Pain management in the postoperative period of amputation surgeries: A scoping review.

BACKGROUND: Pain in the postoperative period of amputation surgeries, when not managed correctly, can have consequences for the patient. PURPOSES AND OBJECTIVES: The aim of this study was to map the scientific evidence on pain management in patients in the postoperative period of amputation surgeries. DESIGN: Scoping review with elaboration based on the recommendations of the Joanna Briggs Institute, supported by The PAGER framework and guided by the PRISMA-ScR Checklist. METHODS: The survey was conducted in August 2022 in 10 data sources. The 3300 publications found were analysed by two independent reviewers, after applying inclusion and exclusion criteria, 16 studies were selected. RESULTS: Publications occurred between the years 1997 and 2022 and mainly dealt with the management of residual pain and phantom limb through pharmacological measures with pain assessment made by numerical scales. CONCLUSIONS: The literature pointed out strategic uses of analgesics and highlighted technologies for neurostimulation through catheters. The need for new studies with non-pharmacological measures and with designs that can prove their effectiveness is reinforced. RELEVANCE TO CLINICAL PRACTICE: The knowledge of these strategies by health professionals allows adequate pain management and patient follow-up for a less traumatic recovery. PATIENT OR PUBLIC CONTRIBUTION: To patient or public involvement in this scoping review.

Development of a virtual simulation game on basic life support.

OBJECTIVE: To validate the content of a virtual learning object in the format of a Role Playing Game - educational simulation game about basic life support, aimed at academics and health professionals. METHOD: Methodological, construction and validation study with qualitative data approach on the content of a virtual learning object, conducted between August and September 2016. RESULTS: The game was developed in 13 screens, of which nine presented contents of basic life support, and the others presented general guidelines for progress in the game. The five suggestions of the experts were accepted by the researchers, and were mostly related to organization, clarity and vocabulary. No item was considered inappropriate by the judges, and the game had a mean content validity index of 0.96 and a Kappa value of 0.92. In the Likert scale evaluation, the game was considered in all analyzes as an excellent content for a virtual learning object. CONCLUSION: This learning technology is expected to support teaching of basic life support techniques for academics and health professionals, and to stimulate the development of similar teaching strategies in other scenarios, in order to bring advancements to the design of health training processes.

Clinic validation protocol for venous ulcers in high complexity. / Validação clínica de protocolo para úlceras venosas na alta complexidade.

OBJECTIVE: To perform clinical validation of a clinical protocol for treatment of individuals with venous ulcers in highly complex health services. METHOD: Methodological quantitative study conducted by four specialist nurses who evaluated 32 patients with venous ulcers, at the Onofre Lopes University Hospital, in Natal/Rio Grande do Norte. Data was collected between July and December/2013 and analysis was carried out using Kappa test (K), considering K ≥ 0.61. RESULTS: Items with unsatisfactory Kappa coefficients were excluded and the experts suggested changes in the categories anamnesis; examinations; verification of pain and pulse signs; surgical treatment of chronic venous disease; prevention of recurrence; reference and counter-reference. CONCLUSIONS: The protocol was validated in the clinical setting and, after adjustments, it contained 15 categories and 76 items. Validation optimized the instrument regarding applicability and relevance.

[Instrument for assessing the quality of mobile emergency pre-hospital care: content validation]. / Instrumento para avaliação da qualidade da assistência préhospitalarmóvel de urgência: validação de conteúdo.

OBJECTIVES: To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD: A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K> 0.80 and CVI ≥ 0.80. RESULTS: Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION: The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.

Factors associated with increased lactate levels in cardiac surgeries: scoping review.

OBJECTIVES: to map the factors associated with increased lactate levels in the postoperative period of cardiac surgery using extracorporeal circulation. METHODS: this is a scoping review carried out in December 2022, across ten data sources. It was prepared in accordance with the recommendations of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta Analyses Extension for Scoping Reviews checklist. RESULTS: the most recurrent findings in studies regarding the factors responsible for the increase in lactate were: tissue hypoperfusion, cardiopulmonary bypass time and use of vasoactive drugs. In 95% of studies, increased lactate was related to increased patient mortality. CONCLUSIONS: discussing the causes of possible complications in cardiac surgery patients is important for preparing the team and preventing complications, in addition to ensuring quality recovery.

