Cuidar de pessoas com dor e insuficiência cardíaca, da teoria da adaptação às condições crônicas de saúde
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Oct 4, 2022
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Introdução: cerca de 85% dos pacientes com insuficiência cardíaca relatam dor, o que suscita preocupação considerando que dependendo do tipo de dor, essa experiência pode afetar a qualidade de vida do paciente e de seus cuidadores.
Objetivo: desenvolver uma estratégia de cuidado de enfermagem baseada em na teoria Adaptação às condições crônicas de saúde de Callista Roy, para reduzir a experiência de dor em pessoas com insuficiência cardíaca.
Metodologia: foi desenvolvida a estrutura conceitual teórico-empírica da teoria de médio alcance Adaptação às condições crônicas de saúde de Callista Roy, a partir da qual a estratégia foi fundamentada conceitualmente e teoricamente. Posteriormente, para especificar as intervenções do plano de cuidados e em coerência com as abordagens teóricas, foi realizada uma revisão sistemática da literatura, buscando nas bases de dados: Sciencedirect, Scopus e Medline, com os termos "dor", "insuficiência cardíaca" e “Intervenções de enfermagem”.
Resultados: foi elaborada uma estratégia com intervenções que abordam os seguintes domínios: fisiológico, com avaliação dos sintomas, exercícios, controle de peso e locais dolorosos; autoconceito e papel com redução da ansiedade, estresse, depressão, treinamento para mudar pensamentos, atitudes e comportamentos; e interdependência, com o compartilhamento de experiências de autocuidado, apoio espiritual e diários de saúde, entre outros.
Conclusão: As evidências e o conhecimento teórico de enfermagem fornecem múltiplas intervenções que podem ser aplicadas em pacientes com insuficiência cardíaca para reduzir a experiência de dor, principalmente por meio de cuidados voltados para o conforto, estimulação cognitiva e suporte familiar, social e espiritual.
Palavra chave: Dor, Insuficiência Cardíaca, Cuidados de Enfermagem, Teoria de Enfermagem.
Keywords
pain, heart failure, nursing care, nursing theorydolor, insuficiencia cardíaca, atención de enfermería, teoría de enfermeríador, insuficiência cardíaca, cuidados de enfermagem, teoria de enfermagem
References
1. Jaramillo C, Gómez E, Hernández E, Saldarriaga C, Flórez N, Buitrago R, et al. Consenso Colombiano para el Diagnóstico y Tratamiento de la Insuficiencia Cardiaca Cronica [Internet]. Bogotá; 2014. Available from: https://scc.org.co/consenso-colombiano-para-el-diagnostico-y-tratamiento-de-la-insuficiencia-cardiaca/
2. Ministerio de Salud y Protección Social de Colombia. Guía de práctica clínica para la prevención, diagnóstico, tratamiento y rehabilitación de la falla cardiaca en población mayor de 18 años, clasificación B,C y D. [Internet]. Guía de Práctica Clínica. Bogotá; 2016. Available from: http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_637/GPC_falla_cardiaca/GPCFallaCardiacaProfesionalesNo53.pdf
3. Dougherty CM, Coats HL, Randall Curtis J, Doorenbos AZ. Development and testing of a goals of care intervention in advanced heart failure. Appl Nurs Res [Internet]. 2017;38(May):99-106. Available from: https://doi.org/10.1016/j.apnr.2017.09.017
4. Yee-Man A, Yuet-Wong FK. Effects of a Home-Based Palliative Heart Failure Program on Quality of Life, Symptom Burden, Satisfaction and Caregiver Burden: A Randomized Controlled Trial. J Pain Symptom Manage [Internet]. 2018;55(1):1-11. Available from: https://doi.org/10.1016/j.jpainsymman.2017.07.047
