DOI 10.35381/cm.v8i1.628
Control y el manejo del dolor en enfermería pediátrica
Control and management of pain in pediatric nursing
Virginia Esmeralda Pincay-Pin
Universidad Estatal del Sur de Manabí, Jipijapa
Ecuador
https://orcid.org/0000-0001-8776-5433
Mónica Patricia Mastarreno-Cedeño
monica.mastarreno@utm.edu.ec
Universidad Técnica de Manabí, Portoviejo
Ecuador
https://orcid.org/0000-0003-3572-7958
Ángela Rosa Briones-Mera
angela.briones@utm.edu.ec
Universidad Técnica de Manabí, Portoviejo
Ecuador
https://orcid.org/0000-0002-2233-3688
Leonela Lissett Ponce-Lino
leytopl@hotmail.com
Universidad Estatal del Sur de Manabí, Jipijapa
Ecuador
https://orcid.org/0000-0002-0809-2929
Recibido: 15 de septiembre 2021
Revisado: 10 de noviembre 2021
Aprobado: 15 de diciembre 2021
Publicado: 01 de enero de 2022
RESUMEN
El objetivo general de la investigación fue realizar un análisis sobre el control y el manejo del dolor en enfermería pediátrica. Se apoyó en la metodología cuantitativa, desde el paradigma positivista, en virtud de que se obtuvieron datos descriptivos desde la recolección de información con el uso del método documental-bibliográfico, analizando artículos arbitrados, tesis y documentos, lo que permitió el desarrollo del cuerpo teórico relacionado al tema de estudio. Se concluye, que el control, el manejo del dolor en enfermería pediátrica, es una acción que el personal de salud gestiona diariamente en los centros de salud con el fin de brindar una atención integral a los niños que asisten en busca de cuidados. El profesional de enfermería debe manejar las orientaciones y escalas para la certificación de dolor y así mejorar los procedimientos para disminuir los dolores en pacientes menores, de los diferentes servicios que presta el sistema de salud.
Descriptores: Enfermedad; personal médico; pediatría. (Tesauro UNESCO).
ABSTRACT
The general objective of the research was to perform an analysis on the control and management of pain in pediatric nursing. It was based on the quantitative methodology, from the positivist paradigm, by virtue of the fact that descriptive data were obtained from the collection of information with the use of the documentary-bibliographic method, analyzing refereed articles, theses and documents, which allowed the development of the theoretical body. Related to the subject of study. It is concluded that control, pain management in pediatric nursing, is an action that health personnel manage daily in health centers in order to provide comprehensive care to children who seek care. The nursing professional must manage the guidelines and scales for the certification of pain and thus improve the procedures to reduce pain in minor patients, of the different services provided by the health system.
Descriptors: Disease; medical personnel; pediatrics. (UNESCO Thesaurus).
INTRODUCTION
The attention that the nursing professional presents in the health dispensing centers is of the utmost importance, since they provide the necessary care for the channeling and treatment of the pain of children who suffer from some pain, in this regard Córdova Jaquez et al. (2012), state:
Nursing plays an important role in pain units as it is the bridge between the patient, family members and the rest of the health professionals. Acts as an observer and intervenes in the comprehensive control of the patient, in the education of the family, with health personnel unfamiliar with pain control, controls and monitors therapeutic readjustment and administration routes, coordinates tasks and is responsible daily care of the patient in close collaboration with the families (p.288).
In this sense, their participation in the control and management of pain in pediatric nursing is of vital importance, to guarantee optimal and timely care for the smallest patients who require special care, since many times due to their age they do not They can express what they feel or suffer. The relief of pain and suffering is considered one of the main rights of the patient, and one of the fundamental responsibilities of the professional practice of Nursing. (Rodríguez Hernández, Fajardo Villarroel and Peña Jiménez, 2016, p.402). Likewise, De los Reyes Corrales (2017) indicates that:
The experience of pain in children is an aspect that is still under study today and trying to improve its assessment, for which there are multiple and diverse scales. They allow children, regardless of their age, evolutionary development, or clinical situation, with or without the ability to verbally express the pain experienced, to be properly assessed. (p.9)
For this assessment, qualified personnel and a professional who is capable of channeling the patient's needs to calm their pain must be counted on. It is necessary for the health team to recognize that different diseases, health conditions, treatments or diagnostic procedures can trigger pain, in order to detect it and treat it in a timely manner. (Zunino et al. 2018, p.68).
However, Llorente Pérez (2015) states that:
Childhood pain has been, for many years, a neglected issue due to the lack of knowledge of nurses, doctors and other health professionals. Throughout history, the false idea has prevailed that a development superior to that of the child is necessary to experience and respond to pain. (p.4)
At the same time, Guerrero Márquez, et al. (2021) indicate that, on the other hand, there are several factors that are associated with ineffective pain management in pediatric emergency services (PEDs).
The main ones are:
• Related to health institutions: lack of obligation to implement their evaluation from the very arrival of the patient to the SUP, lack of protocols for their effective management, lack of records in the medical records of their evaluation and follow-up that make effective control difficult. of patients and the lack of institutional support for training professionals and raising awareness of the problem.
