Orientações terapêuticas da autogestão da dor e ferida cirúrgica após alta hospitalar: uma scoping review

Autores

DOI:

https://doi.org/10.31877/on.2023.47.06

Palavras-chave:

autogestão, período pós-operatório, dor, ferida cirúrgica, oncologia cirúrgica

Resumo

Enquadramento: Sendo a dor e sintomas relacionados com a ferida cirúrgica comuns no período pós-operatório, é fundamental conhecer intervenções para capacitar o doente para a autogestão destes sintomas. Objetivo: Identificar as orientações terapêuticas de suporte à autogestão dos sintomas dor e relacionados com a ferida cirúrgica na pessoa com doença oncológica submetida a cirurgia, após alta clínica. Metodologia: Esta revisão foi guiada pela metodologia da Joanna Briggs Institute (JBI) para scopings reviews e pelo modelo PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) para organização da informação. A estratégia de pesquisa incluiu estudos nas bases de dados CINAHL e MEDLINE, via EbscoHost. Resultados: Foram identificadas 302 publicações e, destas, foram selecionados 8 estudos para a dor e 4 para sintomas relacionados com a ferida cirúrgica. As
intervenções não farmacológicas foram as mais frequentemente descritas e incluíram intervenções do tipo físico e psicossocial, para o sintoma dor. Relativamente à ferida cirúrgica, salientam-se as intervenções de monitorização de sinais e sintomas indicativos de infeção. Conclusão: A evidência indica que o controlo da dor pósoperatória pode beneficiar quando se complementam intervenções farmacológicas com intervenções não farmacológicas. A capacitação para a automonitorização da
ferida cirúrgica, nomeadamente a deteção precoce de sinais de infeção, é o principal promotor para a sua autogestão.

Palavras-chave: autogestão; período pós-operatório; dor; ferida cirúrgica; oncologia cirúrgica

Downloads

Não há dados estatísticos.

Referências

Grady PA, Gough LL. Self-management: A comprehensive approach to management of chronic conditions. Am. J. Public Health. 2018;108: S430–S6. https://doi.org/10.2105/AJPH.2014.302041

Rosland AM, Heisler M, Piette JD. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. J Behav Med. 2012;35(2):221-39.

https://doi.org/10.1007/s10865-011-9354-4

Holman H, Lorig, K. Patient Self-Management : A Key to Effectiveness and Efficiency in Care of Chronic Disease in Care to Effectiveness of Chronic Disease. Public Health Rep. 2004;119:239-43. https://doi.org/doi: 10.1016/j.phr.2004.04.002

Pizzoli SFM, Renzi C, Arnaboldi P, Russell-Edu W, Pravettoni G, Monacis L. From life-threatening to chronic disease: Is this the case of cancers? A systematic review. Cogent Psychol. 2019;6(1).

https://doi.org/10.1080/23311908.2019.1577593

Talboom-Kamp EPWA, Verdijk NA, Kasteleyn MJ, Numans ME, Chavannes NH. From chronic disease management to person-centered eHealth; a review on the necessity for blended care. Clinical eHealth. 2018;1(1):3-7. https://doi.org/10.1016/j.ceh.2018.01.001

Saúde SNd. SNS+ Proximidade - Mudança centrada nas pessoas. 2018.

Odom-Forren J, Wesmiller S. Managing Symptoms: Enhancing Patients Self-Management Knowledge and Skills for Surgical Recovery. Semin Oncol Nurs. 2017;33(1):52-60.

https://doi.org/10.1016/j.soncn.2016.11.005

Avery KNL, Richards HS, Portal A, Reed T, Harding R, Carter R, et al. Developing a real-time electronic symptom monitoring system for patients after discharge following cancer-related surgery. BMC