5. Millerick Y, Armstrong I. Heart failure and palliative care: Training needs assessment to guide priority learning of multiprofessionals working across different care settings. Curr Opin Support Palliat Care [Internet]. 2015;9(1):31-7. Available from: https://doi.org/10.1097/SPC.0000000000000113
6. Kurozumi Y, Oishi S, Sugano Y, Sakashita A, Kotooka N, Suzuki M, et al. Design of a nationwide survey on palliative care for end-stage heart failure in Japan. J Cardiol [Internet]. 2018;71(2):202-11. Available from: http://dx.doi.org/10.1016/j.jjcc.2017.06.009
7. Vélez Peláez S. Insuficiencia cardíaca. In Bogotá; 2016. p. 694-785. Available from: http://scc.org.co/wp-content/uploads/2012/08/capitulo8.pdf
8. Campbell RT, Petrie MC, Jackson CE, Jhund PS, Wright A, Gardner RS, et al. Which patients with heart failure should receive specialist palliative care? Eur J Heart Fail [Internet]. 2018;338-47. Available from: http://doi.wiley.com/10.1002/ejhf.1240
9. González-Robledo G, León J, Buitrago AF, Carvajalino S, Abril D, González V, et al. Cuidado paliativo en falla cardiaca. Rev Colomb Cardiol [Internet]. 2017;24(3):286-96. Available from: http://dx.doi.org/10.1016/j.rccar.2016.10.049
10. Sánchez-Herrera B. Abordajes teóricos para comprender el dolor humano. Aquichan [Internet]. 2003;3(3):32-41. Available from: https://www.redalyc.org/articulo.oa?id=74130306
11. Fawcett J. Applying Conceptual Models of Nursing, Quality Improvement, Research, and Practice. Applying Conceptual Models of Nursing. New York: Springer Publishing Company; 2017.
12. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The Prisma statement. BMJ [Internet]. 2009;339:b2535. Available from: http://dx.doi.org/10.1136/bmj.b2535
13. Grant MJ, Booth A. A typology of reviews: An analysis of 14 review types and associated methodologies. Health Info Libr J [Internet]. 2009;26(2):91-108. Available from: https://doi.org/10.1111/j.1471-1842.2009.00848.x
14. Roy C. Middle Range Theories Derived From Research. In: Generating Middle Range Theory : From Evidence to Practice. New York: Springer Publishing Company; 2014. p. 383.
15. Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP, et al. Effect of a collaborative care intervention vs usual care on health status of patients with chronic heart failure the CASA randomized clinical trial. JAMA Intern Med [Internet]. 2018;178(4):511-9. Available from: https://doi.org/10.1001/jamainternmed.2017.8667
16. Jiang W, Zhang Y, Yan F, Liu H, Gao R. Effectiveness of a nurse-led multidisciplinary self-management program for patients with coronary heart disease in communities: A randomized controlled trial. Patient Educ Couns [Internet]. 2020;103(4):854-63. Available from: https://doi.org/10.1016/j.pec.2019.11.001
17. Barnett LA, Prior JA, Kadam UT, Jordan KP. Chest pain and shortness of breath in cardiovascular disease: A prospective cohort study in UK primary care. BMJ Open [Internet]. 2017;7(5):1-10. Available from: https://doi.org/10.1136/bmjopen-2017-015857
18. Sun J, Zhang Z-W, Ma Y-X, Liu W, Wang C-Y. Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors. World J Clin Cases [Internet]. 2019;7(16):2165-75. Available from: https://doi.org/10.12998/wjcc.v7.i16.2165
19. Haedtke C, Smith M, VanBuren J, Klein D, Turvey C. The Characteristics of Pain in Patients Diagnosed with Depression and Heart Failure. Pain Manag Nurs [Internet]. 2017;18(6):353-62. Available from: https://doi.org/10.1016/j.pmn.2017.05.005
