Title Postupci medicinske sestre u tretmanu postoperativne boli
Title (english) NURSING INTERVENTIONS IN TREATMENT OF POSTOPERATIVE PAIN
Author Jelena Matić
Mentor Vesna Antičević (mentor)
Committee member Rahela Orlandini (predsjednik povjerenstva)
Committee member Matea Dolić (član povjerenstva)
Committee member Vesna Antičević (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2017-02-24, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Bol je univerzalno ljudsko iskustvo nužno za zaštitu organizma od oštećenja, fiziološki simptom koji upozorava na to da će nastati ili su nastali patofiziološki procesi koji mogu oštetiti organ,organizam. Uvijek je subjektivna i definira se kao peti vitalni znak i samim time se želi naglasiti važnost boli kao simptoma. Najnovija teorija boli zasniva se na biopsihosocijalnom modelu po kojoj je bol osjećaj što ga formiraju događaji u živčanom sustavu i organima, individualne karakteristike, obiteljske okolnosti te društvo i kultura življenja. Uobičajena podjela boli je na: tjelesnu, duševnu i tjelesno psihogeno uzrokovanu. Akutna poslijeoperacijska bol nastaje zbog ozljede kožnih, dubokih tjelesnih ili organskih struktura. To je vrsta boli koju bolesnik osjeća izravno nakon operacije, do 7 dana. Kronična poslijeoperacijska bol je bol koja traje dulje od 3 mjeseca nakon operacije. To je patološka bol koja traje dulje od uobičajenoga vremena cijeljenja ili liječenja bolesti. Liječenje poslijeoperacijske boli ovisno je o suradnji više struka. Medicinska sestra iz tima za liječenje boli je prva osoba za kontakt, dok su anesteziolog i klinički farmakolog dostupni prema potrebi. Glavna uloga medicinske sestre je spriječiti nepotrebnu bol kod pacijenta nakon kirurškog zahvata. Sestre su odgovorne za primjećivanje boli kod pacijenta, evaluaciju boli i započinjanje propisane terapije ako je potrebno, ukloniti čimbenike koji mogu pojačati bol, primijeniti nefarmakološke postupke ublažavanja boli, izbjegavati pritisak i napetost bolnog područja, razgovarati s pacijentom o njegovim strahovima te ublažiti strah prisustvom i razgovorom, ponovno procjenjivati bol i dokumentirati pacijentove promjene boli na skali boli. Vizualno analogna ljestvica (VAS) široko se primjenjuje u procjeni poslijeoperacijske boli. VAS-ljestvica na lijevom kraju s oznakom »bez boli«, a na desnom kraju s oznakom »najjača bol koja se da zamisliti« čini se da prelazi ograničenja verbalne ljestvice. Kako bi se što adekvatnije tretirala bol, neophodno je uključiti i samog pacijenta u tretman i kontrolu boli. Aktivno sudjelovanje pacijenta u tretiranju vlastite boli, edukacija o metodama procjene boli i tehnikama kontrole boli utječu na pacijentovo zadovoljstvo što sekundarno može imati utjecaj i na intenzitet boli. Zadovoljstvo dovodi do unutarnjeg balansa pojedinca i može biti percipirana kao sastavna komponenta zdravlja. Opuštanjem se pokušava postići potpuna tjelesna smirenost uz smanjivanje metabolizma, smanjivanje disanja, smanjivanje arterijskog krvnog tlaka, frekvencije rada srca i slično. Balansirana (multimodalna) analgezija metoda je izbora kada god je moguće, a temelji se na uporabi NSAIL-a i paracetamola za blagu bol, uz opioidne analgetike i/ili tehnike lokalne anestezije za umjerenu i intenzivnu bol.
Abstract (english) Pain is universal human experience, necessary for protection of organism from damages, it is a physiological symptom which warns us that will appeare or have been appeared pathophysiological processes which can damage the organ or organism. It is always subjective and is defined as the fifth vital sign and therefore we want to emphasize the importance of pain as a symptom. The latest theory of pain is based on the biopsychosocial model, which describes pain as the feeling that is formed by events in the nervous system and organs, individual characteristics, family circumstances and the society and culture of living. The usual division of pain is: physical, mental and physical psychogenic caused pain. Acute postoperative pain is caused by injury on the skin, deep physical or organic structure. It is kind of pain that the patient feels directly after the operation, up to 7 days. Chronic postoperative pain is pain that lasts for more than 3 months after surgery. It is pathological pain that lasts longer than the usual time of healing or treating disease. The treatment of postoperative pain is dependent on the cooperation of several professions. A nurse from the team for the treatment of pain is the first point of contact, while the anesthesiologist and clinical pharmacologist are available as needed. The main role of the nurse is to prevent unnecessary pain to the patient after surgery. The nurses are responsible for noticing pain on a patient, evaluation of pain and the initiation of pain prescribed treatment if necessary, to remove factors that may enhance the pain, to apply non-pharmacological methods of pain relief, avoid the pressure and tension to the painful area, talking to the patient about his fears and alleviate the presence of fear by conversation, re-evaluate and document the patient´s pain changes on a scale of pain.
The visual analog scale (VAS) is widely used in the evaluation of postoperative pain. VAS scale is marked at the left end with "no pain" and at the right end is labeled "the strongest pain that you can imagine," seems to exceed the limits of verbal scale. In order to adequately treat the pain, it is necessary to involve the patient in the treatment and control of the pain. Active participation of the patient in the treatment of their own pain, training on methods of pain assessment and pain management techniques affect patient satisfaction and as secondary can have an impact on the intensity of pain. Customer satisfaction leads to internal balance of the individual and may be perceived as an integral component of health. Relaxation is trying to achieve complete physical composure while reducing the metabolism, reduce breathing, lowering of arterial blood pressure, heart rate frequency and such. A balanced (multimodal) analgesia is method of choice whenever possible and is based on the use of NSAIDs and paracetamol for mild pain with opioid analgesics and / or techniques of local anesthesia for moderate and intense pain.
Keywords
medicinska sestra
postoperativna bol
pacijent (ključne riječi unio urednik)
Keywords (english)
nurse
postoperative pain
patient (ključne riječi unio urednik)
Language croatian
URN:NBN urn:nbn:hr:176:297209
Study programme Title: Nursing (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) sestrinstva (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-05-05 08:12:50