Escala Portuguesa de Flebite: adaptação transcultural, validade e confiabilidade para uso no Brasil / Portuguese Phlebitis Scale: cross-cultural adaptation, validity and reliability for use in Brazil / Escala Portuguesa de Flebitis: adaptación transcultural, validez y confiabilidad para uso en Brasil

Objetivos: Adaptar a Escala Portuguesa de Flebite para a cultura brasileira e verificar as propriedades psicométricas da versão adaptada. Métodos: Estudo metodológico envolvendo análise da equivalência semântica, cultural e idiomática para adaptação transcultural, cognitive debriefing, verificação da consistência interna e validade de construto. Equivalência foi analisada utilizando percentual de acordos. Validade de construto foi testada utilizando análise fatorial exploratória.A confiabilidade foi avaliada pela consistência interna (α de Cronbach e Ω de McDonald). Resultados: No processo de adaptação transcultural, envolvendo dez especialistas, dois itens não alcançaram concordância ≥ 80% e sofreram ajustes conforme as sugestões recebidas. Doze participantes do cognitive debriefing aprovaram a versão adaptada. Participaram da análise de confiabilidade e de validação do construto 244 adultos em uso de cateter venoso periférico. Análise fatorial exploratória identificou um único fator incluindo todos os itens testados (dor, eritema, edema, rubor no trajeto da veia e cordão venoso palpável) e carga fatorial > 0,743. Consistência interna do conjunto de itens foi alta (α de Cronbach = 0,771 e Ω de McDonald = 0,853). Conclusão: A Escala Portuguesa de Flebite ­ Versão adaptada para o Brasil mostrou-se válida e confiável. Alcançou propriedades que permitem sua utilização na prática clínica, no ensino e pesquisas no país.

Objectives: To adapt the Portuguese Phlebitis Scale to the Brazilian culture and verify the adapted version's psychometric properties. Methods: Methodological study involving analysis of semantic, cultural, and idiomatic equivalence for cross-cultural adaptation, cognitive debriefing, verification of internal consistency, and construct validity. The equivalence was analyzed considering the percentage of agreement among experts. Exploratory factor analysis was used to test construct validity. Reliability was assessed by internal consistency (Cronbach's α and McDonald's Ω). Results: In the cross-cultural adaptation process involving ten experts, two items did not reach an agreement ≥ 80% and underwent adjustments according to the suggestions received. Twelve cognitive debriefing participants approved the adapted version. Adults (n = 244) using a peripheral venous catheter participated in the reliability and construct validation analysis. Exploratory factor analysis identified a single factor, including all tested items (pain, erythema, edema, streak formation along the course of the vein, and palpable venous cord) and factor loading > 0.743. Internal consistency of the set of items was high (Cronbach's α = 0.771 and McDonald's Ω = 0.853). Conclusion: The Portuguese Scale of Phlebitis - Version adapted for Brazil proved valid and reliable. It achieved properties that allow use in Brazil's clinical practice, teaching, and research.

Objetivos: Adaptar la Escala de Flebitis Portuguesa a la cultura brasileña y verificar las propiedades psicométricas de la versión adaptada. Métodos: Estudio metodológico que involucró análisis de equivalencia semántica, cultural e idiomática para adaptación transcultural, debriefing cognitivo, verificación de consistencia interna y validez de constructo. Para el análisis de la concordancia de la equivalencia se utilizó el porcentaje de concordancias. Para probar la validez de constructo, se utilizó el análisis factorial exploratorio. La fiabilidad se evaluó mediante la consistencia interna (α de Cronbach e Ω de McDonald). Resultados: En el proceso de adaptación transcultural, en el que participaron diez expertos, dos ítems no alcanzaron un acuerdo ≥ 80% y se ajustaron de acuerdo con las sugerencias recibidas. Doce participantes en el debriefing cognitivo aprobaron la versión adaptada. Usuarios de catéter venoso periférico (n = 244) participaron en el análisis de confiabilidad y la validación de constructo. El análisis factorial exploratorio identificó un solo factor que incluía todos los ítems probados (dolor, eritema, edema, enrojecimiento en la vena y el cordón venoso palpable) y una carga factorial > 0,743. La consistencia interna de los ítems fue alta (αde Cronbach = 0,771 y Ω de McDonald = 0,853). Conclusión: La Escala Portuguesa de Flebitis ­ Versión adaptada para Brasil demostró ser válida y confiable. Alcanzó propiedades que permiten su uso en la práctica clínica, la docencia e la investigación en Brasil.

