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Advisor(s)
Abstract(s)
Introdução: A dor irruptiva (“breakthrough pain”) é prevalente em doentes com dor oncológica (40 a 80%) e frequentemente sub-diagnosticada e sub-tratada, estando associada a diminuição da capacidade funcional e impacto negativo na qualidade de vida. O sucesso na abordagem da dor irruptiva oncológica depende de uma adequada avaliação da dor. Objetivos: Avaliar o nível de conhecimento de médicos e enfermeiros portugueses sobre dor irruptiva oncológica e identificar fatores profissionais influenciadores desse conhecimento. Metodologia: Estudo observacional, analítico e transversal com abordagem quantitativa. A amostra foi de conveniência, constituída por 429 participantes, dos quais 242 enfermeiros e 187 médicos. Foi desenvolvido um questionário especificamente para o estudo, em formato digital, constituído por questões sobre dor irruptiva oncológica, dividido em dimensões: Definição, Epidemiologia, Caracterização e Classificação, Avaliação, Tratamento e Monitorização. Foi realizado um pré-teste para avaliar a estrutura e compreensão do questionário. Efetuou-se uma análise univariada através de estatística descritiva e uma análise inferencial para o estudo de associações e correlações entre as variáveis. Resultados: Obteve-se um total de 69,4% de respostas corretas. As dimensões que evidenciaram scores mais elevados no questionário, foram a Avaliação (82,45%), a Caracterização e Classificação (72,22%), seguida da Monitorização (71,56%) e Epidemiologia (68,65%). Contrariamente, verificou-se menor percentagem de respostas corretas no Tratamento (49,19%) e na Definição (30,8%). Os médicos demonstraram melhores níveis de conhecimento comparativamente aos enfermeiros, sendo que a formação prévia em cuidados paliativos, especialmente a formação intermédia e avançada, bem como a competência em Medicina Paliativa, estiveram associadas a um nível superior de conhecimentos sobre dor irruptiva oncológica. Os profissionais que trabalhavam em contexto de serviço de urgência, internamento, consulta externa e/ou hospital de dia apresentaram melhores resultados. Verificou-se também, uma correlação entre um maior nível de conhecimento e um menor tempo de exercício profissional. Conclusões: O estudo destaca um bom nível geral de conhecimento dos médicos e enfermeiros que participaram no estudo. No entanto, existem lacunas, nomeadamente na Definição e no Tratamento da DIO. Sugere-se maior investimento institucional pré-graduado em temas curriculares que abordem dor irruptiva oncológica, bem como o acesso generalizado e facilitado a formação continua pós-graduada com foco na DIO.
Introduction: Breakthrough pain is prevalent in cancer patients (40-80%), is often underdiagnosed and undertreated, have a negative impact on quality of life and is associated with reduced functional capacity. Successful management of breakthrough cancer pain depends on adequate pain assessment. Objectives: To evaluate the knowledge of Portuguese physicians and nurses regarding breakthrough cancer pain and to identify professional factors influencing this knowledge. Methodology: Observational, analytical and cross-sectional study using a quantitative approach, with a convenience sample of 429 participants, including 242 nurses and 187 physicians. An online questionnaire was developed specifically for the study, composed of questions about breakthrough cancer pain, divided into dimensions: Definition, Epidemiology, Characterization and Classification, Assessment, Treatment and Monitoring. A pre-test was conducted to assess the structure and comprehension of the questionnaire. Univariate analysis using descriptive statistics, and an inferential analysis were performed to examine associations and correlations between variables. Results: A total of 69.4% of correct responses were obtained. The dimensions with the highest scores in the questionnaire were assessment (82.45%), characterization and classification (72.22%), followed by surveillance (71.56%) and epidemiology (68.65%). In contrast, there was a lower percentage of correct answers for treatment (49.19%) and definition (30.8%). Physicians showed better knowledge than nurses, and previous training in palliative care, especially intermediate and advanced training, and competence in palliative care were associated with higher knowledge of breakthrough cancer pain. Professionals working in an emergency, inpatient, outpatient and/or day hospital setting had better results. There was also an association between a higher level of knowledge and a shorter period of professional practice. Conclusions: The study shows a good general level of knowledge among the participating physicians and nurses. However, there are gaps, particularly in the definition and management of breakthrough cancer pain. Institutional pre-graduate investment in curriculum topics that address cancer pain is suggested, as well as generalized and facilitated access to post-graduate continuing education focused on breakthrough cancer pain.
Introduction: Breakthrough pain is prevalent in cancer patients (40-80%), is often underdiagnosed and undertreated, have a negative impact on quality of life and is associated with reduced functional capacity. Successful management of breakthrough cancer pain depends on adequate pain assessment. Objectives: To evaluate the knowledge of Portuguese physicians and nurses regarding breakthrough cancer pain and to identify professional factors influencing this knowledge. Methodology: Observational, analytical and cross-sectional study using a quantitative approach, with a convenience sample of 429 participants, including 242 nurses and 187 physicians. An online questionnaire was developed specifically for the study, composed of questions about breakthrough cancer pain, divided into dimensions: Definition, Epidemiology, Characterization and Classification, Assessment, Treatment and Monitoring. A pre-test was conducted to assess the structure and comprehension of the questionnaire. Univariate analysis using descriptive statistics, and an inferential analysis were performed to examine associations and correlations between variables. Results: A total of 69.4% of correct responses were obtained. The dimensions with the highest scores in the questionnaire were assessment (82.45%), characterization and classification (72.22%), followed by surveillance (71.56%) and epidemiology (68.65%). In contrast, there was a lower percentage of correct answers for treatment (49.19%) and definition (30.8%). Physicians showed better knowledge than nurses, and previous training in palliative care, especially intermediate and advanced training, and competence in palliative care were associated with higher knowledge of breakthrough cancer pain. Professionals working in an emergency, inpatient, outpatient and/or day hospital setting had better results. There was also an association between a higher level of knowledge and a shorter period of professional practice. Conclusions: The study shows a good general level of knowledge among the participating physicians and nurses. However, there are gaps, particularly in the definition and management of breakthrough cancer pain. Institutional pre-graduate investment in curriculum topics that address cancer pain is suggested, as well as generalized and facilitated access to post-graduate continuing education focused on breakthrough cancer pain.
Description
Keywords
Dor irruptiva oncológica Cuidados paliativos Conhecimentos Médicos Enfermeiros Breakthrough cancer pain Palliative care Knowledge Physicians Nurses