• Related to the dynamics of the emergency services: with peaks in patient oversaturation, often linked to staff shortages. Together, this leads to deficiencies and delays in the assessment, management, and treatment of patients' pain.
• Related to professionals: lack of training, persistence of myths and misconceptions about pediatric pain, fear of the side effects of some drugs, distrust in patients' self-assessment of pain.
• Related to the pediatric patient: developmental and communication factors in neonates and younger children, previous painful experiences, degree of anxiety, fear, and parental support and presence. (p.2)
Hence the importance of having a team of paramedics with special characteristics in patient care and the knowledge to guarantee a good diagnosis and pain management, therefore, the role of nurses in pain management is justified in the management of pain. humanized and person-centered care, based on adequate assessment, intervention, follow-up, prevention and pain reduction (Parra-Giordano et al., 2020, p. 89).
In this sense, Reyes Guevara (2017) ratifies what was previously stated when stating:
It should be remembered that Nursing is the health professional who spends the most time with the patient, therefore, they must be able to identify pain in those who suffer from it, make appropriate use of assessment instruments, work optimally with the multidisciplinary team, initiate actions that alleviate it and check the effectiveness of the methods used. (p.10)
Pain has a relevance at a health, social, economic and family level, it is a very common symptom that leads to consult the emergency rooms of hospitals or health centers very frequently, hence the following investigation is presented whose general objective is to carry out an analysis on the control and management of pain in pediatric nursing.
METHODOLOGY
For the development of this research, it is based on the quantitative methodology, from the positivist paradigm, since descriptive data originating from the data collection are obtained, from the documentary-bibliographic method, refereed articles, theses and documents were analyzed, which allowed developing the theoretical body of this work. In addition, the inductive-deductive method is applied, which suggests that in order to find a truth, the facts must be sought and not based on mere speculation, in addition to starting from general statements to reach specific ones (Dávila, 2006). The researchers organized an investigative process, whose study population was mainly bibliographic documents related to the control and management of pain in pediatric nursing.
RESULTS
After the documentary-bibliographic review, the results of said search and respective analysis related to the subject of study are presented below.
Table 1.
Approaches to the control and management of pain in pediatric nursing.
|
Autor (es)/año |
Enfoque |
|
Sánchez M, Pernía V, Calatrava J. (2005) |
Pain is the most complex human experience and despite the importance of this symptom it is frequently undervalued, only 5% of nursing journals address the issue of pain and its treatment, it is also noted that nursing staff do not use scales for the measurement of post-operative pain, the absence of studies that reflect the degree of patient satisfaction with respect to the treatment of their pain and the little that nursing has taught us about the assessment and management of pain. |
|
Chavarro, C., Triana, L., y García, X. (2017) |
The main objective of the care staff is to support the medical team in managing symptoms, in addition to providing the family with tools that make the doctor's orders more understandable. Also, in conjunction with the social worker, it is responsible for facilitating access to other health services (examples: home care and services such as ambulance transfer). (p.85) |
|
Ortega-López, et al., (2018) |
Education in pain management is essential to give nursing staff a starting point for pain management, which is why the importance of including it in study programs and continuing education for nursing staff has been pointed out , since it does not require new strategies; but of the educational preparation, which leads the nursing staff to the use of scientific knowledge in their daily practice. (p.30) |
Preparation: The authors.
According to the authors, three aspects of utmost importance can be visualized, which are described below:
• Undervaluation of pain by medical journals and the lack of use of scales to measure pain.
• Staff support providing tools to family members facilitating access to health services.
• Training in pain management through education to train health personnel.
Diagnostic and therapeutic protocols in pediatric emergencies
A fundamental aspect of pain assessment is that it be personalized and that the same scale or measurement instrument be used with each patient. This will lead to better communication between children and health professionals and therefore to a better understanding of the problem and better pain management since, in this way, the monitoring of the effectiveness of the treatment is guaranteed and/or or non-pharmacological measures that have been initiated. A simple way to achieve this is to institutionalize in each center a suitable scale for each age range and/or cognitive status and that these are well known and used by all professionals.
In cooperative patients from 3-4 years of age, whenever possible, we will let the child himself assess his pain using self-report scales. The minimum information that must be collected must contain: the location, intensity and characteristics of the pain. (Guerrero Márquez, et al., 2021)
CONCLUSIÓN
Consulted of: Diagnostic and Therapeutic Protocols in Pediatric Emergencies. Guerrero Marquez, et al. (2021).
The control and management of pain in pediatric nursing is an action that health personnel manage daily in health centers in order to provide comprehensive care to children who seek care, precisely nursing plays a great role, since they take care of the children and their relatives from the first moment, providing them with the first care, in addition to the orientations for the corresponding treatment. The nursing professional must manage the guidelines and scales for the certification of pain and thus improve the procedures to reduce pain in minor patients, of the different services provided by the health system.
INTEREST CONFLICT
The authors declare that they have no conflict of interest in the publication of the article.
FINANCING
Self financed.
GRATITUDE
To the State University of South Manabí; for supporting the development of research.
CONSULTED REFERENCES
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