The intervention research on treatment by Xianchen to rabbits model of chemotherapeutic phlebitis

ABSTRACT PURPOSE: To develop a chemotherapeutics induced phlebitis and explore the effects of Xianchen on the phlebitis treatment. METHODS: Forty-eight rabbits were divided into two series. Phlebitis model induced by vincristine was established at each series. The first series had 24 rabbits, which were divided into four groups (6 hours, 12 hours, 18 hours, 24 hours) after vincristine infusion. The grades of phlebitis through visual observation and histopathological examination were observed. The second series had also 24 rabbits. Interventions were performed 12 hours after vincristine infusion. These rabbits were randomly divided into four groups, according to treatment: Hirudoid (bid), Xianchen (daily), Xianchen (tid), Xianchen (five times a day). Four days after intervention, the venous injury through visual observation and histopathological examination were evaluated. RESULTS: Series 1: Phlebitis appeared 12 hours after infusion of vincristine through visual observation. There was a significant difference (p<0.05) between 6 hours and 24 hours, 6 hours and 18 hours through visual observation. However, the inflammation happened 6 hours after infusion, the loss of venous endothelial cells demonstrated differences among four groups through histopathological evaluation (p<0.05). There were significant differences (p<0.05) after 4 days among the intervention groups through visual observation, the effects of Xianchen group (five times a day) were better than Xianchen group (tid) (p<0.01). The treatment of edema demonstrated differences among groups through histopathological evaluation (p<0.05), Xianchen (five times a day) better relieved the degree of edema (p<0.05). CONCLUSIONS: The study showed that inflammatory reaction of phlebitis appeared early. Xianchen can treat vincristine induced phlebitis, as well as Hirudoid. It is particularly effective in the treatment of edema, and there is a remarkable dose-response relationship.

Flebite em acessos venosos periféricos de pacientes de um Hospital do Vale do Paraíba / Phlebitis associated with peripheral intravenous catheter among in-patients of a Hospital in Vale do Paraíba

A flebite caracteriza-se por uma inflamação aguda da veia, causando edema, dor, desconforto, eritema ao redor da punção e um "cordão" palpável ao longo do trajeto. Objetivou-se identificar a presença ou ausência de flebite em pacientes internados em um hospital geral, bem como os fatores que influenciam as complicações em punção venosa e o tempo de permanência dos cateteres intravenosos periféricos. Trata-se de um estudo prospectivo, quantitativo, do tipo descritivo-exploratório, que analisou 76 pacientes. Destes, 24 (31,6%) evoluíram com flebite, sendo que 10 (41,6%) foram classificados como flebite grau I, nove (37,5%) grau II, quatro (16,7%) grau III e apenas um (4,2%) como grau IV. O tempo de permanência do cateter variou entre três e 120 horas, com a média de 49 horas. A Enfermagem desenvolve importante papel na prevenção das complicações associadas à manutenção do acesso venoso periférico, devendo avaliar criteriosamente os riscos de flebite.

La flebitis se caracteriza por una inflamación aguda de la vena, causando hinchazón, dolor, malestar, enrojecimiento alrededor de la punción, y una "cadena" palpable a lo largo del trayecto. El objetivo de este estudio fue identificar la presencia de flebitis en pacientes de un hospital general, así como los factores que influyen en las complicaciones de la punción venosa y el tiempo de permanencia de los catéteres venosos periféricos. Se trata de un estudio prospectivo, cuantitativo, descriptivo y exploratorio, que analizó 76 pacientes. De este total 24 (31,6%) tuvieron flebitis: 10 (41,6%) sujetos fueron clasificados como flebitis grado I, nueve (37,5%) grado II, cuatro (16,7%) Grado III y sólo uno (4,2%) como grado IV. El tiempo de uso de los catéteres varió de tres a 120 horas, con un promedio de 49 horas. Enfermería tiene un papel importante en la prevención de complicaciones asociadas con el acceso venoso periférico y debe evaluar cuidadosamente los riesgos de la flebitis.

