Execução do ultrassom à beira leito no paciente crítico: protocolo de revisão de escopo / Bedside ultra sound execution for critical patient: scope review protocol

OBJETIVO: Descrever as evidências científicas acerca do ultrassom à beira do leito, executado pelos profissionais de saúde em ambiente crítico. MÉTODO: Revisão de escopo pautado nas normas e termos metodológicos do Joanna Briggs Institute (JBI), norteada pela pergunta "Como está descrito na literatura o uso do Point-of-Care Ultrasound - POCUS / ultrassom à beira do leito pelos profissionais de saúde na assistência direta ao paciente crítico?". A busca envolve nove bases de dados e na literatura cinzenta. A seleção de evidências se apresenta em três etapas, e para o gerenciamento das referências dos estudos se utiliza o software Mendeley. A avaliação dos estudos está sustentada nos critérios preestabelecidos de inclusão, e foi realizada por três revisores, sendo dois de modo independente e um terceiro para a preciação das divergências. Os dados extraídos têm apresentação descritiva e sintética dos resultados.

OBJECTIVE: To describe the scientific evidence about bedside ultrasound health professionals performing in a critical environment. METHOD: Scope review based on Joanna Briggs Institute methodological terms and standards, guided by the question "How is the use of Point-of-Care Ultrasound - POCUS / ultrasound at the bedside described in the literature by health professionals in direct care to critical patients?". The search involves nine data bases and in the gray literature. The selection of evidence is in three stages, and the Mendeley software is used to manage study references. The study evaluation is based on the pre-established inclusion criteria and was carried out by three reviewers, two independently and a third, to assess differences. The extracted data has a descriptive and synthetic presentation of the results.

Post-operative pain management by nurses in an intensive care unit: a best practice implementation project.

INTRODUCTION: Post-operative pain is the most prevalent type of acute pain. Nurses are the health care professionals who most frequently assess pain, as well as evaluating the patient's response to pain management treatment and monitoring for the occurrence of adverse events. Thus, to improve outcomes and quality of care, the interventions used by nurses should be based on best practices. OBJECTIVES: The aim of this project was to implement best practices in post-operative pain management in an intensive care unit. METHODS: This evidence implementation project was conducted in a hospital for the surgical treatment of orthopedic diseases and trauma. The project followed the JBI evidence implementation framework. The project used JBI PACES software as well as JBI's Getting Research into Practice (GRiP) audit and feedback tools to develop eight audit criteria for the baseline and follow-up audits. RESULTS: The baseline audit showed that criteria 3 and 6 had low compliance, with few patients having documented plans and goals, and receiving multimodal analgesia in the ICU, respectively. Criteria 7 and 8, which assessed the use of opioids and follow-up by a pain specialist, revealed compliance of 60% and 50%, respectively. Criterion 3 improved from 0% to 20%. Criteria 6, 7, and 8 also improved, rising to 30%, 22.8%, and 50%, respectively. CONCLUSION: The project improved compliance with best practices in post-operative pain management. Further studies are needed to ensure the project's long-term sustainability.

Risk management and safety in the use of patient-controlled analgesia pumps: a scoping review / Gestão de risco e segurança no uso de bomba de analgesia controlada pelo paciente: revisão de escopo

ABSTRACT BACKGROUND AND OBJECTIVES: Patient-controlled analgesia (PCA) is effective in controlling pain, but has numerous associated risks, such as: hypotension, respiratory depression, seizures and excessive sedation. The promotion of patient safety aims to reduce the risk of unnecessary health injuries and, therefore, it is important to analyze the failures and risk factors present throughout the process proactively. Therefore, the aim of this study was to map the available evidence on the risks of adverse events associated with the PCA technique and patient safety actions. CONTENTS: This is a scoping review conducted according to the JBI methodology, whose research question was based on the PCC strategy. The source of information is open and the search occurred in three stages. The databases used were: Medline/Pubmed; LILACS; CINAHL/ EBSCOhost; CENTRAL; Portal Capes; SCOPUS; Web of Science; Google academic; Brazilian Digital Library of Theses and Dissertations; Portal NICE; and Portal ISMP. The search strategy was divided into 3 stages: the first occurred in Medline and Cinahl to identify articles and index terms on the topic; the second used all keywords in all included databases; the third consisted of tracking searches in the reference lists of the included studies. The search resulted in 1,164 studies, of which 83 were selected based on the inclusion criteria: addressing the risks associated with the PCA pump or safety measures, hospital context, without restriction as to the type of study, language, and year. The studies are distributed in categories: previous diseases, profile of indications, types of opioids, types of pump and infusion, adverse effects, incidents without harm, stages of risk, and safety measures. CONCLUSION: This study made it possible to identify the risks of adverse events associated with the use of PCA in different stages and safety actions, demonstrating that when performed with appropriate patients, trained staff, safe devices, and correct prescription it provides a statistically significant improvement in pain relief, safely with advantages that conventional analgesia does not have.

