Pain assesment in patients in intensive care unit

Teoretična izhodišča: Bolečina je vedno neprijetna izkušnja, ki nam sporoča, neko dogajanje v našem telesu. Že nekaj let se obravnava kot peti vitalni znak, nezdravljena bolečina pa lahko pušča dolgoročne posledice. Ocena bolečine je pogosto odvisna od sposobnosti ocenjevalca. Najbolj zanesljiva ocena bolečine je tista, ki jo poda pacient sam. Za oceno bolečine je na voljo veliko število različnih lestvic, ki nam omogočajo, da bolečina postane vidna. To je še posebej pomembno pri tistih pacientih, ki ne morejo sami poročati o bolečini. Ker pa se bolečina izraža kot subjektivna izkušnja, lahko pri ocenjevanju prihaja do pomot. Metodologija: Pri pisanju diplomskega dela smo uporabili opisno oziroma deskriptivno metodo dela. Literatura je bila pridobljena s pomočjo podatkovnih baz PubMed in Cinahl. Uporabljen je bil sistematični pregled strokovne ter znanstvene literature. V analizo smo vključili 13 raziskav. Rezultati: Pri kritično bolnih neodzivnih pacientih in pacientih, ki ne morejo komunicirati se za oceno bolečine priporočata in največkrat uporabljata opazovalna ter vedenjska lestvica za oceno bolečine. Za oceno stopnjo budnosti se uporablja skala za merjenje stopnje agitacije in sedacije. Za čimbolj učinkovito zdravljenje je potrebno kontinuirano ocenjevanje in dokumentiranje in poznavanje orodij za ocenjevanje. Diskusija in zaključek: Ocenjevalne lestvice za ocenjevanje bolečine kritično bolnih so relativno nov pripomoček, zato so potrebne še nadaljnje študije, še posebej za tiste skupine pacientov, pri katerih so raziskave pokazale določena odstopanja. V tej smeri delujejo tudi novejše metode ocenjevanja s sodobnimi tehnikami, ki avtomatsko ocenjujejo in aplicirajo ustrezno analgetično dozo. Medicinska sestra ostaja ključna pri vrednotenju bolečine pacienta, zato potrebuje nenehno usposabljanje in izobraževanje.Theoretical starting points: Pain is always an unpleasant experience, which tells us that something is happening in our body. For several years it has been considered as a fifth vital sign. Untreated pain can leave long-term consequences. The assessment of pain often depends on the ability of the assessor. The most reliable assessment of pain is the one given by the patient himself. A large number of different scales are available for evaluation of pain and they allow us to make the pain visible. This is important especially by patients who can not verbalize their pain. However, mistakes can occur in the assessment, as pain is a subjective experience. Methodology: In writing the thesis, we used a descriptive method of work. The literature was obtained using the PubMed and Cinahl databases. We used a systematic overview of professional and scientific literature. 13 studies were included in the analysis. Results: Observational and behavioral pain scales are the most commonly used and recommended for critically ill unresponsive patients and patients who can not communicate. Agitation-Sedation Scale is used to estimate the degree of patient\u27s alertness. For the most effective treatment, continuous evaluation and documentation and knowledge of evaluation tools are required. Discussion and conclusion: Evaluation scales for assessing critically ill patients are a relatively new tool. Further studies are needed, especially for those groups of patients whose studies have shown deviations due to the use of an inappropriate scales. New methods of pain assessment with modern techniques that automatically evaluate the appropriate analgesic dose are also developing. Nurses are in position to evaluate the patient\u27s pain, and therefore their constant training and education is required