Cancer. 2019;19(1). https://doi.org/10.1186/s12885-019-5657-6

Richards HS, Portal A, Absolom K, Blazeby JM, Velikova G, Avery KNL. Patient experiences of an electronic PRO tailored feedback system for symptom management following upper gastrointestinal

cancer surgery. Qual Life Res. 2020. https://doi.org/10.1007/s11136-020-02539-w

Cata JP, Corrales G, Speer B, Owusu-Agyemang P. Postoperative acute pain challenges in patients with cancer. Best Pract Res Clin Anaesthesiol. 2019;33(3):361-71.

https://doi.org/10.1016/j.bpa.2019.07.018

Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. The Lancet. 2006;367(9522):1618-25. https://doi.org/10.1016/s0140-6736(06)68700-x

Shipton EA. The transition from acute to chronic post surgical pain. Anaesth Intensive Care. 2011;39:824-36.

Park R, Mohiuddin M, Arellano R, Pogatzki-Zahn E, Klar G, Gilron I. Prevalence of Postoperative Pain Following Hospital Discharge: Protocol for a Systematic Review. JMIR Res Protoc. 2020;9(12):e22437. https://doi.org/10.2196/22437

Baratta JL, Schwenk ES, Viscusi ER. Clinical consequences of inadequate pain relief: barriers to optimal pain management. Plast Reconstr Surg. 2014;134(4 Suppl 2):15S-21S.

https://doi.org/10.1097/PRS.0000000000000681

Pfail JL, Garden EB, Gul Z, Katims AB, Rosenzweig SJ, Razdan S, et al. Implementation of a nonopioid protocol following robot-assisted radical cystectomy with intracorporeal urinary diversion.

Urol Oncol. 2021;39(7):436.e9-.e16. https://doi.org/10.1016/j.urolonc.2021.01.002

Jacobs BL, Rogers D, Yabes JG, Bandari J, Ayyash OM, Maganty A, et al. Large reduction in opioid prescribing by a multipronged behavioral intervention after major urologic surgery. Cancer.

;127(2):257-65. https://doi.org/10.1002/cncr.33200

Higgins TM, Pham M, McDonald J, Le Neveu M, Haslett W, Erekson E, et al. The Effect of State Legislation on Opioid Prescribing Practices Foll owing Gynecologic Surgery. J Gynecol Surg.

;37(4):291-6. https://doi.org/10.1089/gyn.2020.0139

Gunasingha RMKD, Niloy IL, Wetstein BB, Learn PA, Turza LC. Keeping tabs: Reducing postoperative opioid prescriptions for patients after breast surgical procedures. Surgery. 2021;169(6):1316-22. https://doi.org/10.1016/j.surg.2020.11.045

Odom-Forren J, Wesmiller S. Managing Symptoms: Enhancing Patients Self-Management Knowledge and Skills for Surgical Recovery. Semin Oncol Nurs. 2017;33(1):52-60. https://doi.org/10.1016/j.soncn.2016.11.005

Small C, Laycock H. Acute postoperative pain management. Br J Surg. 2020;107(2):e70-e80. https://doi.org/10.1002/bjs.1147

DGS. “Feixe de Intervenções” para a Prevenção da Infeção do Local Cirúrgico. In: DGS, editor. dqs@dgs.min-saude.pt2022.

DGS. Prevenção da Infeção do Local Cirúrgico. dqs@dgs.minsaude.pt2013.

Tanner J, Khan D, Aplin C, Ball J, Thomas M, Bankart J. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs. J Hosp Infect. 2009;72(3):243-50.

https://doi.org/10.1016/j.jhin.2009.03.021

Macefield R, Richards HS, Avery KNL, Portal A, Harding R, Reed T, et al. A hospital-integrated symptom monitoring system for patients after discharge following surgery: a pilot study in cancer-related surgery. Trials. 2019;20. https://doi.org/10.1186/s13063-019-3688-6