20. Chi NC, Barani E, Fu YK, Nakad L, Gilbertson-White S, Herr K, et al. Interventions to Support Family Caregivers in Pain Management: A Systematic Review. J Pain Symptom Manage [Internet]. 2020;60(3):630-656.e31. Available from: https://doi.org/10.1016/j.jpainsymman.2020.04.014
21. Hasanpour-Dehkordi A, Khaledi-Far A, Khaledi-Far B, Salehi-Tali S. The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran. Appl Nurs Res [Internet]. 2016;31:165-9. Available from: http://dx.doi.org/10.1016/j.apnr.2016.03.005
22. Conley S, Feder SL, Jeon S, Redeker NS, Renfield B. Daytime and Nighttime Sleep Characteristics and Pain Among Adults with Stable Heart Failure. J Cardiovasc Nurs [Internet]. 2019;34(5):390-8. Available from: https://doi.org/10.1097/JCN.0000000000000593
23. Lee SY, Kang J. Effect of virtual reality meditation on sleep quality of intensive care unit patients: A randomised controlled trial. Intensive Crit Care Nurs [Internet]. 2020;59:102849. Available from: https://doi.org/10.1016/j.iccn.2020.102849
24. Chen J, Walsh S, Delaney C, Cong X. Pain Management in Patients with Heart Failure: A Survey of Nurses’ Perception. Pain Manag Nurs [Internet]. 2020;21(4):365-70. Available from: https://doi.org/10.1016/j.pmn.2019.09.004
25. Vicente Herrero MT, Delgado Bueno S, Bandrés Moyá F, Ramírez Iñiguez de la Torre MV, Capdevila García L. Valoración del dolor. Revisión Comparativa de Escalas y Cuestionarios. Rev la Soc Española del Dolor. 2018;25(4):228-36.
26. Bhattarai P, Hickman L, Phillips JL. Pain among hospitalized older people with heart failure and their preparation to manage this symptom on discharge: a descriptive–observational study. Contemp Nurse [Internet]. 2016;52(2–3):204-15. Available from: http://dx.doi.org/10.1080/10376178.2016.1175311
27. Arcos-Medina L, Méndez-Toro A, Rojas-Ruiz I, Torres S, Tabares S. Caracterización clínico epidemiológica de pacientes hospitalizados con diagnóstico de falla cardiaca descompensada con fracción de eyección reducida del Hospital Militar Central. Acta Médica Colomb [Internet]. 2020;45(1):1-9. Available from: https://dx.doi.org/10.20986/resed.2018.3632/2017
28. Velarde Montalvo LM. Cuidado de enfermería en el adulto con insuficiencia cardiaca congestiva cronica, Hospital María Auxiliadora, 2019. Universidad Inca Garcilaso la Vega [Internet]. 2021 Feb 25 [cited 2021 Sep 21]; Available from: http://repositorio.uigv.edu.pe/handle/20.500.11818/5327#.YUpK3uHeLm0.mendeley
29. Quirino Afonso B, da Costa Ferreira N, Gengo e Silva Butcher R de C. Conceptual and operational definitions for the indicators of the nursing outcome classification: Symptom control in patients with heart failure in palliative care. Enferm Clin [Internet]. 2020;30(6):386-97. Available from: https://doi.org/10.1016/j.enfcli.2020.01.001
2. Ministerio de Salud y Protección Social de Colombia. Guía de práctica clínica para la prevención, diagnóstico, tratamiento y rehabilitación de la falla cardiaca en población mayor de 18 años, clasificación B,C y D. [Internet]. Guía de Práctica Clínica. Bogotá; 2016. Available from: http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_637/GPC_falla_cardiaca/GPCFallaCardiacaProfesionalesNo53.pdf
3. Dougherty CM, Coats HL, Randall Curtis J, Doorenbos AZ. Development and testing of a goals of care intervention in advanced heart failure. Appl Nurs Res [Internet]. 2017;38(May):99-106. Available from: https://doi.org/10.1016/j.apnr.2017.09.017
