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Objective:To explore the effect of Manchester pain management model (MPMM) combined with empowerment education nursing intervention on pain and recovery after cesarean section, and to provide reference for promoting recovery after cesarean section.Methods:A quasi-experimental study was conducted. A total of 120 pregnant women who underwent cesarean section in Shanxi Maternal and Child Health Hospital from September 2021 to June 2022 were selected by convenient sampling method and divided into observation group and control group according to the random number table method, with 60 cases in each group. The observation group received nursing intervention based on MPMM combined with empowerment education, while the control group received routine nursing. The degree of pain, postoperative recovery and nursing satisfaction were compared between the two groups.Results:After the intervention, the pain scores of the observation group were (5.13 ± 1.14), (4.17 ± 0.97), (3.56 ± 0.75) and (3.04 ± 0.79) points in the resting state 8, 12, 24 and 48 h after the operation, respectively, which were lower than (6.02 ± 0.81), (5.05 ± 1.08), (4.48 ± 0.82), (3.50 ± 0.95) points of the control group, the differences were statistically significant ( t values were 2.88 to 6.41, all P < 0.05). The pain scores of the observation group at 8, 12, 24 and 48 hours after operation were (6.98 ± 0.72), (6.44 ± 0.76), (5.48 ± 0.91) and (4.50 ± 0.89) points, respectively, which were lower than (7.62 ± 0.69), (7.47 ± 0.94), (6.95 ± 1.23), (6.18 ± 0.93) points of the control group, the differences were statistically significant ( t values were 4.84 to 10.12, all P<0.05). The time of getting out of bed for the first time in the observation group was (24.70 ± 2.53) h, which was lower than (26.32 ± 3.37) h in the control group, and the difference was statistically significant ( t=2.97, P<0.05). The success rate of first breastfeeding in the observation group was 76.7% (46/60), which was higher than 58.3% (35/60) in the control group, and the difference was statistically significant ( χ2=4.60, P<0.05). The overall nursing satisfaction score of the observation group was (8.25 ± 1.39) points, which was higher than (7.73 ± 1.04) points of the control group, and the difference was statistically significant ( t=-2.31, P<0.05). Conclusions:The nursing intervention based on Manchester pain management model combined with empowerment education can effectively reduce the pain after cesarean section, promote postpartum recovery and improve nursing satisfaction, which is worthy of clinical promotion.
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RESUMEN El cáncer se consideraba una enfermedad rara en niños y adolescentes, sin embargo, en las últimas décadas ha habido un aumento considerable de este padecimiento. Según la Unión Internacional Contra el Cáncer las estadísticas señalan que cada año más de 160 mil niños son diagnosticados. El dolor es un síntoma cardinal en estos pacientes. La evaluación es compleja y requiere entrenamiento en el uso de escalas diseñadas y validadas para las distintas edades. El manejo del dolor por cáncer en los niños es un gran reto, pero al mismo tiempo una oportunidad para el personal de la salud de ejercer sus conocimientos y habilidades para ayudarlos. Este trabajo tiene como objetivo exponer las principales características del dolor por cáncer en pediatría, su evaluación y manejo, sobre la base de los conocimientos fisiopatológicos, teniendo en cuenta los aspectos referenciados en lo más actualizado de la literatura especializada. Se realizó un enfoque integral que incluye tanto medidas farmacológicas como no farmacológicas.
ABSTRACT Cancer was considered a rare disease in children and adolescents; however, in recent years there has indicate that each year more than 160 thousand children are diagnosed. Pain is a cardinal symptom been a considerable increase in this disease. According to the International Union Against Cancer, statistics in these patients. The evaluation is complex and requires training in the use of scales designed and validated for different ages. Managing cancer pain in children is a great challenge, but at the same times an opportunity for health personnel to exercise their knowledge and skills to help them. This work aims to expose the main characteristics of pain from cancer in pediatrics, its evaluation and management, based on the pathophysiological knowledge, taking into account the aspects referenced in the most current specialized literature. All through a comprehensive approach that includes both pharmacological and non-pharmacological measures.
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El cáncer en edades pediátricas es una enfermedad rara, sin embargo, en los últimos años ha aumentado su incidencia y prevalencia de una manera considerable. La Unión Internacional Contra el Cáncer señala que cada año alrededor de 160 mil niños son diagnosticados con cáncer en el mundo y en Cuba se diagnostican cada año aproximadamente 300 nuevos casos en menores de 18 años. Los problemas que enfrentan los niños con cáncer y sus familias son cada vez mayores, lo cual requiere nuevas y complejas estrategias de tratamiento. El manejo de este tipo de dolor es un gran reto para el personal médico, pues le obliga a desarrollar conocimientos y habilidades que ayuden al niño que sufre. Palabras clave: edades pediátricas; cáncer; manejo del dolor ABSTRACT Cancer in pediatric ages is an uncommon disease, however, in recent years its incidence and prevalence has increased considerably. The International Union Against Cancer notes that every year around 160 thousand children are diagnosed with cancer in the world and in Cuba approximately 300 new cases are diagnosed every year in children under 18. The problems confronted by children with cancer and their families are growing, which requires new and complex treatment strategies. The management of this type of pain is a great challenge for the medical staff, as it compels them to develop knowledge and skills for helping children who suffer.