Anaya DA, Cormier JN, Xing Y, Koller P, Gaido L, Hadfield D, et al. Development and validation of a novel stratification tool for identifying cancer patients at increased risk of surgical site infection. Ann Surg. 2012;255(1):134-9. https://doi.org/10.1097/SLA.0b013e31823dc107

Hari M, Rosenzweig M. Incidence of preventable postoperative readmissions following pancreaticoduodenectomy: implications for patient education. Oncol Nurs Forum. 2012;39(4):408-12. https://doi.org/10.1188/12.ONF.408-412

Shah M, Douglas J, Carey R, Daftari M, Smink T, Paisley A, et al. Reducing ER Visits and Readmissions after Head and Neck Surgery Through a Phone-based Quality Improvement Program. Ann Otol Rhinol Laryngol. 2021;130(1):24-31. https://doi.org/10.1177/0003489420937044

Petherick ES, Dalton JE, Moore PJ, Cullum N. Methods for identifying surgical wound infection after discharge from hospital: a systematic review. BMC Infect Dis. 2006;6:170. https://doi.org/10.1186/1471-2334-6-170

Macefield RC, Reeves BC, Milne TK, Nicholson A, Blencowe NS, Calvert M, et al. Development of a single, practical measure of surgical site infection (SSI) for patient report or observer completion. J Infect Prev. 2017;18(4):170-9. https://doi.org/10.1177/1757177416689724

Peters M.D.J, Godfrey C, McInerney P, Munn Z, Tricco A.C, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E MZE, editor. JBI Reviewer’s Manual, JBI, 20202020.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

https://doi.org/10.1136/bmj.n71

Trotter PB, Norton LA, Loo AS, Munn JI, Voge E, Ah-See KW, et al. Pharmacological and other interventions for head and neck cancer pain: a systematic review. J Oral Maxillofac Surg. 2013;3(4):e1.

https://doi.org/10.5037/jomr.2012.3401

Tola YO, Chow KM, Liang W. Effects of non-pharmacological interventions on preoperative anxiety and postoperative pain in patients undergoing breast cancer surgery: A systematic review.

J Clin Nurs. 2021;30(23-24):3369-84. https://doi.org/10.1111/jocn.15827

Hill BL, Lefkowits C. Strategies for Optimizing Perioperative Pain Management for the Cancer Patient. Surg Oncol Clin N Am. 2021;30(3):519-34. https://doi.org/0.1016/j.soc.2021.02.011

Gordon DB, Dahl JL, Miaskowski C, McCarberg B, Todd K, Paice JA, et al. American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management. Arch Intern Med. 2005;165:1574-80. https://doi.org/10.1001/archinte.165.14.1574

Swarm RA, Paice JA, Anghelescu DL, Are M, Bruce JY, Buga S, et al. Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2019;17(8):977-

https://doi.org/10.6004/jnccn.2019.0038

British Columbia Cancer Agency. Symptom Management Guidelines:PAIN. 2018 [Available from: http://www.bccancer.bc.ca/managing-symptoms-site/Documents/Pain-from-Cancer.pdf.

National Cancer Institute. Cancer Pain Control: Support for People With Cancer. 2019. [Available from: https://www.cancer.gov/publications/patient-education/pain-control]

American Society. Scars and Wounds. 2020. [Available from:

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/hair-skin-nails/scars-and-wounds.html2020]

Cancer research UK . Surgery for cancer - Going home after surgery. 2019 [Available from: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/surgery/long-term-problems]

Cancer Council Australia. Understanding Surgery. A guide for people with cancer, their families and friends 2019. [Available from:https://www.cancer.org.au/assets/pdf/understanding-surgery-booklet]

Nallani R, Fox CC, Sykes KJ, Surprise JK, Fox CE, Reschke AD, et al. Pain Management and Education for Ambulatory Surgery: A Qualitative Study of Perioperative Nurses. J Surg Res. 2021;260:419-27. https://doi.org/10.1016/j.jss.2020.11.001