4. Yee-Man A, Yuet-Wong FK. Effects of a Home-Based Palliative Heart Failure Program on Quality of Life, Symptom Burden, Satisfaction and Caregiver Burden: A Randomized Controlled Trial. J Pain Symptom Manage [Internet]. 2018;55(1):1-11. Available from: https://doi.org/10.1016/j.jpainsymman.2017.07.047
5. Millerick Y, Armstrong I. Heart failure and palliative care: Training needs assessment to guide priority learning of multiprofessionals working across different care settings. Curr Opin Support Palliat Care [Internet]. 2015;9(1):31-7. Available from: https://doi.org/10.1097/SPC.0000000000000113
6. Kurozumi Y, Oishi S, Sugano Y, Sakashita A, Kotooka N, Suzuki M, et al. Design of a nationwide survey on palliative care for end-stage heart failure in Japan. J Cardiol [Internet]. 2018;71(2):202-11. Available from: http://dx.doi.org/10.1016/j.jjcc.2017.06.009
7. Vélez Peláez S. Insuficiencia cardíaca. In Bogotá; 2016. p. 694-785. Available from: http://scc.org.co/wp-content/uploads/2012/08/capitulo8.pdf
8. Campbell RT, Petrie MC, Jackson CE, Jhund PS, Wright A, Gardner RS, et al. Which patients with heart failure should receive specialist palliative care? Eur J Heart Fail [Internet]. 2018;338-47. Available from: http://doi.wiley.com/10.1002/ejhf.1240
9. González-Robledo G, León J, Buitrago AF, Carvajalino S, Abril D, González V, et al. Cuidado paliativo en falla cardiaca. Rev Colomb Cardiol [Internet]. 2017;24(3):286-96. Available from: http://dx.doi.org/10.1016/j.rccar.2016.10.049
10. Sánchez-Herrera B. Abordajes teóricos para comprender el dolor humano. Aquichan [Internet]. 2003;3(3):32-41. Available from: https://www.redalyc.org/articulo.oa?id=74130306
11. Fawcett J. Applying Conceptual Models of Nursing, Quality Improvement, Research, and Practice. Applying Conceptual Models of Nursing. New York: Springer Publishing Company; 2017.
12. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The Prisma statement. BMJ [Internet]. 2009;339:b2535. Available from: http://dx.doi.org/10.1136/bmj.b2535
13. Grant MJ, Booth A. A typology of reviews: An analysis of 14 review types and associated methodologies. Health Info Libr J [Internet]. 2009;26(2):91-108. Available from: https://doi.org/10.1111/j.1471-1842.2009.00848.x
14. Roy C. Middle Range Theories Derived From Research. In: Generating Middle Range Theory : From Evidence to Practice. New York: Springer Publishing Company; 2014. p. 383.
15. Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP, et al. Effect of a collaborative care intervention vs usual care on health status of patients with chronic heart failure the CASA randomized clinical trial. JAMA Intern Med [Internet]. 2018;178(4):511-9. Available from: https://doi.org/10.1001/jamainternmed.2017.8667
16. Jiang W, Zhang Y, Yan F, Liu H, Gao R. Effectiveness of a nurse-led multidisciplinary self-management program for patients with coronary heart disease in communities: A randomized controlled trial. Patient Educ Couns [Internet]. 2020;103(4):854-63. Available from: https://doi.org/10.1016/j.pec.2019.11.001
17. Barnett LA, Prior JA, Kadam UT, Jordan KP. Chest pain and shortness of breath in cardiovascular disease: A prospective cohort study in UK primary care. BMJ Open [Internet]. 2017;7(5):1-10. Available from: https://doi.org/10.1136/bmjopen-2017-015857
18. Sun J, Zhang Z-W, Ma Y-X, Liu W, Wang C-Y. Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors. World J Clin Cases [Internet]. 2019;7(16):2165-75. Available from: https://doi.org/10.12998/wjcc.v7.i16.2165