Non-pharmacological strategies to reduce stress and anxiety in endovascular procedures: A scoping review.

AIM: This study aimed to identify and map the production of knowledge on non-pharmacological strategies to reduce stress and anxiety in patients undergoing endovascular procedures. DESIGN: Scoping review. METHODS: The review was performed using the PRISMA-ScR guidelines. The searches were conducted in Scopus, PubMed, Web of Science, Wiley Online Library, BVS/BIREME, Lilacs, Gale Academic OneFile, SciELO, Cochrane Library, CAPES Catalog of Dissertations and Theses, Oswaldo Cruz Foundation Portal of Theses and Dissertations, and Theses and Dissertations from Latin America. RESULTS: Twenty-two articles were selected. The articles were published from 2001 to 2022, mostly in Iran, and there was a predominance of randomized clinical trials. The Spielberger State-Trait Anxiety Inventory was the most used instrument. The findings indicated that music therapy, educational guidelines or videos on the procedure, massage, psychological preparation and aromatherapy were the main non-pharmacological therapies used to reduce anxiety and stress in patients undergoing vascular procedures.

Nursing diagnosis proposal "Impaired Peripheral Venous Return": concept formation.

OBJECTIVES: to develop a nursing diagnosis proposal focused on venous return. METHODS: this is a concept analysis according to the model proposed by Walker and Avant, which is operationalized through an integrative review. The study was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol recommendations. RESULTS: the analysis of the 131 studies allowed identifying attributes, antecedents and consequences. The most common attribute was decreased venous flow. The antecedents most frequently found were structural and/or functional valve deficiency, advanced age and peripheral venous thrombosis. The most common consequences were peripheral edema, venous ulcer and pain in the extremity. CONCLUSIONS: the formulated nursing diagnosis was proposed as part of Domain 4, Activity/rest, in Class 4, Cardiovascular/pulmonary responses, with eight defining characteristics, five related factors, six at-risk populations and four associated conditions.

Early diagnosis of HIV/aids infection: concept analysis.

OBJECTIVES: to analyze the concept of "early diagnosis of HIV/Aids infection" in light of Walker and Avant's conceptual analysis model. METHODS: concept analysis study based on the framework proposed by Walker and Avant, instrumented by a scoping review conducted in April 2022, following the recommendations of the Joanna Briggs Institute and checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. The search was made in eight data sources, obtaining sixteen articles. RESULTS: the study found homosexual intercourses, early examination, anti-HIV antibodies, CD4 count, and sexually transmitted infection as the main attributes of the concept. As antecedents: information, risky behavior, unprotected sexual relations, prevention, and access to the service. As main consequences: antiretroviral treatment, seroconversion, transmission, and consultations. FINAL CONSIDERATIONS: the study approached the circumstantial situations of the theme, its attributes, antecedents, and consequences, qualifying the work process based on knowledge of nursing practice.

Effectiveness of techniques for insertion of nasoenteral probe in critical patients: Randomized clinical trial.

INTRODUCTION: despite being a common procedure, nasally placed small-bowel feeding tube insertion is not risk-free and can compromise patient safety. Due to the fact that nasally placed small-bowel feeding tube is commonly inserted '"blindly," with the patient head in the neutral position, sometimes the process becomes difficult and traumatic, and may present higher level of complexity in physiological or induced coma and intubated patients. Therefore, adverse events (AEs) route errors can occur during this procedure. This study aimed to determine the effectiveness of different nasally placed small-bowel feeding tube insertion techniques in coma and intubated patients, in comparison with conventional method. METHODS: A prospective, randomized and controlled clinical trial will be carried out with coma and intubated patients admitted to the Intensive Care Unit (ICU). Thirty-nine patients will be randomly divided into 3 groups: group who will have the tube inserted in a conventional manner with the head in the neutral position, group with the head positioned laterally to the right, and, finally, with the head in the neutral position, with assistance of a laryngoscope. The primary endpoint will be: first, second and total attempt success rate; and time required for the first successful attempt and the sum of all attempts. Complications during insertion included tube bending, twisting, knotting, mucosal bleeding, and insertion into the trachea. Patient vital signs will be measured.