RESUMO JUSTIFICATIVA E OBJETIVOS: A analgesia controlada pelo paciente (ACP) é eficaz no controle da dor, porém apresenta inúmeros riscos associados, tais como: hipotensão arterial, depressão respiratória, convulsões e sedação excessiva. A promoção da segurança do paciente visa reduzir o risco de lesões desnecessárias à saúde e, para tanto, é importante analisar as falhas e fatores de risco presentes em todo o processo de forma proativa. Portanto, o objetivo deste estudo foi mapear as evidências disponíveis sobre os riscos de eventos adversos associados à técnica de ACP e a ações de segurança do paciente. CONTEÚDO: Trata-se de uma revisão de escopo realizada segundo a metodologia Joanna Briggs Institute para Scoping Reviews, cuja questão de pesquisa se baseou na estratégia PCC (P: população; C: conceito; C: contexto). As bases de dados utilizadas foram: Medline/Pubmed, LILACS, CINAHL/EBSCOhost, CENTRAL, Portal Capes, SCOPUS, Web of Science, Google acadêmico, Biblioteca Digital Brasileira de Teses e Dissertações, Portal NICE, Portal ISMP. A estratégia de busca foi dividida em 3 etapas: a primeira ocorreu na Medline e Cinahl para identificar artigos e termos de índice sobre o tema; a segunda utilizou todas as palavras-chaves em todas as bases de dados incluídas; a terceira consistiu no rastreamento de pesquisas nas listas de referências dos estudos incluídos. A busca resultou em 1.164 estudos, dos quais 83 foram selecionados com base nos seguintes critérios de inclusão: abordagem dos riscos associados à bomba de ACP ou a medidas de segurança, contexto hospitalar, sem restrição quanto ao tipo de estudo, idioma e ano. Os achados sintetizados estão distribuídos em categorias: doenças prévias, perfil das indicações, tipos de opioides, tipos de bomba e de infusão, efeitos adversos, incidentes sem lesões, estágios de risco e medidas de segurança. CONCLUSÃO: Este estudo possibilitou identificar os riscos de eventos adversos associados ao uso da ACP em diferentes estágios e ações de segurança, demonstrando que quando realizada com pacientes adequados, com equipe treinada, dispositivos seguros e prescrição correta, fornece uma melhora estatisticamente significativa no alívio da dor, de forma segura e com vantagens que a analgesia convencional não possui.

Recommendations for the extraction, analysis, and presentation of results in scoping reviews.

Scoping reviewers often face challenges in the extraction, analysis, and presentation of scoping review results. Using best-practice examples and drawing on the expertise of the JBI Scoping Review Methodology Group and an editor of a journal that publishes scoping reviews, this paper expands on existing JBI scoping review guidance. The aim of this article is to clarify the process of extracting data from different sources of evidence; discuss what data should be extracted (and what should not); outline how to analyze extracted data, including an explanation of basic qualitative content analysis; and offer suggestions for the presentation of results in scoping reviews.

Transfusão de sangue e hemocomponentes para as Testemunhas de Jeová: revisão de escopo / Blood and blood component transfusion for Jehovah´s Witnesses: a scoping review / Transfusión de sangre y hemocomponentes para los Testigos de Jehová: revisión del alcance

Objetivo: mapear os estudos que abordam a não transfusão de sangue e hemocomponentes ao paciente Testemunha de Jeová. Método: revisão de escopo, seguindo o método proposto pelo Instituto Joanna Briggs. Foram realizadas buscas em doze bases de dados nacionais e internacionais, em outubro de 2020. Não foi utilizado recorte temporal. Resultados: dos 1435 artigos encontrados nas bases de dados pesquisadas, 21 foram incluídos neste estudo, seus conteúdos foram sintetizados em três categorias: 1) Estratégias alternativas ao uso de hemocomponentes; 2) Abordagem jurídica na recusa do paciente Testemunha de Jeová; 3) Abordagem bioética na recusa do paciente Testemunha de Jeová. Conclusão: a presente revisão de escopo permitiu mapear a literatura e conhecer as inquietações e as estratégias usadas na assistência ao paciente TJ que por questões religiosas recusa transfusão de sangue e hemocomponentes. A compreensão dessas alternativas será fundamental para a garantia de uma assistência segura e na preservação da autonomia do indivíduo.

