxygen therapy and noninvasive ventilation are control modalities of some situations of dyspnea, where the use of diuretics, bronchodilators, steroids, benzodiazepines and strong opioids are effective strategies. Non-pharmacological measures: psycho-emotional support, hypnosis, counseling/ training/instruction, therapeutic adherence, music therapy, massage, relaxation techniques, telephone support, functional and respiratory reeducation equally improve health gains. CONCLUSION: Cancer pain and dyspnea control require comprehensive and multimodal approach. Implications for nursing practice: best practice guidelines developed based on scientific evidence may support clinical decision-making with better quality, safety and effectiveness.
背景和目的：概述在紧急情况下控制癌症患者疼痛和呼吸困难的最佳实践指南。内容：PI[C]O问题，来源于EBSCO（Medline with Full Text，CINAHL，Plus with Full Text，British Nursing Index），回顾性地从2009年9月到2014年，以及参考实体发布的指南：肿瘤护理学会（2011年）、国家癌症综合网络（2011年；2014年）和癌症护理安大略省（2010年），共15篇文章。充分控制症状的第一阶段是系统化评估。药理学疼痛控制应符合世界卫生组织修改的镇痛阶梯，包括滴定、等痛、阿片类药物轮换、给药途径、难以控制的疼痛状况和不良反应控制。氧气治疗和无创通气是某些呼吸困难情况的控制方式，使用利尿剂、支气管扩张剂、类固醇、苯二氮卓类药物和强效阿片类药物是有效的策略。非药物措施：心理情感支持、催眠、咨询/培训/指导、坚持治疗、音乐治疗、按摩、放松技巧、电话支持、功能和呼吸再教育同样可以改善健康。结论：癌症疼痛和呼吸困难的控制需要综合和多模式的方法。对护理实践的启示：基于科学证据制定的最佳实践指南可以支持更高质量、安全性和有效性的临床决策。
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