Use of a menthol popsicle in managing postoperative thirst in patients undergoing radical prostatectomy: A randomized clinical trial.

Background and aim: Thirst is a real bother that most patients feel in the immediate postoperative period when they still need to fast. Many approaches regarding symptomatic relief strategies have been described in the literature, but strategies with cold water and/or menthol are effective in quenching thirst, as they act on pre-absorptive mechanisms. This study aims to evaluate the effectiveness of using menthol popsicles in relieving postoperative thirst in patients undergoing radical prostatectomy. Material and methods: This is a randomized controlled clinical trial with a quantitative approach. In all, 44 patients were evaluated in the immediate postoperative period of radical prostatectomy, with the intensity and discomfort of thirst being evaluated initially and subsequently. The study consisted of two groups: (1) the placebo group, popsicles without the addition of menthol substrates and (2) the experimental group, popsicles with the addition of 0.05% minty substrates. Results: The results demonstrate that the sociodemographic and clinical characteristics were homogeneous at the α = 5% significance level, except the occupation variable. The test detected changes in the intensity and discomfort of thirst in relation to the pre- and post-intervention times for the primary outcome when the groups were analyzed separately and for the interaction of the group versus time, there was no statistical difference between the groups. Conclusion: It was possible to prove that both the menthol popsicle and the popsicle without the addition of menthol were effective in relieving postoperative thirst in patients undergoing radical prostatectomy, but there was no statistically significant difference when comparing the two groups. Trial registration: The Brazilian Registry of Clinical Trials (RBR-8c3chr7).

Patient safety with covid-19 in hospital units: a scoping review.

OBJECTIVE: Map, in the scientific literature, the actions taken to promote the safety of patients with covid-19 in the hospital context. METHODS: This is a scoping review according to the Joanna Briggs Institute, using the Checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. In April 2022, searches were performed on nine data sources. The results were summarized in a table and analyzed descriptively. RESULTS: Fifteen studies were selected to compose the final sample. Most articles refer to cohort studies, followed by clinical trials. As for the areas of activity, there was a predominance of surgical centers, followed by adult and pediatric Intensive Care Units. CONCLUSIONS: With this review, it was possible to map measures such as contingency plans and reorganization of beds, rooms, and operating rooms, in addition to the isolation and distancing practiced by patients and professionals.

Effect of Zingiber Officinale in the Management of Nausea and Vomiting Induced by Treatment With Cisplatin Associated With Radiotherapy: A Randomized Controlled Trial.

OBJECTIVE: evaluate the efficacy of Zingiber Officinale in the management of nausea and vomiting induced by treatment with cisplatin associated with radiotherapy in patients with uterine cervical neoplasms. METHODS: a triple-blind, randomized, placebo-controlled trial. Interventions: Comparing the effects of ginger with institutional antiemetic therapy (ondansetron with dexamethasone). Patients with cervical cancer who started treatment with cisplatin with an indication of 40 mg/m² associated with radiotherapy, aged over 18 years, and with the ability to tolerate swallowing a capsule were recruited and equally allocated (1:1:1) into 3 groups of 16 patients each (the ginger capsules 250 mg group, ginger capsules 500 mg group, and placebo group). Nausea and vomiting were measured on baseline, 7 days after the first dose of medication and every seven consecutive days during a treatment break. RESULTS: The 250 mg ginger group had an 8.0% greater chance of experiencing nausea within 24 h after the chemotherapy infusion than the placebo group, although there is no statistical significance (P = .92986). The 500 mg ginger group showed a 63.9% reduction in nausea under the same conditions (P = .40460). No change was detected in the occurrence of nausea episodes during the 6 weeks (P = .8664) or between the groups (P = .2817). No change was detected in acute or late vomiting during the 6 weeks (P = .3510) or between the groups (P = .8500 and P = .5389, respectively). CONCLUSION: Ginger supplementation does not reduce the intensity of acute and late nausea and vomiting. REBEC (RBR-47yx6p9).

[The academic education in nursing and multiple-victim incidents: an integrative review]. / A formação acadêmica de enfermagem e os incidentes com múltiplas vítimas: revisão integrativa.