Objective: to map studies that address non-transfusion of blood and blood components to Jehovah's Witness patients. Method: this scoping review used the method proposed by the Joanna Briggs Institute. Twelve Brazilian and international databases were searched in October 2020. No time frame was used. Results: of the 1435 articles found in the databases searched, 21 were included in this study. Their contents were summarized into three categories: 1) strategies alternative to the use of blood components; 2) legal approaches to refusal by Jehovah's Witness patients; and 3) bioethical approaches to refusal by Jehovah's Witness patients. Conclusion: this scoping review mapped the literature and identified the concerns and strategies used in care for Jehovah's Witness patients who refuse transfusions of blood and blood products for religious reasons. Understanding these alternatives will be fundamental to guaranteeing safe care and preserving patient autonomy.

Objetivo: mapear los estudios que abordan la no transfusión de sangre y hemocomponentes a pacientes Testigos de Jehová. Método: revisión del alcance, siguiendo el método propuesto por el Instituto Joanna Briggs. Se realizaron búsquedas en doce bases de datos nacionales e internacionales, en octubre de 2020. No se estipuló un recorte temporal. Resultados: de los 1435 artículos encontrados en las bases de datos investigadas, 21 fueron incluidos en este estudio, sus contenidos se resumieron en tres categorías: 1) Estrategias alternativas al uso de hemocomponentes; 2) Enfoque legal en cuanto al rechazo del paciente testigo de Jehová; 3) Enfoque bioético del rechazo de un paciente testigo de Jehová. Conclusión: esta revisión de alcance permitió mapear la literatura y conocer las preocupaciones y estrategias utilizadas en la atención de los pacientes Testigos de Jehová que, por motivos religiosos, rechazan transfusiones de sangre y hemocomponentes. Comprender estas alternativas será fundamental para garantizar una atención segura y preservar la autonomía del individuo.

Good practices in central venous catheter maintenance in time of covid-19: an observational study.

OBJECTIVES: to assess adherence to good practices for central venous catheter maintenance by the nursing team during the COVID-19 pandemic. METHODS: observational, cross-sectional, quantitative research with non-participant observation. Data collection was guided by an instrument developed for this study, consisting of five dimensions. It took place in the intensive care unit of a university hospital in the city of Rio de Janeiro. RESULTS: a total of 700 observations were carried out, which resulted, in general, in 402 (57.4%) procedures for adherence to good practices. Hand hygiene (8%) and Performing the dressings (10%) were the dimensions with the lowest adherence. CONCLUSIONS: good practices for central venous catheter maintenance were partially present in the routine of the nursing team during the COVID-19 pandemic. In critical moments, intensifying the qualification of the teams for a better adaptation to the new work processes is a strategy to sustain the patient safety culture.

Recursos audiovisuais como ferramenta de ensino da segurança do paciente: uma revisão integrativa da literatura

Resumo Objetivo: Apresentar resultados de uma revisão integrativa da literatura nacional e internacional sobre o uso de tecnologias educacionais com mídias audiovisuais para o ensino da segurança do paciente. Fonte de dados: Foram analisados artigos publicados de 2010 a 2020 a partir da seleção nas bases de dados da Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs) via Biblioteca Virtual de Saúde, Medline via PubMed-NCBI, Scopus e a CINAHL. Resumo das conclusões: A amostra final foi composta de oito estudos. Foram identificadas três modalidades de tecnologias educacionais audiovisuais. Se apropriar destas ferramentas no ensino da Segurança do Paciente, com uso de cenários, por exemplo, onde o indivíduo se enxerga como parte de um todo, tornar-se-ia uma oportunidade de qualificar os profissionais e estudantes da saúde, e quiçá fomentar uma assistência mais segura, reduzindo a cultura punitiva ainda presente e melhorando a comunicação efetiva entre a equipe multidisciplinar.

Tools for the investigation of adverse events: scoping review.

OBJECTIVE: To map, in the literature, the risk management tools aimed at investigating health adverse events. METHOD: Scoping review according to the Joanna Brigss Institute, with acronym PCC (Population: hospitalized patients, Concept: tools for the investigation of adverse events, and Context: health institutions) carried out in MEDLINE (OVID), EMBASE, LILACS, Scopus, CINAHL, and gray literature. RESULTS: The search totaled 825 scientific productions, 31 of which met the objective of the study, which consisted of 27 scientific articles and 4 expert consensus. It was possible to carry out a synthesis of the necessary steps for the investigation of adverse events and use of the tools according to the extent of damage. CONCLUSION: The practice of investigating adverse events should be guided by a thorough understanding of contributing factors, a fair culture, and the involvement of senior leadership.

