Prepoznavanje in obvladovanje bolečine pri nedonošenčku : pregled literature

Razpet, Anka (author), Bizjak, Martina (mentor)

Uvod: Bolečina ima pri nedonošenčku številne neugodne učinke. Za medicinsko sestro je pomembno da jo zna opaziti, oceniti in lajšati. Bolni novorojenčki in nedonošenčki lahko pogosto doživljajo ponavljajočo se in dolgotrajno bolečino, povzročeno zaradi številnih ponavljajočih se diagnostičnih in terapevtskih postopkov. Namen: Namen diplomskega dela je opredeliti in predstaviti prepoznavanje in obvladovanje bolečine pri nedonošenčku in opisati vlogo medicinske sestre pri preprečevanju in lajšanju bolečine. Metode dela: Uporabljena je bila deskriptivna metoda dela s kritičnim branjem javno dostopnih virov literature, ki se navezujejo na podatke iz objavljenih člankov. Podatki so bili pridobljeni z analizo domače in tuje strokovne in znanstvene literature. Pregledana je bila domača in tuja literatura, objavljena v časovnem okvirju od leta 2006 do 2016. Rezultati: Poznamo številne potrjene in zanesljive lestvice za ocenjevanje akutne bolečine pri nedonošenih novorojenčkih. Za obvladovanje bolečine pri nedonošenčku, sta pomembna oba pristopa nefarmakološki in farmakološki, predvsem pa sposobnost medicinske sestre da bolečino pravočasno prepozna. Razprava in sklep: Obvladovanje prisotne bolečine je ena temeljnih človekovih pravic, in nujen del celostne obravnave in zdravljenja nedonošenčkov. Ključnega pomena pri obvladovanju bolečine je preventiva. Potrebno je slediti napisanim smernicam in protokolom, ki temeljijo na načelih minimalnega rokovanja in omejitvi škodljivih dražljajev. Ko se bolečim postopkom ne moremo izogniti, je smiselna uporaba stopenjskega pristopa. Medicinske sestre se sicer strinjajo, da nedonošenčki bolečino občutijo in izražajo. Težave navajajo pri samem opazovanju in ocenjevanju bolečine pri uporabi bolečinskih lestvic. Kljub napisanim smernicam se protibolečinski ukrepi pri nedonošenčkih še vedno premalo uporabljajo. Neprepoznana ali nezdravljena akutna in kronična bolečina se odraža predvsem na možganih in s tem na otrokovem razvoju. Opazovanje in ocenjevanje bolečine je težka naloga za zdravstvene delavce. Vsi člani zdravstvenega tima, bi se morali stalno izobraževati in se vključevati v multidisciplinarne time, v katerih medsebojno sodelujejo medicinske sestre, zdravniki, anesteziologi, farmacevti, psihologi in fizioterapevti, kateri se ukvarjajo z bolečino pri nedonošenčku. Dobro počutje nedonošenčka bi moral biti izziv za nadaljnje raziskave na tem področju.

• Language: Slovenian
• Keywords: nedonošenček, bolečina, prepoznava, obravnava, neonatalne bolečinske lestvice, medicinska sestra
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-100210
• COBISS.SI-ID: 5410923
• Publication date in RUL: 15.03.2018

Secondary language

• Language: English
• Title: Pain assessment and management in premature born baby : literature review

Abstract

Introduction: Pain has numerous unpleasant effects on a preterm infant. It is important that nurse relieve, evaluate and recognize it. Sick newborns and preterm infants often experience repetitive and long lasting pain caused by numerous diagnostic and therapeutic procedures. Purpose: The purpose of the diploma work is to identify and present the recognition and management of pain in the preterm infants and describe the role of nurse in preventing pain. Methods: A descriptive method of work was used, with critical reading of publicly accessible sources of literature related to data from published articles. The data were obtained through the analysis of local and foreign professional and scientific literature. Local and foreign literature, published in the time frame from 2006 to 2016, was reviewed. Results: Several validated and reliable pain scales exist to measure acute pain in preterm infants. For the management of pain in preterm infants, both approaches, non – pharmacological and pharmacological are important, and above all, the ability of a nurse to recognize pain in time. Discussion and conclusion: Managing pain presents one of the fundamental human rights, and an necessary part of the holistic treatment of preterm infants. Prevention is the key component in managing pain. It is necessary to follow written guidelines and protocols based on evidences on the principles of minimal handling and limiting harmful stimuli. When the painful procedure cannot be avoided, it is reasonable to use a tire approach. Nurses agreed that preterm infants feels and express pain. Problems are indicated at the observation and assessment in the use of pain scales. Despite the written guidelines, the pain relief treatment in preterm infants is still not used enough. Unrecognized or untreated acute and chronic pain is mainly reflected in the brain and thus on the child's development. Observing and assessing pain is a difficult task for health professionals. All members of the health team should be constantly educated, involved into research work and to participate in muldisciplinary teams, where nurses, doctors, anaesthetists, pharmacists, psychologists and physiotherapists cooperate with each other and deals with neonatal pain. The well being of preterm infants should be a challenge for further research work in this area.

• Keywords: preterm infant, pain, recognition, management, neonatal pain scales, nurse