The objective of this study is to reflect on the knowledge, competencies and skill that must be promoted during the academic education of nurses for an effective professional practice in view of a multiple-victim incident (MVI). This is an integrative literature review regarding academic nursing education. The literature survey was performed on the BDENF, LILACS, SciELO, MEDLINE, Web of Knowledge and HighWire Press databases, using the following descriptors: higher education; nursing education; emergency nursing; and mass casualty incidents. The publications permitted considerations regarding the following themes: particularities; competencies and skills essential in nursing practice in view of multiple-victim incidents; and the professors' strategies to promote those competencies and skills. The literature analysis demonstrated that nursing education should be configured as a space to develop critical thinking skills, which requires professors to have an eclectic educational background.

Use of ginger to control nausea and vomiting caused by chemotherapy in patients with cervical cancer undergoing treatment: An experiment.

INTRODUCTION: Uterine cervix tumors have an invasive nature, with the capacity to proliferate to surrounding organs such as the vagina, bladder, and rectum, as well as the capacity for dissemination and involvement of structures distant from its place of origin. According to the International Federation of Gynecology and Obstetrics, patients with stages IB I, IB I microscopic (small dimension <4 cm) are indicated for radiotherapy or adjuvant chemoradiotherapy with cisplatin (40 mg/m2). However, cisplatin has side effects such as hematological implications (anemia, neutropenia, and thrombocytopenia), gastrointestinal disorders (nausea, vomiting, diarrhea, constipation), and fatigue. Zingiber officinale contains bioactive compounds that act on pregnancy and postoperative nausea, chemotherapy-induced nausea and vomiting, and also in the management of fatigue, myalgia, and insomnia. This study aimed to evaluate the effects of ginger on chemotherapy-induced nausea and vomiting in patients with cervical cancer undergoing treatment with cisplatin and radiotherapy. METHODS AND ANALYSES: A randomized intervention clinical and controlled trial with a triple-blind design is described, comparing the effects of institutional antiemetic therapy alone, as well as in combination with 2 different ginger concentrations. ETHICS AND DISSEMINATION: Due to the nature of the study, we obtained approval from the Division Ethics Committee of Liga Contra o Câncer. All participants signed an informed consent form prior to randomization. The results of this study will be published in peer-reviewed journals. The data collected will also be available in a public repository of data. TRIAL REGISTRATION NUMBER: This study is registered in the Brazilian Registry of Clinical Trials under number RBR-47yx6p9. This study was approved by the Division Ethics Committee of Liga Contra o Câncer under CAAE 40602320.0.0000.5293.

Strategies for thirst management in postoperative adult patients: a scoping review.

OBJECTIVES: to map the strategies for managing thirst in postoperative adult patients. METHODS: scoping review was conducted in October 2021 in 19 data sources: 14 databases and 5 platforms to search in the grey literature. It was prepared according to the recommendations of the Joanna Briggs Institute and the checklist of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Nine selected articles were part of the final sample. RESULTS: there is evidence of strategies to manage postoperative thirst using interventions such as water, ice, mentholated measures, carbohydrate and protein enriched fluid, oral hydrator, flavored gargling, cold gargling, wet gauze, 0.75% citric acid spray, and cold water. FINAL CONSIDERATIONS: the strategies observed may be reduced to cold and menthol use, salivary stimulants, and early introduction of fluids. The outcomes were positive in all the studies reviewed.

Semantic validation of educational technology with caregivers of children and adolescents undergoing chemotherapy.

OBJECTIVE: Semantically validate an educational technology with the caregiver of children and adolescents undergoing chemotherapy. METHOD: Methodological study, with a quantitative approach, guided by the theoretical framework of psychometry, developed between March and April 2022, with nine caregivers of children and adolescents undergoing chemotherapy. Educational technology is a digital animation film about the pediatric chemotherapy treatment process, used as a tool for health education. RESULTS: In the reliability assessment, the Intraclass Correlation Coefficient was 0.936 [95%CI 0.868-0.984] with p < 0.05 and Cronbach's alpha of 0.943, demonstrating satisfactory internal consistency. Regarding the semantic analysis, the domains related to objectives, organization, language, appearance, and motivation showed an agreement rate above 80%. CONCLUSION: Educational technology showed satisfactory rates, proving to be a valid, reliable, and important instrument to be used by caregivers of children and adolescents undergoing chemotherapy.