Mitchell M. Home recovery following day surgery: a patient perspective. Journal of clinical nursing. 2015;24(3-4):415-27. https://doi.org/10.1111/jocn.12615

Chaparro-Diaz L, Rojas MZ, Carreño-Moreno SP. Optimising postoperative discharge plans for patients undergoing surgical treatment for gastric cancer: a literature review. Gastroenterol

Nurs. 2021;19(1):34-40. https://doi.org/10.12968/gasn.2021.19.1.34

Harrison JD, Young JM, Auld S, Masya L, Solomon MJ, Butow PN. Quantifying postdischarge unmet supportive care needs of people with colorectal cancer: a clinical audit. Colorectal Dis. 2011;13(12):1400-6. https://doi.org/10.1111/j.1463-1318.2010.02478.x

Patil JD, Sefen JAN, Fredericks S. Exploring Non-pharmacological Methods for Pre-operative Pain Management. Front Surg. 2022;9:801742. https://doi.org/10.3389/fsurg.2022.801742

Boitano TKL, Sanders LJ, Gentry ZL, Smith HJ, Leath CA, Xhaja A, et al. Decreasing opioid use in postoperative gynecologic oncology patients through a restrictive opioid prescribing algorithm. Gynecol Oncol. 2020;159(3):773-7. https://doi.org/10.1016/j.ygyno.2020.09.014

Choi KS, Jeong YM, Lee E, Kim KI, Yee J, Lee BK, et al. Association of pre-operative medication use with post-surgery mortality and morbidity in oncology patients receiving comprehensive geriatric

assessment. Aging Clin Exp Res. 2018;30(10):1177-85. https://doi.org/10.1007/s40520-018-0904-2

Ellis JL, Ghiraldi EM, Cohn JA, Nitti M, Friedlander JI, Ginzburg S, et al. Prescribing Trends in Post-operative Pain Management After Urologic Surgery: A Quality Care Investigation for Healthcare

Providers. Urology. 2021;153:156-63. https://doi.org/10.1016/j.urology.2020.11.070

Fearon NJ, Benfante N, Assel M, Chesnut GT, Vickers A, Levine M, et al. Standardizing Opioid Prescriptions to Patients After Ambulatory Oncologic Surgery Reduces Overprescription. Jt Comm

J Qual Patient Saf. 2020;46(7):410-6. https://doi.org/10.1016/j.jcjq.2020.04.004

Glaser GE, Kalogera E, Kumar A, Yi J, Destephano C, Ubl D, et al. Outcomes and patient perspectives following implementation of tiered opioid prescription guidelines in gynecologic surgery.

Gynecol Oncol. 2020;157(2):476-81. https://doi.org/10.1016/j.ygyno.2020.02.025

Kay AH, Venn M, Urban R, Gray HJ, Goff B. Postoperative narcotic use in patients with ovarian cancer on an Enhanced Recovery After Surgery (ERAS) pathway. Gynecol Oncol. 2020;156(3):624-8.

https://doi.org/10.1016/j.ygyno.2019.12.018

Ruano A, Garcia-Torres F, Galvez-Lara M, Moriana JA. Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis. J Pain Symptom

Manage. 2022;63(5):e505-e20. https://doi.org/10.1016/j.jpainsymman.2021.12.021

Mohamed Bayoumi MM, Khonji LMA, Gabr WFM. Are nurses utilizing the non-pharmacological pain management techniques in surgical wards? PLoS One. 2021;16(10):e0258668.

https://doi.org/10.1371/journal.pone.0258668

Chan EY, Blyth FM, Nairn L, Fransen M. Acute postoperative pain following hospital discharge after total knee arthroplasty. Osteoarthr Cartil. 2013;21(9):1257-63. https://doi.org/10.1016/j.joca.2013.06.011

Fan M, Chen Z. A systematic review of non-pharmacological interventions used for pain relief after orthopedic surgical procedures. Exp Ther Med. 2020;20(5):36. https://doi.org/10.3892/etm.2020.9163

