Assistência de Enfermagem a pacientes com dor lombar / Nursing care for patients with low back pain: a scope review / Cuidados de enfermería para pacientes con lumbalgia: una revisión de alcance

Objetivo: identificar na literatura e descrever a assistência prestada por enfermeiros a pacientes com dor lombar. Método: revisão de escopo, segundo método Joanna Briggs Institute (JBI) e recomendações Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR). Foi utilizada a estratégia de pesquisa População-Conceito-Contexto para compor a questão de pesquisa. Foram incluídos artigos de seis bases de dados indexadas, sem limite de tempo, nos idiomas português, inglês e espanhol. Resultados: obtiveram-se 1.025 artigos com a busca nas bases de dados, sendo selecionadas 23 publicações para análise após a aplicação dos critérios de exclusão. As informações foram categorizadas em histórico e avaliação do paciente, intervenções invasivas e não invasivas e educação em saúde. Conclusões: há prevalência de intervenções não farmacológicas e práticas educativas no acompanhamento do enfermeiro ao paciente com dor lombar. O sucesso no cuidado é reforçado pela capacidade do profissional em sistematizar a assistência prestada.(AU)

Objective: to identify in the literature and describe the assistance provided by nurses to patients with low back pain. Method: scope review, according to the Joanna Briggs Institute (JBI) method and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) recommendations. The research strategy Population-Concept-Context was used to compose the research question. Articles from six indexed databases were included, with no time limit, in Portuguese, English and Spanish. Results: 1,025 articles were obtained after searching the databases, with 23 publications selected for analysis after applying the exclusion criteria. Information was categorized into patient history and assessment, invasive and non-invasive interventions, and health education. Conclusions: there is a prevalence of non-pharmacological interventions and educational practices in nurses' monitoring of patients with low back pain. Success in care is reinforced by the professional's ability to systematize the assistance provided.(AU)

Objetivo: identificar en la bibliografía y describir la asistencia prestada por enfermeras a pacientes con lumbalgia. Método: revisión del alcance, según el método del Instituto Joanna Briggs (JBI) y las recomendaciones Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR). Se utilizó la estrategia Población-Concepto-Contexto para componer la pregunta de investigación. Se incluyeron artículos de seis bases de datos indexadas, sin límite de tiempo, en los idiomas portugués, inglés y español. Resultados: se obtuvieron 1025 artículos con la búsqueda en las bases de datos y 23 publicaciones para análisis después de aplicar los criterios de exclusión. La información fue categorizada en historia y evaluación del paciente, intervenciones invasivas y no invasivas y educación para la salud. Conclusiones: Existe una prevalencia de intervenciones no farmacológicas y prácticas educativas en los cuidados de enfermería a pacientes con lumbalgia. El éxito en la atención se ve reforzado por la capacidad del profesional para sistematizar la asistencia prestada.(AU)

In vivo exposure for fear of pain and avoidance of movement in low back pain / Exposición en vivo al miedo al dolor y evitación del movimiento en dolor lumbar / Exposição ao vivo para o medo da dor e evitação do movimento em dor lombar

ABSTRACT Objectives: to verify the effects of hierarchization and in vivo exposure for fear of pain, avoidance of movement, and anxiety in chronic low back pain. Methods: quasi-experimental study. The 27 patients who participated graded the damage associated with the movements in each of the 40 activities of daily living depicted in pictures using a scale from 0 to 100. The patients chose five out of all the activities that received a score higher than 50 to carry out the exposure. The intensities of fear and anxiety were measured before and after each exposure session. Results: the frequencies of the gender were equal, and the mean age was 44.9 years. The activities chosen more frequently for the exposure were shoveling (33.3%) and running (33.3%). There was reduction of fear and anxiety before and after exposure (p<0.001). Conclusions: hierarchization and in vivo exposure were effective in reducing fear and anxiety.

RESUMEN Objetivos: verificar los efectos de la jerarquización y exposición viva al supuesto miedo al dolor y evitar el movimiento y la ansiedad en pacientes con dolor lumbar crónico. Métodos: estudio cuasiexperimental. Los 27 pacientes que participaron clasificaron el dolor de cada uno de los 40 movimientos de la actividad cotidiana representados en fotos, utilizando una escala de 0-100. Entre las actividades clasificadas con más de 50, eligieron 5 para realizar la exposición. La intensidad del miedo y la ansiedad fueron medidas antes y después de cada sesión de exposición. Resultados: la muestra expresó equivalencia entre sexos, media etaria de 44,9 años. Las actividades más elegidas para la exposición fueron: trabajar con la pala (33,3%) y correr (33,3%). Hubo reducción del miedo y de la ansiedad antes y después de las exposiciones (p<0,001). Conclusiones: la jerarquización y exposición vivas fueron efectivas para reducir el miedo y la ansiedad.

