RESUMO
BACKGROUND: A total of 14.5% of cancer patients develop malignant neoplastic wounds (MNW), characterised as friable, exudative, fetid, bleeding, and painful. Some studies report that all patients with MNW experience pain, but there is lack of scientific evidence to support their treatment. OBJECTIVE: To map and examine the existing evidence on topical therapies to manage pain in adult patients with MNW. METHOD: A scoping review protocol was designed, according to the Joanna Briggs Institute (JBI) methodology. The databases CINAHL, LILACS, Embase, Scopus, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR and the grey literature, for searching published and unpublished studies in English, Portuguese and Spanish. The selection will be made by at least two reviewers. The summary of the results will be narrative, with graphs and tables. Qualitative and quantitative studies and reviews will be included, describing the use of topical pain therapies in patients with MNW. CONCLUSION: This study will allow to classify and discuss the available topical therapies, and to recommend future primary studies.
INTRODUCCIÓN: El 14,5% de los pacientes con cáncer desarrolla heridas neoplásicas malignas (HNM), caracterizadas como friables, exudativas, fétidas, sangrantes y dolorosas. Algunos estudios reportan que todos los pacientes con HNM experimentan dolor, pero hay escasez de evidencia científica para fundamentar su tratamiento. OBJETIVO: Mapear y examinar la evidencia existente sobre terapias tópicas para manejar el dolor en pacientes adultos con HNM. MÉTODO: Se diseñó un protocolo de revisión de alcance, de acuerdo con la metodología del Joanna Briggs Institute (JBI). Serán consultadas las bases de datos CINAHL, LILACS, Embase, Scopus, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR y la literatura gris, para la búsqueda de estudios publicados y no publicados en inglés, portugués y español. La selección estará a cargo de, al menos, dos revisores. La síntesis de los resultados será narrativa, con gráficos y tablas. Se incluirán estudios cualitativos, cuantitativos y revisiones, que describan el uso de terapias tópicas para el dolor en pacientes con HNM. CONCLUSIÓN: Este estudio permitirá clasificar y discutir las terapias tópicas disponibles, y recomendar futuros estudios primarios.
Assuntos
Neoplasias , Manejo da Dor , Adulto , Etnicidade , Humanos , Literatura de Revisão como AssuntoRESUMO
The objective of this study was to evaluate interobserver reliability and the concurrent criterion validity of the adapted version of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System to Brazilian Portuguese. For the evaluation of interobserver reliability using the photograph database, 36 nurses classified 30 skin tears (STs) into three groups, according to its definitions (adapted version). For the evaluation through clinical application, 23 nurses classified 12 STs present in 8 thoracic and cardiovascular postoperative patients at a tertiary hospital in Sao Paulo, Brazil. For the data collection of patients, an enterostomal therapist nurse classified the ST found by simultaneously using the adapted ISTAP version and the Skin Tear Audit Research (STAR) Classification System to test the concurrent criterion validity. The average of 17.83 correct answers (SD = 5.03) resulted from 1080 photograph observations, with Fleiss κ = 0.279 (reasonable concordance level). The interobserver reliability in the clinical application resulted in a global correct answer percentage of 76.7% in 85 observations. The concurrent criterion validity was attested by the total correlation (r = 1) between ISTAP and STAR. The ISTAP classification for ST is a reliable instrument and also valid in Brazil, making it another option to be used in clinical practice.