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Resumen: Las mujeres en etapa gestacional que presentan dolor severo y solicitan tratamiento farmacológico analgésico (autoadministrado o por prescripción) representan un desafío para la atención médica, ya que la mayoría de los medicamentos cruzan la barrera placentaria. Existen momentos de particular preocupación para la administración de medicamentos durante la gestación: el período de la organogénesis (semana gestacional 4-10) y el período previo al nacimiento. Se recomienda, cuando sea posible, considerar primero las opciones de tratamiento no farmacológico, usar un solo fármaco a la dosis más baja efectiva y no usar medicamentos que puedan generar interacción farmacológica. Cuando el uso de la terapia de medicación es constante, se sugiere una comunicación y contacto estrecho entre el médico encargado de la supervisión de la gestación y el médico especialista en dolor. Los medicamentos han sido categorizados de acuerdo con el riesgo fetal por múltiples organizaciones. Este trabajo hace una revisión de las medicaciones más frecuentes.
Abstract: Pregnant women with pain that is severe enough to warrant pharmacological treatment (self-administered or prescribed by attendants) represent a challenging group as medicines given to them almost always cross the placenta. While most medicines are safe, there are particular times of concern, notably the period of organogenesis (week 4-10) and just before birth. Where possible, nonpharmacological treatment options should be considered, use only one drug at the most effective dose and do not use medications that can generate pharmacological interaction. Ongoing analgesic use requires close liaison between the health professional managing the pregnancy and the health professional managing the pain. Medicines that may be prescribed during pregnancy have been categorized according to fetal. This work makes a review of the most frequently used medications for pain management and its adverse effects reported in the short and long term.
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Objetivo: descrever o manejo da dor em crianças pela equipe de enfermagem. Metodologia: estudo qualitativo, realizado em unidade pediátrica de hospital universitário na cidade de Salvador, Bahia, em 2012. Participaram do estudo três enfermeiras, duas técnicas e duas auxiliares de enfermagem. Foram realizadas entrevistas semiestruturadas, analisadas por meio da técnica de análise de conteúdo, emergindo três categorias: Identificação da dor na criança internada; Instrumentos de avaliação da dor; Prevenção e Tratamento da dor, após aprovação do estudo pelo Comitê de Ética em Pesquisa da instituição, sob o parecer de número 79/11. Resultados: foram evidenciadas intervenções prioritariamente farmacológicas em detrimento das não-farmacológicas, intervenções insuficientes e pouco resolutivas, não utilização dos instrumentos adequados, além da não participação dos pais nesse cenário. Conclusão: percebe-se a necessidade de aprofundamento científico entre a equipe para o manejo da dor, além da reprodução do modelo biomédico no que concerne ao tratamento medicamentoso.
Objective: to describe pain management in children by the nursing team. Methodology: this qualitative study in a pediatric unit of a university hospital in Salvador, Bahia, was conducted in 2012, after approval by the research ethics committee (Opinion No. 79/11). Three nurses, two technicians and two nursing auxiliaries participated in the study. Semi-structured interviews were carried out and analyzed using content analysis, from which three categories emerged: identifying pain in the hospitalized child; pain assessment instruments; preventing and treating pain. Results: findings included pharmacological interventions prioritized over non-pharmacological interventions; insufficient and ineffective interventions; failure to use appropriate instruments; and parental non-participation in this scenario. Conclusion: the team needed more in-depth scientific training in pain management, beyond reproduction of the biomedical drug treatment model.
Objetivo: describir cómo el equipo de enfermería maneja el dolor en niños. Metodología: estudio cualitativo, realizado en unidad pediátrica de hospital universitario en la ciudad de Salvador, Bahía, en 2012. Participaron del estudio tres enfermeras, dos técnicas y dos auxiliares de la enfermería. Se realizaron entrevistas semiestructuradas, analizadas por medio de la técnica de análisis de contenido. Surgieron tres categorías: identificación del dolor en el niño internado; instrumentos de evaluación del dolor; prevención y tratamiento del dolor, tras la aprobación del estudio por el Comité de Ética en Investigación de la institución, bajo el parecer de número 79/11. Resultados: se evidenciaron intervenciones prioritariamente farmacológicas en detrimento de las no farmacológicas, intervenciones insuficientes y poco resolutivas, no utilización de los instrumentos adecuados, además de la no participación de los padres en ese escenario. Conclusión: se percibe la necesidad de profundización científica entre el equipo para el manejo del dolor, además de la reproducción del modelo biomédico en lo respecta al tratamiento medicamentoso.