Basic Human Needs in the Elderly Receiving Palliative Care: A Scoping Review.

Purpose: This scoping review identified scientific evidence on basic human needs (BHNs) in the elderly receiving palliative care. Methods: Systematic searches were conducted using six electronic databases (PubMed, CINAHL, Scopus, Lilacs, IBECS, and Web of Science). The initial search resulted in 1,227 articles, of which 104 were identified as potentially relevant. Fifty-three articles that met the inclusion criteria were identified and included in the final analysis. Results: Using the three hierarchical dimensions of the BHN model, 17 needs were organised, with five in the psychobiological dimension, 10 in the psychosocial dimension, and two in the psychospiritual dimension. These needs reflect the importance of care with dignity and relief from suffering for the elderly in palliative care. Conclusion: Recognising impaired BHNs in elderly people receiving palliative care will contribute to better care plans for the elderly, considering the multiple bio-psycho-social-spiritual dimensions of BHNs. This review points to a predominance of psychosocial needs.

Good practices in central venous catheter maintenance in time of covid-19: an observational study / Buenas prácticas en la manutención del catéter venoso central en tiempos de COVID-19: un estudio observacional / Boas práticas na manutenção do cateter venoso central em tempos de COVID-19: um estudo observacional

ABSTRACT Objectives: to assess adherence to good practices for central venous catheter maintenance by the nursing team during the COVID-19 pandemic. Methods: observational, cross-sectional, quantitative research with non-participant observation. Data collection was guided by an instrument developed for this study, consisting of five dimensions. It took place in the intensive care unit of a university hospital in the city of Rio de Janeiro. Results: a total of 700 observations were carried out, which resulted, in general, in 402 (57.4%) procedures for adherence to good practices. Hand hygiene (8%) and Performing the dressings (10%) were the dimensions with the lowest adherence. Conclusions: good practices for central venous catheter maintenance were partially present in the routine of the nursing team during the COVID-19 pandemic. In critical moments, intensifying the qualification of the teams for a better adaptation to the new work processes is a strategy to sustain the patient safety culture.

RESUMEN Objetivos: evaluar adhesión a buenas prácticas de manutención del catéter venoso central por grupo de enfermería en tiempos de COVID-19. Métodos: investigación observacional, transversal, cuantitativa con observación no participante. La recolecta de datos fue orientada por instrumento desarrollado para este estudio, constituido por cinco dimensiones. Ocurrió en unidad de terapia intensiva de un hospital universitario en Rio de Janeiro. Resultados: fueron realizadas 700 observaciones, que resultaron, en el general, en 402 (57,4%) procedimientos de adhesión a las buenas prácticas. Higiene de las manos (8%) y Realización de curativos (10%) fueron las dimensiones con menor adhesión. Conclusiones: las buenas prácticas de manutención del catéter venoso central se mostraron parcialmente presentes en la rutina del grupo de enfermería durante la pandemia de COVID-19. En momentos críticos, intensificar la calificación de los grupos para una mejor adaptación a los nuevos procesos laborales es una estrategia para sustentar la cultura de seguridad del paciente.

RESUMO Objetivos: avaliar a adesão às boas práticas de manutenção do cateter venoso central pela equipe de enfermagem durante a pandemia de COVID-19. Métodos: pesquisa observacional, transversal, quantitativa com observação não participante. A coleta de dados foi orientada por instrumento desenvolvido para este estudo, constituído por cinco dimensões. Ocorreu em unidade de terapia intensiva de um hospital universitário na cidade do Rio de Janeiro. Resultados: foram realizadas 700 observações, que resultaram, no geral, em 402 (57,4%) procedimentos de adesão às boas práticas. Higiene das mãos (8%) e Realização de curativos (10%) foram as dimensões com menor adesão. Conclusões: as boas práticas de manutenção do cateter venoso central mostraram-se parcialmente presentes na rotina da equipe de enfermagem durante a pandemia de COVID-19. Em momentos críticos, intensificar a qualificação das equipes para uma melhor adaptação aos novos processos de trabalho é uma estratégia para sustentar a cultura de segurança do paciente.

Self-efficacy and fear of pain to movement in chronic low back pain: an intervention developed by nurses.