Phlebitis is an acute inflammation of the vein that causes swelling, pain, discomfort, redness around the puncture and a palpable cord-like vein. The objective of the study was to identify the incidence or absence of phlebitis in patients in a general hospital, the complications associated with venipuncture and the length of time the catheters remained in situ. This is a prospective quantitative study with an exploratory and descriptive nature which analyzed 76 patients. Of these, 24 (31.6%) developed phlebitis; 10 (41.6%) were classified as Grade I phlebitis, 9 (37.5%) as Grade II, 4 (16.7%) as Grade III and 1 (4.2%) as Grade IV. The length of time the device remained in situ ranged from 3 to 120 hours with an average of 49 hours. Nursing has an important role in preventing complications associated with peripheral intravenous access. Furthermore, the risk of phlebitis should be carefully evaluated.

Effect of external use of sesame oil in the prevention of chemotherapy-induced phlebitis

Intravenous chemotherapy is an important mean for the treatment of cancers. Infusion phlebitis [Ph] is a common and acute complication of chemotherapy. The frequency of Ph is about 70% in patients undergoing chemotherapeutic management. It can induce the pain, increase the risk of thrombophlebitis, lead to incomplete follow-up, and thereby, affect the patient's health status. Respecting the great importance of these issues, it is essential to prevent Ph. This study conducted to determine the effect of external use of Sesame Oil [SO] in the prevention of Ph. Sixty patients with colon or rectum cancer, who admitted for chemotherapeutic management, enrolled in clinical trial and were randomly divided into two equal groups: Control and Intervention. Ten drops of SO was applied twice a day for 14 days externally in intervention group, whereas the control group received nothing. Incidence and grade of Ph was measured in both groups. Data was analyzed through independent t-test, X[2], Fisher's exact test, Mann-Whitney, and Lagrange survival using SPSS 16. The incidence of Ph was 10% and 80% in intervention group and control group, respectively.There was a significant difference between two groups [p < 0.05]. Ph was 8 times more frequent in control group [R R = 8; AR R = 70%]. In addition, there was statistically significant difference between the grade and incidence of Ph with SO and control group [p < 0.05]. According to these results, it seems that external use of SO is effective, safe and well-tolerated for prophylaxis from Ph. Therefore, it can be suggested as a selected prevention method for reducing the complication

Flebitis postinfusión en catéteres venosos periféricos: Una actualización del arte / Post infusion phlebitis in peripheral venous catheters; An actualization of the art

Las diferentes patologías y su manejo actual hacen que la terapia endovenosa sea frecuentemente utilizada en un gran número de pacientes admitidos en unidades de hospitalización, y más aún, sean fundamentales en las unidades de cuidados intensivos. No obstante, pesar de los beneficios, su utilización no está exenta de complicaciones, siendo una de las más frecuentes la flebitis post infusión o flebitis química, asociándose a una alta incidencia (alrededor de un 15 a 80% de los pacientes con accesos venosos periféricos) y se atribuye principalmente a la irritación provocada por medicamentos administrados por esta vía. Es responsabilidad de enfermería la instalación de una vía venosa periférica y sus cuidados, por lo que es de suma importancia conocer los signos y síntomas de flebitis para su detección precoz y, además, formas de prevención y su manejo una vez que esté presente. Sin embargo, pese a que existen numerosos estudios referentes a su prevención y tratamiento, aún no hay resultados concluyentes que permitan recomendar una medida determinada.

Different pathologies and their current management make intravenous therapy frequently used for the majority of patients admitted to hospital units and are even more critical in intensive care units. Still, despite of the benefits, Its use is not free of complications, being one of the most frequent post infusion phlebitis or chemical phlebitis, associated with a high incidence (around 15 to 80% of patients with peripheral venous access) and is mainly attributed to the irritation caused by medication administered by this route. Is responsibility of nursing staff the installation of peripheral venous catheters and its care, so it is important to recognize the signs and symptoms of phlebitis for early detection and also forms of prevention and handling this once it is present. However, while there are numerous studies concerning the prevention and treatment, there are no conclusive results yet to recommend a particular measure.