Non-pharmacological analgesia strategies in adult and elderly endovascular procedures: a scoping review.

OBJECTIVES: To identify the main non-pharmacological analgesia strategies used in clinical practice in adult and elderly endovascular procedures. METHODS: scoping review, undertaken in July 2021, on 12 national and international data sources. The recommendations of the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist were followed. Thirteen studies were selected to compose the sample, with no time or language cut-off. RESULTS: the main non-pharmacological strategies found were cold compress, use of music, and reflexology. The most prevalent procedures were coronary angiography, peripheral venous catheterization, and femoral catheter removal. Pain measurement by Visual Numeric Scale and Visual Analog Scale described pain reduction in adults and elderly. CONCLUSIONS: the main non-pharmacological strategies found were cold compress, use of music, and reflexology, which reduce pain in adults and the elderly.

Music-induced analgesia for adults and older adults during femoral arterial sheath removal after cardiac catheterization: a randomized clinical trial protocol.

BACKGROUND: Cardiovascular diseases cause the death of 17.5 million people every year. Cardiac catheterization is an invasive diagnostic exam that allows treatment followed by the examination and can cause some complications such as pain. From this perspective, music has alleviated suffering and promoted pain relief for patients. This study aims to evaluate the effectiveness of music therapy to relieve pain in adults and older adults during femoral arterial sheath removal after cardiac catheterization. METHODS: This is a randomized controlled clinical trial, with two arms and a single-blind design to be carried out with 68 patients equally allocated into control and experimental groups. The intervention will be applied with the use of headphones without any musical transmission in the control group or with the patient's musical preference in the experimental group with sound intensity of 60 dB. These patients will be evaluated in three moments: immediately before, during and 15 min after the painful procedure. The primary outcome includes reduction of pain intensity verified by the Visual Analogue Scale and the secondary outcome corresponds to improvement of vital signs and vocal and facial pain expressions. DISCUSSION: This study will allow by testing a non-pharmacological strategy to relieve pain during femoral sheath removal after cardiac catheterization, having its parameters evaluated at three moments: immediately before (30 min), during the procedure and 15 min after the painful procedure. It also enables the use of a low-cost, potentially effective resource that makes nursing care more humanized by improving user satisfaction with the service provided, in addition to reducing the need for post-procedure analgesics. TRIAL REGISTRATION: This study is registered on the Brazilian Clinical Trials Registry (REBEC) platform under number RBR-3t3qwp7 (05/04/2022) and was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE 52,586,521.8.0000.5537 (11/11/2021).

Massage for pain relief in newborns submitted to puncture: systematic review.

OBJECTIVE: To analyze in the scientific literature the effects of massage on pain relief in newborns submitted to puncture. METHOD: Systematic review with meta-analysis performed in October 2020, using PubMed, Web of Science, CINAHL, Scopus, Cochrane and Gale databases. Studies without time frame were included, which used massage as the main technique for relieving neonatal pain during puncture. Data were extracted using standardized forms and the synthesis of results occurred in a descriptive way. RESULTS: From the 12 studies included, massage was effective in pain relief in 83.3% of the studies. The comparative meta-analysis of massage versus routine care that assessed duration of crying obtained a statistically significant result (p = 0.0002; 95% CI -85.51 to -27.09). CONCLUSION: Massage contributes to neonatal pain relief by reducing pain score and reducing crying time in newborns submitted to puncture.

Glucose and reflexology for pain relief during arterial puncture in neonates: a protocol.

OBJECTIVE: To present a study protocol to compare glucose and reflexology in pain relief in neonate intensive care during arterial punctures. METHODS: A randomized, controlled, double-blind clinical trial protocol will be carried out at a teaching hospital maternity, with30 newborns admitted to neonate intensive care who are to undergo blood collection by arterial puncture. They will be randomly assigned to a control group (25% glucose) or an intervention group (foot reflexology). The primary outcome will be neonate pain scores during and after arterial puncture. Secondary outcomes will be crying time and variation in neonates' vital signs during and after the arterial puncture procedure. Registration number RBR-639bff. DISCUSSION: The results of this trial will provide new insights into the most appropriate intervention for the relief of neonate pain during painful procedures.