OBJECTIVE: To test the effect of interventions to chronic low back pain developed by nurses in the Program to Increase Self-efficacy and Reduce the Fear of Pain and Avoidance of Movement. METHOD: Clinical trial, with 81 patients, carried out in 2016, at the Pain Outpatient Clinic in São Luís, Maranhão, Brazil. The groups received: A (education and exposure), B (education) and C (control). Chi-square, Fisher's Exact, ANOVA and Kruskal Wallis tests were performed. RESULTS: Patients in groups A and B improved self-efficacy, anxiety, depression, and disability, compared to group C. The reduction in fear of pain and avoidance of movement was greater in Group A, which also showed a decrease in current pain and overall scores compared to Group B and C. CONCLUSION: Education was effective in increasing the Self-Efficacy Belief. For the Belief of Fear of Pain and Avoidance of Movement and pain intensity, the association with exposure showed better results.

A Bibliometric Analysis of Published Literature in Postoperative Pain in Elderly Patients in Low- and Middle-Income Countries.

Postoperative pain (POP) remains a major challenge for surgeons and anesthesiologists worldwide, especially in low- and middle-income countries. Elderly patients are at higher risk for undertreatment of pain. Despite that, there is a paucity of papers addressing POP among this population in developing countries. This study aimed to provide a bibliometric analysis of the literature concerning postoperative pain in elderly patients from low- and middle-income countries. It was performed an extensive search of papers on this subject through the Web of Science and Scopus database using a series of uniterms and, including publications from 2001 to 2021. Publication quality was assessed by using total citation frequency, average citations per item and other citation indexes. Citation indexes were low, with the highest reaching 15 citations. In conclusion, few studies of postoperative pain in the elderly in countries with medium and low income, indicating a need that has not yet been met for this population and in these areas of the world. The published studies were not specifically aimed at the elderly, had limited impact, low international visibility. They were not epidemiological studies and are not robust, weakening knowledge and decision-making towards policies directed at this vulnerable population.

The use of guarana (Paullinia cupana) as a dietary supplement for fatigue in cancer patients: a systematic review with a meta-analysis.

OBJECTIVE: The objective of the present study was to carry out a systematic review with a meta-analysis to assess evidence about the use of guarana fruit to manage fatigue in cancer patients. METHODOLOGY: The data were extracted from the EMBASE, Scopus, MEDLINE, CENTRAL, and CINAHL databases, in any language, using the descriptors "neoplasms" and "Paullinia" or "guarana powder" and "placebos" and "fatigue". Searches were also conducted to identify any grey literature. Clinical studies with patients who presented cancer-related fatigue as a primary outcome and who used guarana as a dietary supplement were included. The risk of bias in randomized clinical trials was analyzed according to the Cochrane recommendations. The quality of the evidence was assessed using the GRADE system. For studies with the same types of tumors and treatments, meta-analysis was also conducted. RESULTS: A total of 383 studies were found and, of these, seven were included in the review, for a total of 427 cancer patients. The instruments used to analyze fatigue were the Brief Fatigue Inventory (BFI), the Chalder Fatigue Scale, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FATIGUE), and the Piper Scale. Some studies presented a low risk of bias for all the categories. Meta-analysis was conducted for three studies about breast cancer, which presented sufficient data. The use of guarana did not reduce cancer-related fatigue compared with placebo groups (mean of - 0.02 [95% CI - 1.54, 1.50]; p = 0.98) and the quality of evidence according to GRADE was very low. CONCLUSION: Dietary supplements are used to improve cancer-related fatigue. The results of this review showed that the use of guarana was not superior to the placebo groups, pointing to the need for further studies with better methodological quality.

Ângulo de fase para avaliar risco ou cicatrização de lesões: revisão sistemática / Phase angle for assessing lesion risk or healing: a systematic review / Ángulo de fase para evaluar el riesgo o la cicatrización de lesiones: revisión sistemática

OBJETIVO: Avaliar a efetividade do ângulo de fase medido por bioimpedância elétrica como preditor para avaliação de cicatrização em pacientes com lesões cutâneas ou risco de desenvolvê-las. MÉTODO: Revisão sistemática operacionalizada segundo metodologia Joanna Briggs Institute, recomendações checklist PRISMA. A amostra contemplou pacientes acima de 18 anos com lesões cutâneas variadas. RESULTADOS: Quatro estudos demonstraram o uso do ângulo de fase para o desfecho cicatrização e um estudo apontou uma possível relação do ângulo de fase com previsão de surgimento e risco de lesão por pressão. Foram obtidos pontos de cortes para determinadas lesões. Por não ter sido possível metanálise, se propõe a realização de estudos primários sobre o tema deste estudo. CONCLUSÃO: Apesar de serem poucos os trabalhos científicos com o tema proposto, foi possível demonstrar evidência moderada para o desfecho "cicatrização" e baixa para o desfecho "risco de lesão". Registro no PROSPERO com número CRD420201549.