[ preventative role of sesame oil on phlebitis induced by anti-neoplastic agents]

Phlebitis is an inflammatory response to intravenously injected chemotherapy drugs and the reported incidences about 70% among colorectal cancer patients. The purpose of this study was to determine the effect of external use of Sesame Oil [SO] in prevention of chemotherapy-induced phlebitis. This randomized controlled clinical trial was performed on 60 patients with colon or rectum cancer, who randomly divided in two equal, control and intervention groups. This protocol was used 10 drops of SO every 12 hours, two times a day, from the first day of chemotherapy up to the four tenth day, whereas control group received nothing. Data tools included a bipartite questionnaire [demographic Q, clinical Q and Infusion Therapy scale] for measurement of phlebitis. The incidence of phlebitis in intervention group were significantly lower than that in control group [p<0.05]. Kaplan-Meier survival analysis showed that the median survival was Less than 4 days in the intervention and 8 days more in the control. In addition, there was statistically significant difference between grade and incidence of chemotherapy-induced phlebitis with SO and control group [p<0.05]. This study shows that external use of SO is effective and well tolerated for prophylaxis from chemotherapy- induced phlebitis. Therefore, it can be suggest as a selected Prevention method for reducing the complication

Factores de Riesgo asociados con la aparición de flebitis en pacientes ingresados en el servicio de medicina interna del HALF, durante el período de enero a diciembre 2005 / Factors of Risk associated with the phlebitis appearance in patients entered in the service of internal medicine of the HALF, during the period of January to December 2005

El presente trabajo se realizó en el Hospital Escuela Antonio Lenin Fonseca durante el período de enero a diciembre del año 2005. Se trata de un estudio de casos y controles para determinar los factores de riesgo en la aparición de flebitis en los pacientes ingresados al servicio de medicina interna en el período antes mencionado. Sedeterminaron los criterios de inclusión y exclusión tanto para los casos como para los controles. Se elaboró una ficha de recolección de datos. La muestra se constituyó por el universo o totalidad de los casos de flebitis presentados en el servicio y período ya mencionado siendo de 32 pacientes, los controles homogéneos a los casos en edad y sexo se constituyeron en 64 pacientes para un total de 94 sujetos en estudio. Lo recolectado en la ficha de datos se procesó en el programa EPI-INFO obteniendose el OR (Odd Ratio) y el valor de p para determinar que variables en estudio se constituían en factores de riesgo para la aparición de flebitis. Se encontró como factores de riesgo el sitio de venopunción (antebrazo), la ausencia de medidas de asepsia y el uso inadecuado de las técnicas de venopunción, también la dificultad o imposibilidad del paciente para deambular.

Occurrence and predisposing factors of phlebitis in patients with Iv therapy

Catheterization is the most common invasive and stressful treatment for inpatients. In addition to pain, its complications are threatening patients' life. One of these complications is phlebitis. Phlebitis is a serious complication that causes an unexpected increase in hospitalization period and treatment costs. It may cause sepsis and emboli. The accepted rate for phlebitis is%5 or less, while some studies report that rate between 25-70 percent. The main objective of this study is determining phlebitis occurrence and its predisposing factors in surgical wards of Ardabil hospitals. This study is a descriptive cross-sectional one. In this study, 400 cases of catheters in patients hospitalized in surgical wards of hospitals were randomly selected and studied. In this study, the peripheral catheter of patients over 12 years was studied and parameters such as demographic data, diagnosis, catheter type, drugs, solutions, catheterization period, vein, dressing type and rate of phlebitis were studied and then the data were analyzed with SPSS. Results showed that most of patients [%31/9] had catheter for 4 days.Most of the catheters [%37] were inserted in cephalic veins. The occurrence of phlebitis rate was 19.6 percent in 72hr while post infusion phlebitis rate was 16.5 percent. In most cases [%85] catheters were covered with no sterile dressing. Regarding high rate of phlebitis in this study, it seems necessary to conduct education on more appropriate application of catheters in patients in order to diminish phlebitis