Vloga medicinske sestre pri obravnavi bolečine po histerektomiji : diplomsko delo

Maliqaj, Arbnore (avtor), Mihelič Zajec, Andreja (mentor)

Uvod: Operativna odstranitev maternice oziroma histerektomija je pogost kirurški poseg v sodobni medicini, za katerega so značilne hude pooperativne bolečine in obdobje okrevanja, kar je odvisno od vrste histerektomije. Namen in cilji: Namen diplomskega dela je predstaviti pojav pooperativne bolečine pri pacientkah po histerektomiji ter vlogo medicinske sestre pri obravnavi pooperativne in kronične bolečine. Predstaviti želimo tudi razliko v doživljanju bolečine glede na vrsto posega, ugotoviti trajanje bolečine in analgezije ter predstaviti vlogo medicinske sestre pri vodenju bolečine. Metode: Uporabili smo deskriptivno metodo. Ustrezno literaturo smo zbrali s pomočjo podatkovnih zbirk, kot so kataložna baza podatkov slovenskih knjižnic Cobiss.si ter tuje baze ScienceDirect, CINAHL, Cochrane in PubMed. Poiskali smo pregledne, izvirne znanstvene in strokovne članke, ki obravnavajo pacientke v pooperativnem obdobju po histerektomiji in so bili objavljeni od leta 2010 do leta 2018. V analizo smo, glede na izključitvene kriterije vključili 30 člankov od 683 identificiranih. Rezultati: Abdominalna histerektomija je v primerjavi z drugimi načini odstranitve najbolj raziskovana. Prednosti laparoskopske histerektomije pred vaginalno in abdominalno so krajša hospitalizacija, minimalne pooperativne bolečine in hitrejše okrevanje. V pooperativnem obdobju ima različna vrsta analgezij različen učinek na pooperativne bolečine. Po podatkih iz raziskav je bila prevalenca kronične bolečine med vaginalno in abdominalno histerektomijo podobna. Pri pogostosti pojava bolečin ni bilo ugotovljenih nobenih razlik med vsemi načini histerektomije. Izkazalo se je povprečno znanje zdravstvenih delavcev pri ocenjevanju in obvladovanju bolečin po operaciji. Ugotovljeno je bilo, da imajo medicinske sestre slabo strokovno znanje o bolečini, zaradi pomanjkanja vsebin o bolečini v izobraževalnih programih. Razprava in zaključek: Kljub tehnološkemu napredku in teoretičnemu znanju o bolečini ta še vedno ostaja izziv za zdravstvene delavce. Pri obravnavi bolečin ima velik pomen tudi pogovor s pacientko. Abdominalna histerektomija, kot najbolj raziskovan način, je povezana z visoko stopnjo bolečine ter dolgo trajajočim okrevanjem v pooperativnem obdobju. Priprava pacientk na operativni poseg je pomemben ukrep za zmanjševanje bolečine in anksioznosti. Vedno bolj se pri histerektomiji opravljajo minimalno invazivni pristopi, kot posledica pa so zmanjšanje pooperativnih bolečin in krajše hospitalizacije. V zdravstvu še vedno v velikem odstotku prevladuje farmakološki način zdravljenja bolečin.

• Jezik: Slovenski jezik
• Ključne besede: abdominalna histerektomija, vaginalna histerektomija, laparoskopska histerektomija, pooperativna bolečina, analgezija, medicinska sestra, trajanje bolečin
• Vrsta gradiva: Diplomsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Leto izida: 2018
• PID: 20.500.12556/RUL-104074
• COBISS.SI-ID: 5507435
• Datum objave v RUL: 04.10.2018

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: The role of nurse in treating pain after hysterectomy : diploma work

Izvleček

Introduction: Operative removal of uterus or hysterectomy is a common surgery in modern medicine for which severe postoperative pains and the period of recuperation is characteristic, which depends on the type of hysterectomies. Purpose and goals: The purpose of the bachelor’s thesis is to present the emergence of the postoperative pain of patients after the hysterectomy and the goal of a nurse in treating the postoperative and chronic pain. We also want to present the difference in experiencing the pain with regards to the type of surgery, to ascertain the pain duration and analgesia, and to present the role of the nurse in treating the pain. Methods: We used the descriptive method. We collected the appropriate literature by means of databases, such as the catalog database of Slovenian libraries Cobiss.si and foreign bases ScienceDirect, CINAHL, Cochrane, and PubMed. We looked for original scientific articles which deal with patients in the postoperative period after the hysterectomy and were published from the year 2010 to the year 2018. In the analysis according to exclusion criteria, 30 articles from 683 were used. Results: Abdominal hysterectomy is the most researched in comparison with the other methods of removal. The advantages of laparoscopic hysterectomy in comparison to vaginal and abdominal are a shorter period of hospitalization, minimal postoperative pains, and faster recuperation. Local anesthesia has an ephemeral action on pain relief during the postoperative period. According to research data, the prevalence of chronic pain was similar between vaginal and abdominal hysterectomy. No differences among all the types of hysterectomy were ascertained in the frequency of the emergence of pain. Average knowledge of healthcare workers in evaluating and handling pains after the operation was ascertained. It was ascertained that nurses have poor professional knowledge on pain because of the lack of content on pain in educational programs. Discussion and conclusion: In spite of technological progress and theoretical knowledge on pain, the latter still remains a challenge for healthcare workers. A conversation with the patient is of great significance here. Abdominal hysterectomy as the most researched method is connected with a great level of pain and long-lasting recuperation in the postoperative period. The preparation of the patients is an important measure for the pain relief and to diminish the anxiety. Minimally invasive approaches are increasingly more performed in the case of hysterectomy, as a consequence of postoperative pain relief and shorter hospitalization. Pharmacological method of pain treatment still prevails in the healthcare in a great percentage.

• Ključne besede: abdominal hysterectomy, vaginal hysterectomy, laparoscopy hysterectomy, postoperative pain, analgesia, nurse, duration of pain