OBJECTIVE: To assess the effectiveness of the phase angle measured by electrical bioimpedance as a predictor for healing evaluation in patients with skin lesions or risk of developing them. METHOD: A systematic review operationalized according to Joanna Briggs Institute methodology, PRISMA checklist recommendations. The sample included patients over 18 years old with varied skin lesions. RESULTS: Four studies demonstrated the use of phase angle for the healing outcome and one study indicated a possible relationship between phase angle and the prediction of the onset and risk of pressure ulcer. Cut-off points were obtained for certain lesions. As it was not possible to perform a meta-analysis, it is proposed to conduct primary studies on the theme of this study. CONCLUSION: Although there are few scientific papers with the theme proposed, it was possible to demonstrate moderate evidence for the "healing" outcome and low evidence for the "risk of lesion" outcome. Registration in PROSPERO with number CRD420201549.

OBJETIVO: Evaluar la efectividad del ángulo de fase medido por bioimpedancia eléctrica como predictor para la evaluación de la cicatrización en pacientes con lesiones cutáneas o riesgo de desarrollarlas. MÉTODO: Revisión sistemática realizada según la metodología del Joanna Briggs Institute, recomendaciones checklist PRISMA. La muestra incluyó a pacientes mayores de 18 años con diferentes lesiones cutáneas. RESULTADOS: Cuatro estudios demostraron el uso del ángulo de fase para el resultado cicatrización y un estudio señaló una posible relación entre el ángulo de fase y la previsión de la aparición y el riesgo de lesión por presión. Se obtuvieron puntos de corte para ciertas lesiones. Como no fue posible realizar un metaanálisis, se propone realizar estudios primarios sobre el tema de este estudio. CONCLUSIÓN: Aunque hay pocos estudios científicos sobre el tema propuesto, fue posible demostrar evidencia moderada para el resultado "cicatrización" y baja para el resultado "riesgo de lesión". Inscripción en PROSPERO con número CRD420201549.

Segurança do paciente oncológico em uso de morfina: protocolo de escopo / Safety of cancer patients using morphine: scoping review protocol / Seguridad de los pacientes con cáncer que utilizan morfina: protocolo de alcance

OBJETIVO: Mapear as práticas de segurança do paciente realizadas em pacientes oncológicos paliativos em uso de morfina para o controle da dor. MÉTODO: Revisão de escopo para responder à pergunta: Quais as evidências sobre as práticas de segurança do paciente realizadas em pacientes oncológicos paliativos que fazem uso de morfina para o controle da dor? A busca será realizada nas bases de dados MEDLINE, LILACS, Scopus, Embase, Web of Science, Cochrane e CINAHL e literatura cinzenta. Após a busca, todos as citações serão agrupadas no software Rayyan e as duplicatas removidas. Os títulos e resumos serão selecionados por dois revisores independentes. O texto completo das citações selecionadas será avaliado em detalhes em relação aos critérios de inclusão por dois revisores independentes. Os dados extraídos serão apresentados em um diagrama ou forma tabular de maneira que se alinhe com o objetivo desta revisão de escopo, e um resumo narrativo será fornecido

OBJECTIVE: To map the patient safety practices performed in palliative cancer patients using morphine for pain control. METHOD: A scoping review to answer the following question: What is the evidence on the patient safety practices performed in palliative cancer patients using morphine for pain control? The search will be carried out in the MEDLINE, LILACS, Scopus, Embase, Web of Science, Cochrane and CINAHL databases, as well as in the gray literature. After the search, all citations will be grouped in the Rayyan software and the duplicates will be removed. Titles and abstracts will be selected by two independent reviewers. The full text of the selected citations will be evaluated in detail in relation to the inclusion criteria by two independent reviewers. The extracted data will be presented in diagram or table formats so that it aligns with the objective of this scoping review, and a narrative abstract will be provided.

