Braden Scale in pressure ulcer risk assessment.

OBJECTIVE: To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU). METHODS: A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale. RESULTS: The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it. CONCLUSION: The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.

Braden Scale in pressure ulcer risk assessment / La Escala de Braden en la evaluación del riesgo de lesión por presión / A Escala de Braden na avaliação do risco para lesão por pressão

ABSTRACT Objective: To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU). Methods: A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale. Results: The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it. Conclusion: The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.

RESUMEN Objetivo: Analizar La aplicabilidad de la Escala de Braden a individuos internados en UTI con el diagnóstico de enfermería, movilidad del lecho perjudicada, en su potencial de predicción para desarrollar lesión por presión. Métodos: Estudio transversal, cuantitativo, que evaluó, con la Escala de Braden, todos los pacientes internados en una UTI entre noviembre de 2016 a febrero de 2017. Resultados: La prevalencia de lesión por presión fue 35,8% (24/67), 58,3% (14/24) del sexo masculino, el diagnóstico AVE-isquémico representó el 51,9% (12/27), el AVE-hemorrágico 7,4% (2/27) y la crisis convulsiva 3,7% (1/27). Entre los pacientes clasificados con riesgo muy alto para desarrollar lesión por presión 83,3% (20/53) La desarrollaron y el 76,7% (33/53) no la desarrollaron. Conclusión: El desempeño de la Escala de Braden presentó equilibrio entre sensibilidad y especificidad, mostrándose mejor instrumento predictivo de riesgo en esa clientela.

RESUMO Objetivo: Analisar a aplicabilidade da Escala de Braden a indivíduos internados em Unidade de Terapia Intensiva (UTI) com o diagnóstico de enfermagem "mobilidade do leito prejudicada", em seu potencial de predição do desenvolvimento de lesão por pressão (LPP). Métodos: Estudo transversal, quantitativo, que avaliou, com a Escala de Braden, pacientes internados em uma UTI entre novembro de 2016 e fevereiro de 2017. Resultados: A prevalência de lesão por pressão foi 35,8% (24/67), no sexo masculino (58,3%; 14/24), com diagnóstico de acidente vascular encefálico (AVE) isquêmico (51,9%; 12/27) e com acidente vascular encefálico hemorrágico (7,4%; 2/27). Dentre os pacientes classificados com risco muito alto de desenvolver lesão por pressão, 83,3% (20/53) a desenvolveram e 76,7% (33/53) não a desenvolveram. Conclusão: O desempenho da Escala de Braden apresentou equilíbrio entre sensibilidade e especificidade, mostrando-se melhor instrumento preditivo de risco nessa clientela.

Chronic pain, associated factors, and impact on daily life: are there differences between the sexes?

This pioneering cross-sectional study in São Luís, Maranhão State, Brazil, aimed to compare men and women with chronic pain by identifying associated factors and characterizing the pain and its impact on daily life. Considering an expected prevalence of 25%, 95% confidence interval, and 3% precision, a cluster sample of 1,597 individuals was selected. The descriptive analysis showed a predominance of women, age bracket of 18 to 29 years, and brown skin color. Prevalence of chronic pain was higher in women than in men. Risk factors were analyzed with logistic regression. Increasing age was an associated risk factor for chronic pain in both sexes. In women, 12 or more years of schooling were associated with lower prevalence of chronic pain, and divorce or widowhood was associated with higher prevalence. Lower back pain and headache were the two most frequently reported sites. There was no difference between the sexes in time since onset or intensity of pain. Chronic pain had a greater impact on daily life for women and generated more feelings of sadness.

Prevalence, characteristics, and factors associated with chronic pain with and without neuropathic characteristics in São Luís, Brazil.

CONTEXT: Chronic pain (CP) with and without neuropathic characteristics is a public health problem. This is the first population-based study in South America, and the third in the world, to use the Douleur Neuropathique 4 Questions (DN4) tool in epidemiologic studies. OBJECTIVES: The objectives were to estimate the prevalence and associated factors of CP with and without neuropathic characteristics in São Luís, Brazil. METHODS: We surveyed 1597 people. The DN4 questionnaire was applied. Poisson regression was used to analyze the risk factors. RESULTS: The prevalence of CP was 42%, and 10% had CP with neuropathic characteristics (CPNC). The results showed that female sex and age ≥30 years were associated with an increased prevalence of CP (P<0.001) and education ≥12 years with a reduction in the prevalence of CP. The sensations listed in the DN4 were more common in people with CPNC and most frequent were pins and needles (87.9%). The cephalic region (36%) and limbs (51%) were the locations most affected. Most respondents felt pain between six months and four years (51.6%), with daily frequency (45%). Pain intensity, the impediments caused by pain, and sadness were more prevalent in people who had CPNC (P<0.001). Health status was regular for most, 50.9% did not know the cause of their pain, 64.1% used drugs, and only 7% had consulted with a pain specialist. Dissatisfaction with treatment was reported by 55%. CONCLUSION: CP with and without neuropathic characteristics is a public health problem in Brazil, with high prevalence and great influence on people's daily lives.

Chronic pain, associated factors, and impact on daily life: are there differences between the sexes? / Dor crônica, fatores associados e influência na vida diária: existe diferença entre os sexos?

This pioneering cross-sectional study in São Luís, Maranhão State, Brazil, aimed to compare men and women with chronic pain by identifying associated factors and characterizing the pain and its impact on daily life. Considering an expected prevalence of 25%, 95% confidence interval, and 3% precision, a cluster sample of 1,597 individuals was selected. The descriptive analysis showed a predominance of women, age bracket of 18 to 29 years, and brown skin color. Prevalence of chronic pain was higher in women than in men. Risk factors were analyzed with logistic regression. Increasing age was an associated risk factor for chronic pain in both sexes. In women, 12 or more years of schooling were associated with lower prevalence of chronic pain, and divorce or widowhood was associated with higher prevalence. Lower back pain and headache were the two most frequently reported sites. There was no difference between the sexes in time since onset or intensity of pain. Chronic pain had a greater impact on daily life for women and generated more feelings of sadness.

Estudo transversal, pioneiro em São Luís, Maranhão, Brasil, com o objetivo de comparar homens e mulheres com dor crônica por meio da identificação dos fatores associados, caracterização da dor e influência na vida diária. Considerando a prevalência de 25%, nível de 95% de confiança e precisão de 3% foram entrevistadas 1.597 pessoas selecionadas por amostragem do tipo conglomerado. Na análise descritiva houve predomínio do sexo feminino, faixa etária entre 18 e 29 anos e cor parda. A prevalência de dor crônica foi maior nas mulheres em relação aos homens. Utilizou-se regressão logística para análise dos fatores de risco. Maior idade foi um fator associado à dor crônica em ambos os sexos. Nas mulheres, escolaridade a partir de 12 anos de estudos associou-se à menor prevalência, e estar divorciada/viúva e desempregada à maior prevalência de dor crônica. As regiões lombar e cefálica foram as mais referidas como locais de dor. Não houve diferença entre os sexos em relação ao tempo e intensidade dolorosa. A dor crônica teve maior influência na vida diária das mulheres e gerou mais sentimento de tristeza.