RESUMO Objetivos: verificar os efeitos do uso da hierarquização e exposição ao vivo para a crença de medo da dor e evitação do movimento e ansiedade em pacientes com dor lombar crônica. Métodos: estudo quase-experimental. Os 27 pacientes que participaram graduaram o dano de cada um dos 40 movimentos de atividades da vida diária representados em fotos, utilizando uma escala de 0 a 100. Dentre as atividades graduadas acima de 50, escolheram 5 para realizar a exposição. As intensidades do medo e da ansiedade foram mensuradas antes e depois de cada sessão de exposição. Resultados: a frequência entre os sexos foi equitativa, a média da idade foi de 44,9 anos. As atividades mais escolhidas para a exposição foram trabalhar com a pá (33,3%) e correr (33,3%). Houve redução do medo e ansiedade antes e após as exposições (p<0,001). Conclusões: a hierarquização e exposição ao vivo foram efetivas na redução do medo e da ansiedade.

Effect of alternative therapies compared with drug therapy for patients with low back pain on their functional health status

Despite the increased use and acceptance of alternative therapy practices by patients and health care providers, there is relatively little information available concerning the reasons for use or its effect on patient functional health status and well-being. The aim of this study was to evaluate the effect of alternative therapies compared with drug therapy for patients with low back pain on their functional health status. A consecutive sample of 115 subacute low back pain recruited from neurology outpatient clinic, pain management clinic and physiotherapy departments the Ain Shams University Hospital, and Ain Shams Specialized Hospital, they were divided into 3 equal groups group I: patients under exercise therapy, group II: patients under transcutaneous electrical nerve stimulation [TENS] therapy, and group III: patients under drug therapy. Data were collected through Functional Health Status Questionnaire, Visual Analogue Scale, Roland Morris Disability Questionnaire, and Low Back Pain Outcome Scale. All groups were evaluated for before and after each treatment, then 6 months later. Results of this study revealed highly statistically significant differences between the three group therapies in relation to effectiveness on decreasing pain intensity and level of disability [X[2]57.306, p=0.000 and X[2]= 71.934, p=0.000 respectively] with higher tendency of exercise therapy followed by TENS therapy, while drug therapy was the least after 6 months. Meanwhile, there was highly statistically significantly difference low back pain outcome scores in the exercise therapy group at follow-up. In addition, highly statistically significantly negative correlations were detected between functional health status scores and disability levels in all study group. In conclusion the results of this study revealed that exercise therapy alongside with patient's guidelines have highly positively significant effect in improving patients' with low back pain regarding to functional health status, level of disability and reducing pain intensity throughout follow up phases rather than TENS therapy or drug therapy

The Experience of Life Experiences among Patients with Chronic Low Back and Extremity Pain / 간호학회지

PURPOSE: The purpose of this study was to understand the meaning and nature of pain experienced among patients with chronic pain. The present study adopted a hermeneutic phenomenological method which was developed by van Manen. METHOD: The participants for this study were 4 men and 5 women, who were over the age of 20 with chronic pain more than 6 months. Data was collected by using in-depth interviews and observations from September, 2004 to December, 2004.The contents of the interviews were tape-recorded with the consent of the subject. RESULT: The essential themes that fit into the context of the 4 existential grounds of body, time, space and other people were 'untamed and unremitting pain', 'the body as an obstacle', 'continuity of suffering time as if the moment would never end', 'a narrow radial range of action' and 'separating from other people'. CONCLUSION: Patients with chronic pain experienced and perceived the world through the filter of their pain. It is necessary for nurses to understand the experiences of chronic pain patients and to provide more empathic, supportive care. Further research is needed on nursing interventions that could help chronic patients cope with and find the meaning in their suffering.

Contribuiçäo ao estudo das cervicodorsolombalgias em profissionais de enfermagem / Contribution to study of the back pain in a nursing staff

Com o objetivo de verificar características da ocorrência de cervicodorsolombalgias em profissionais da enfermagem e de determinar fatores ergonômicos e posturais relacionados com essa mesma ocorrência, entrevistaram-se e avaliaram-se 75 funcionários de um hospital universitário governamental. A análise dos resultados sugere que realmente as dores nas costas representam um sério e expressivo problema para o pessoal de enfermagem, sobretudo para as auxiliares e atendentes de enfermagem. Verificou-se também que este pessoal sofre essencialmente de lombalgia e cervilombalgia, sendo muito frequente encontrar uma associaçäo de regiöes com problemas. As funcionárias de enfermagem sentem que as dores nas costas säo produzidas principalmente pelo transporte e movimentaçäo de pacientes e pela manutençäo de posturas inadequadas e estáticas, sendo que também foram significativas as queixas sobre atividades näo relacionadas com a manipulaçäo de pacientes. Outro fato constatado é que grande parte das agressöes à coluna vertebral estäo relacionadas com fatores ergonômicos inadequados de mobiliários e equipamentos utilizados nas atividades cotidianas da enfermagem.

Consideraçoes sobre os procedimentos de movimentaçäo e transporte de pacientes / Procedures of dislocation and transport of patients

Este trabalho apresenta um levantamento bibliográfico sobre a ocorrência de lesöes dorsais entre o pessoal de enfermagem e o relacionamento destas com a movimentaçäo e transporte de pacientes. Expöe também os inúmeros fatores que podem prejudicar esses procedimentos