Sarmento S, Santos K, Dantas J, Silva B, Dantas D, Dantas R. Terapias não farmacológicas no alívio da dor pós-operatória de cirurgias cardíacas: revisão de escopo. Online Braz J Nurs. 2021.

https://doi.org/10.17665/1676-4285.20216494

Clarke HA, Manoo V, Pearsall EA, Goel A, Feinberg A, Weinrib A, et al. Consensus Statement for the Prescription of Pain Medication at Discharge after Elective Adult Surgery. Can J Pain. 2020;4(1):67-85. https://doi.org/10.1080/24740527.2020.1724775

Burhenn P, Olausson J, Villegas G, Kravits K. Guided imagery for pain control. Clin J Oncol Nurs. 2014;18(5):501-3. https://doi.org/10.1188/14.CJON.501-503

Topcu SY, Findik UY. Effect of relaxation exercises on controlling postoperative pain. Pain Manag Nurs. 2012;13(1):11-7. https://doi.org/10.1016/j.pmn.2010.07.006

Engwall M, Duppils GS. Music as a nursing intervention for postoperative pain: a systematic review. J Perianesth Nurs. 2009;24(6):370-83. https://doi.org/10.1016/j.jopan.2009.10.013

Watkins AA, Johnson TV, Shrewsberry AB, Nourparvar P, Madni T, Watkins CJ, et al. Ice packs reduce postoperative midline incision pain and narcotic use: a randomized controlled trial. J Am Coll Surg. 2014;219(3):511-7. https://doi.org/10.1016/j.jamcollsurg.2014.03.057

Komann M, Weinmann C, Schwenkglenks M, Meissner W. Non-Pharmacological Methods and Post-Operative Pain Relief: An Observational Study. Anesth Pain Med. 2019;9(2):e84674.

https://doi.org/10.5812/aapm.84674

Veal FC, Thompson AJ, Perry LJ, Bereznicki LR, Peterson GM. Pain intensity and pain self-management strategies following discharge after surgery: An Australian prospective observational study. J Clin Pharm Ther. 2018;43(1):8-14. https://doi.org/10.1111/jcpt.12584

Pieper B, Sieggreen M, Nordstrom CK, Freeland B, Kulwicki P, Frattaroli M, et al. Discharge Knowledge and Concerns of Patients Going Home With a Wound. J Wound Ostomy Continence

Nurs. 2007;34:245-53. https://doi.org/doi:10.1097/01.won.0000270817.06942.00

Kirkland-Kyhn H, Generao SA, Teleten O, Young HM. Teaching Wound Care to Family Caregivers. Am J Nurs. 2018;118:63-7. https://doi.org/doi:10.1097/01.NAJ.0000530941.11737.1c

Senn B, Mueller MD, Hasenburg A, Blankenstein T, Kammermann B, Hartmann A, et al. Development of a Postsurgical PatientReported Outcome Instrument for Women With Vulvar Neoplasia.

Oncol Nurs Forum. 2012;39(6):E489-E98. https://doi.org/10.1188/12.ONF.E489-E498

Fernandes CS, Magalhães B, Santos C, Galiano JMM. IGestSaúde a mobile application for the self-management of symptoms associated with chemotherapy treatment: Development protocol.

Nurs Pract Today. 2021;8:X-X. https://doi.org/10.18502/npt.v8i2.5126

Downloads

Publicado

04-12-2023

Como Citar

1.
Almeida AM, Martins T, Lima L. Orientações terapêuticas da autogestão da dor e ferida cirúrgica após alta hospitalar: uma scoping review. Onco.News [Internet]. 4 de Dezembro de 2023 [citado 10 de Dezembro de 2024];(47):e0207. Disponível em: https://onco.news/index.php/journal/article/view/207

Edição

Secção

Artigos de Revisão