OBJETIVO: Mapear las prácticas de seguridad del paciente realizadas en pacientes con cáncer paliativo que utilizan morfina para el control del dolor. MÉTODO: Revisión de alcance para responder a la pregunta: ¿Cuál es la evidencia sobre las prácticas de seguridad del paciente que se implementan en pacientes con cáncer paliativo que utilizan morfina para el control del dolor? La búsqueda se realizará en las bases de datos MEDLINE, LILACS, Scopus, Embase, Web of Science, Cochrane y CINAHL y literatura gris. Después de la búsqueda, todas las citas se agruparán en el software Rayyan y se eliminarán los duplicados. Los títulos y resúmenes serán seleccionados por dos revisores independientes. El texto completo de las citas seleccionadas será evaluado en detalle según los criterios de inclusión por dos revisores independientes. Los datos extraídos se presentarán en un diagrama o en forma de tabla para que se alineen con el objetivo de esta revisión de alcance, y se proporcionará un resumen narrativo.

Aplicação de jogos educativos para avaliação do autocuidado em doentes cardíacos: protocolo de scoping review / Application of educational games for assessing self-care behaviors in patients with cardiovascular diseases: a scoping review protocol / Aplicación de juegos educativos para la evaluación del autocuidado en pacientes cardíacos: protocolo de revisión exploratoria

Resumo Contexto: O conhecimento sobre a doença influencia o autocuidado em doentes cardíacos e a aplicação de jogos educativos em saúde constituem uma proposta de coparticipação. Objetivo: Mapear jogos educativos destinados a avaliação do comportamento de autocuidado em doentes cardíacos. Método de revisão: Trata-se de protocolo de scoping review segundo o método do Joanna Briggs Institute, onde na definição dos participantes, conceito e contexto (PCC), serão incluídos como participantes: doentes cardíacos, sob diferentes doenças cardiovasculares; no conceito: jogos educativos para avaliação do comportamento de autocuidado; e no contexto: estudos realizados a nível ambulatório. E para tal, serão consultadas bases indexadas, como: MEDLINE, CINAHL, LILACS, ERIC, Cochrane Library, JBI Connect e literatura cinzenta. A extração e síntese dos dados serão realizadas por revisores independentes. Apresentação e interpretação dos resultados: A narrativa, tabelas e quadros permearão a apresentação e interpretação dos resultados. Conclusão: A expetativa é um resultado consolidado sobre jogos educativos para avaliação do comportamento de autocuidado em doentes cardíacos.

Abstract Context: Knowledge of the disease influences the self-care behaviors of cardiac patients, and the application of educational games in health is a proposal for co-participation. Objective: To map educational games for assessing self-care behaviors in cardiac patients. Review method: Scoping review protocol according to the Joanna Briggs Institute method based upon the PCC (Participants, Concept and Context) framework: Participants will include patients with different cardiovascular diseases; the Concept will be educational games for assessing self-care in cardiac patients; and the Context will be studies conducted in outpatient settings. Indexed databases such as MEDLINE, CINAHL, LILACS, ERIC, Cochrane Library, JBI Connect, and gray literature will be consulted. Independent reviewers will extract and synthesize the data. Presentation and interpretation of the results: A narrative summary, tables, and charts will be used to present and interpret the results. Conclusion: This study is expected to consolidate the results about educational games for assessing self-care behaviors in cardiac patients.

Resumen Contexto: El conocimiento sobre la enfermedad influye en el autocuidado en los pacientes cardíacos y la aplicación de juegos educativos en la salud constituye una propuesta de coparticipación. Objetivo: Mapear los juegos educativos destinados a evaluar el comportamiento de autocuidado en pacientes cardíacos. Método de revisión: Se trata de un protocolo de revisión exploratoria según el método del Instituto Joanna Briggs, donde en la definición de participantes, concepto y contexto (PCC) se incluirán como participantes, pacientes cardíacos con diferentes enfermedades cardiovasculares; como concepto, juegos educativos para la evaluación de la conducta de autocuidado, y como contexto, estudios realizados a nivel ambulatorio. Para ello, se consultarán bases indexadas como MEDLINE, CINAHL, LILACS, ERIC, Cochrane Library, JBI Connect y literatura gris. La extracción y la síntesis de los datos las realizarán revisores independientes. Presentación e interpretación de los resultados: La narración, las tablas y los gráficos marcarán la presentación e interpretación de los resultados. Conclusión: La expectativa es un resultado consolidado sobre los juegos educativos para la evaluación del comportamiento de autocuidado en los pacientes cardíacos.

Chronic Pain Management during the Covid-19 Pandemic: A Scoping Review.