19. Haedtke C, Smith M, VanBuren J, Klein D, Turvey C. The Characteristics of Pain in Patients Diagnosed with Depression and Heart Failure. Pain Manag Nurs [Internet]. 2017;18(6):353-62. Available from: https://doi.org/10.1016/j.pmn.2017.05.005
20. Chi NC, Barani E, Fu YK, Nakad L, Gilbertson-White S, Herr K, et al. Interventions to Support Family Caregivers in Pain Management: A Systematic Review. J Pain Symptom Manage [Internet]. 2020;60(3):630-656.e31. Available from: https://doi.org/10.1016/j.jpainsymman.2020.04.014
21. Hasanpour-Dehkordi A, Khaledi-Far A, Khaledi-Far B, Salehi-Tali S. The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran. Appl Nurs Res [Internet]. 2016;31:165-9. Available from: http://dx.doi.org/10.1016/j.apnr.2016.03.005
22. Conley S, Feder SL, Jeon S, Redeker NS, Renfield B. Daytime and Nighttime Sleep Characteristics and Pain Among Adults with Stable Heart Failure. J Cardiovasc Nurs [Internet]. 2019;34(5):390-8. Available from: https://doi.org/10.1097/JCN.0000000000000593
23. Lee SY, Kang J. Effect of virtual reality meditation on sleep quality of intensive care unit patients: A randomised controlled trial. Intensive Crit Care Nurs [Internet]. 2020;59:102849. Available from: https://doi.org/10.1016/j.iccn.2020.102849
24. Chen J, Walsh S, Delaney C, Cong X. Pain Management in Patients with Heart Failure: A Survey of Nurses’ Perception. Pain Manag Nurs [Internet]. 2020;21(4):365-70. Available from: https://doi.org/10.1016/j.pmn.2019.09.004
25. Vicente Herrero MT, Delgado Bueno S, Bandrés Moyá F, Ramírez Iñiguez de la Torre MV, Capdevila García L. Valoración del dolor. Revisión Comparativa de Escalas y Cuestionarios. Rev la Soc Española del Dolor. 2018;25(4):228-36.
26. Bhattarai P, Hickman L, Phillips JL. Pain among hospitalized older people with heart failure and their preparation to manage this symptom on discharge: a descriptive–observational study. Contemp Nurse [Internet]. 2016;52(2–3):204-15. Available from: http://dx.doi.org/10.1080/10376178.2016.1175311
27. Arcos-Medina L, Méndez-Toro A, Rojas-Ruiz I, Torres S, Tabares S. Caracterización clínico epidemiológica de pacientes hospitalizados con diagnóstico de falla cardiaca descompensada con fracción de eyección reducida del Hospital Militar Central. Acta Médica Colomb [Internet]. 2020;45(1):1-9. Available from: https://dx.doi.org/10.20986/resed.2018.3632/2017
28. Velarde Montalvo LM. Cuidado de enfermería en el adulto con insuficiencia cardiaca congestiva cronica, Hospital María Auxiliadora, 2019. Universidad Inca Garcilaso la Vega [Internet]. 2021 Feb 25 [cited 2021 Sep 21]; Available from: http://repositorio.uigv.edu.pe/handle/20.500.11818/5327#.YUpK3uHeLm0.mendeley
29. Quirino Afonso B, da Costa Ferreira N, Gengo e Silva Butcher R de C. Conceptual and operational definitions for the indicators of the nursing outcome classification: Symptom control in patients with heart failure in palliative care. Enferm Clin [Internet]. 2020;30(6):386-97. Available from: https://doi.org/10.1016/j.enfcli.2020.01.001
Como Citar
Gómez Tovar, L. O., Henao Castaño, Ángela M., & Salazar Herrán, R. L. (2022). Cuidar de pessoas com dor e insuficiência cardíaca, da teoria da adaptação às condições crônicas de saúde. Investigación En Enfermería: Imagen Y Desarrollo, 24. https://doi.org/10.11144/Javeriana.ie24.cpdi
Seção
Artículos de Revisión Integrativa o Sistemática
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