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Características definidoras mais sensíveis do diagnóstico de enfermagem dor aguda em doentes adultos internados em cuidados intensivos
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Abstract(s)
A dor aguda é um problema comumente encontrado em pessoas em situação crítica e tem um efeito lesivo que pode pôr em causa a sua estabilidade hemodinâmica e, consequentemente, o seu prognóstico. Apesar dos doentes críticos, devido à sua condição especial, muitas vezes não conseguirem verbalmente exprimir a dor, não significa que não estejam a experienciá-la(Barr et al., 2013). Estão validadas inúmeras escalas para avaliação da dor no doente crítico que têm em linha de conta vários parâmetros observáveis de forma a auxiliar na identificação de episódios de dor. O processo de enfermagem orienta o enfermeiro na sua prática, sendo a compreensão das suas etapas fundamental. Ao realizar o diagnóstico de enfermagem, o enfermeiro tem de ter em conta o conjunto de inferências observáveis que vão definir determinado diagnóstico. A NANDA-I define as inferências observáveis como características definidoras do diagnóstico de enfermagem(Herdman & Kamitsuru, 2018). Como a dor aguda tem efeitos muito negativos para os doentes críticos, é necessário que a avaliação e o diagnóstico de dor aguda sejam precisos. Para isso, é necessário que sejam identificadas rigorosamente as caraterísticas definidoras. Com o objetivo de mapear a extensão e o tipo de evidência existente em relação às caraterísticas definidoras do diagnóstico de enfermagem “dor aguda”, foi realizada uma scoping review, de forma a identificar as mais sensíveis, que estão presentes em doentes adultos internados em unidades de cuidados intensivos. Como conclusões, pode-se referir que, dado o impacto que a dor tem nas pessoas em situação crítica internadas em unidades de cuidados intensivos, é importante que a avaliação da dor seja realizada de forma sistemática e baseada na evidência. Esta revisão revela as características definidoras mais sensíveis do diagnóstico de enfermagem dor aguda em doentes adultos internados em unidades de cuidados intensivos, o que poderá ser um auxílio para os enfermeiros que cuidam desta população. Paralelamente a este estudo, foram realizados 2 estágios com intuito de desenvolver competências de enfermeiro especialista na área da pessoa em situação crítica, em contexto de cuidados intensivos e serviço de urgência, com descrição e análise das atividades desenvolvidas.
Acute pain is a problem commonly found in people in critical situations and has a damaging effect that can jeopardize their hemodynamic stability and, consequently, their prognosis. Due to the special condition of critically ill patients who are often unable to verbally express pain, it does not mean that they are not experiencing it (Barr et al., 2013). Numerous scales are validated for pain assessment in critically ill patients that contemplate several observable parameters in order to assist in the identification of episodes of pain. The nursing process guides nurses in their practice, and understanding their stages is fundamental. When performing the nursing diagnosis, the nurse must consider the set of observable inferences that will define a specific diagnosis. NANDA-I defines the observable inferences as defining characteristics of the nursing diagnosis (Herdman & Kamitsuru, 2018). As acute pain has very negative effects for critically ill patients, it is necessary that the assessment and diagnosis of acute pain is accurate. For that, it is necessary that the defining characteristics are rigorously identified. With the objective of mapping the extent and type of existing evidence in relation to the defining characteristics of the “acute pain” nursing diagnosis, a scoping review was carried out to identify the most sensitive ones that are present in adult patients hospitalized in nursing intensive care units. As conclusions, it can be said that given the impact that pain has on people in critical situations hospitalized in intensive care units, it is important that pain assessment is carried out in a systematic and evidence-based manner. This review reveals the most sensitive defining characteristics of the nursing diagnosis of acute pain in adult patients admitted to intensive care units, which may be an aid to nurses who care for this population. Parallel to this study, 2 internships were carried out in order to develop skills as a specialist nurse in the area of people in critical situations, in the context of intensive care and emergency services, with description and analysis of the activities developed.
Acute pain is a problem commonly found in people in critical situations and has a damaging effect that can jeopardize their hemodynamic stability and, consequently, their prognosis. Due to the special condition of critically ill patients who are often unable to verbally express pain, it does not mean that they are not experiencing it (Barr et al., 2013). Numerous scales are validated for pain assessment in critically ill patients that contemplate several observable parameters in order to assist in the identification of episodes of pain. The nursing process guides nurses in their practice, and understanding their stages is fundamental. When performing the nursing diagnosis, the nurse must consider the set of observable inferences that will define a specific diagnosis. NANDA-I defines the observable inferences as defining characteristics of the nursing diagnosis (Herdman & Kamitsuru, 2018). As acute pain has very negative effects for critically ill patients, it is necessary that the assessment and diagnosis of acute pain is accurate. For that, it is necessary that the defining characteristics are rigorously identified. With the objective of mapping the extent and type of existing evidence in relation to the defining characteristics of the “acute pain” nursing diagnosis, a scoping review was carried out to identify the most sensitive ones that are present in adult patients hospitalized in nursing intensive care units. As conclusions, it can be said that given the impact that pain has on people in critical situations hospitalized in intensive care units, it is important that pain assessment is carried out in a systematic and evidence-based manner. This review reveals the most sensitive defining characteristics of the nursing diagnosis of acute pain in adult patients admitted to intensive care units, which may be an aid to nurses who care for this population. Parallel to this study, 2 internships were carried out in order to develop skills as a specialist nurse in the area of people in critical situations, in the context of intensive care and emergency services, with description and analysis of the activities developed.
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Keywords
Dor aguda Diagnósticos de enfermagem, Cuidados intensivos Acute pain Nursing diagnoses Intensive care