BACKGROUND: The COVID-19 pandemic has led caregivers to modify patient healthcare, with a high impact on patients with chronic pain. AIMS: To map recommendations for the management of chronic pain patients during the COVID-19 pandemic and propose a workflow for the management of these patients. DESIGN: This was a scoping review. METHODS: The databases searched were PubMed, Embase, CINAHL, Scopus, Cochrane Library, and LILACS. The studies were examined by two independent reviewers. The disagreements between reviewers were resolved through discussion or with a third reviewer. RESULTS: We presented the results in the form of a table, a workflow, and a narrative summary. The search resulted in 13 studies selected for full reading, including one consensus, five guidance documents, two expert panels, one joint statement, two educational flyers, and two free comments. We considered new technologies, including telemedicine. Each pain service needs to establish a screening model, classifying patients according to corresponding severity. Particular attention should be given to patients who use opioids and are at risk of misusing them. Nonpharmacological approaches and pain education should be maintained, considering the use of telehealth. CONCLUSIONS: Recommendations for the management of chronic pain during COVID-19 include adjustments to the patient care model. The workflow proposes the use of telemedicine, screening for painful intensity, and the use of color-signaled intervention packages according to severity (green, yellow, and red).

Self-efficacy and fear of pain to movement in chronic low back pain: an intervention developed by nurses / Autoeficacia y temor de dolor al movimiento en la lombalgía crónica: una intervención desarrollada por enfermeiras / Autoeficácia e medo da dor ao movimento na lombalgia crônica: uma intervenção desenvolvida por enfermeiras

ABSTRACT Objective: To test the effect of interventions to chronic low back pain developed by nurses in the Program to Increase Self-efficacy and Reduce the Fear of Pain and Avoidance of Movement. Method: Clinical trial, with 81 patients, carried out in 2016, at the Pain Outpatient Clinic in São Luís, Maranhão, Brazil. The groups received: A (education and exposure), B (education) and C (control). Chi-square, Fisher's Exact, ANOVA and Kruskal Wallis tests were performed. Results: Patients in groups A and B improved self-efficacy, anxiety, depression, and disability, compared to group C. The reduction in fear of pain and avoidance of movement was greater in Group A, which also showed a decrease in current pain and overall scores compared to Group B and C. Conclusion: Education was effective in increasing the Self-Efficacy Belief. For the Belief of Fear of Pain and Avoidance of Movement and pain intensity, the association with exposure showed better results.

RESUMEN Objetivo: Evaluar el efecto de las intervenciones para el dolor lumbar crónico desarrolladas por las enfermeras en el programa para aumentar la autoeficacia y reducir el miedo al dolor y evitar el movimiento. Método: Ensayo clínico, con 81 pacientes, realizado en 2016, en la Clínica del Dolor en São Luís, Maranhão, Brasil. Los grupos recibieron: A (educación y exposición), B (educación) y C (control). Se realizaron pruebas de Chi-cuadrado, Exacta de Fisher, ANOVA y Kruskal Wallis. Resultados: Los pacientes en los grupos A y B mejoraron la autoeficacia, la ansiedad, la depresión y la discapacidad, en comparación con el grupo C. La reducción en el miedo al dolor y la evitación del movimiento fue mayor en el Grupo A, que también mostró una disminución en el dolor actual y las puntuaciones generales de en comparación con los grupos B y C. Conclusión: Educación fue efectiva para aumentar la creencia en la autoeficacia. Para la creencia del miedo al dolor y la evitación del movimiento y la intensidad del dolor, la asociación con la exposición mostró mejores resultados.

RESUMO Objetivo: Testar o efeito de intervenções para lombalgia crônica desenvolvidas por enfermeiros no Programa para Aumentar a Autoeficácia e Diminuir o Medo da Dor e Evitação do Movimento. Método: Ensaio clínico, com 81 pacientes, realizado em 2016, no Ambulatório de Dor em São Luís, Maranhão, Brasil. Os grupos receberam: A (educação e exposição), B (educação) e C (controle). Realizaram-se testes Qui-quadrado, Exato de Fisher, ANOVA e Kruskal Wallis. Resultados: Pacientes dos grupos A e B melhoraram a autoeficácia, ansiedade, depressão e incapacidade, comparados ao grupo C. A redução no medo da dor e evitação do movimento foi maior no Grupo A, que também apresentou diminuição na dor atual e escores gerais de dor, comparado ao Grupo B e C. Conclusão: A Educação foi efetiva no aumento da Crença de Autoeficácia. Para a Crença de Medo da Dor e Evitação ao Movimento e intensidade da dor, a associação com exposição mostrou melhores resultados.