Phantom pain management after limb amputation in community care

Izhodišča: Zaradi neustrezne obravnave fantomske bolečine in lajšanja le-te, se lahko kakovost življenja drastično spremeni na slabše. Okrnjeno je gibanje, slabše je zaznavanje okolice, neprimerno sprejemanje zdravstvenega stanja lahko privede tudi do psihičnih motenj ali celo samopoškodovanja. Namen našega diplomskega dela je raziskati pristope lajšanja fantomske bolečine v patronažnem varstvu. Raziskovalne metode: V diplomskem delu je bila uporabljena deskriptivna metoda ter kvalitativna metodologija. V empiričnem delu smo izvedli študijo primera. Metoda zbiranja podatkov je bila intervju, ki je potekal na pacientovem domu. Vprašanja so bila odprtega tipa in sestavljena po modelu 14. življenjskih aktivnostih Virginie Henderson. Zbrane podatke smo analizirali z deskriptivno metodo. Rezultati: Gospod L. S. je star 79 let, živi v hiši z ženo. Fantomsko bolečino ima od amputacije desne noge. Amputacija je bila nadkolenska. Za lajšanje bolečine ima predpisano terapijo. Pri vsakodnevnih aktivnostih potrebuje pomoč. Proteze ne nosi že skoraj 20 let. Ima tudi sladkorno bolezen tipa 2. Diplomirana medicinska sestra v patronažnem varstvu je pri gospodu izvaja negovalno intervencijo nege rane - krna, 3 krat na teden po naročilu osebne zdravnice. Poskusila je tudi z mazanjem in masažo noge ter krna, vendar fantomska bolečina ostaja. Drugih tehnik se ni posluževala. Diskusija in zaključek: Rezultati so pokazali, da je diplomirana medicinska sestra v patronažnem varstvu poskušala lajšati fantomsko bolečino pri pacientu. Izvajala je masažo in mazanje okončine ter prevez rane – krna. Prišli smo do zaključka, da načini lajšanja fantomske bolečine, ki jih je patronažna medicinska sestra izvajala niso bili uspešni. V takšnem primeru bi morala preizkusiti več različnih nefarmakoloških tehnik.Introduction: Because of the inadequate treatment of phantom pain and the relief of it, the quality of life can drastically change to worse in all areas. The movement is reduced, the perception of the environment is poorer and inappropriate reception of the condition can lead to psychological disorders or even self-harm. The purpose of our diploma thesis is to explore approaches to alleviating phantom pain in community care. Methods: In the diploma thesis we used descriptive methods and qualitative research metod based on interpretivism. In the theoretical part, the method of reviewing Slovene and foreign literature was used. In the empirical part, a case study was carried out. The method of data collection was an interview that took place at the patient\u27s home. The collected data were analyzed using a descriptive method. Results: Mr. L. S. is 79 years old, living in a house with his wife. He has phantom pain in his right leg since the amputation and needs help with his daily activities. Amputation was made above knee. He has a prescribtion for pain relieve medications. The prosthesis was not worn for almost 20 years. He has diabetes type 2 and is taking medications for it. Most common techniques the community nurse used with patient L. S. was the wound management, which she did 3 times a week at the request of a doctor. She changed the dressings and also clean it with water weekly. She tried with application of the ointment and massaging his leg and stump, but it did not help. She did not try other techniques. Discussion and conclusions: Results showed, that the community nurse tried managing the pain. She performed massage, ointment application and wound dressing. We came to the conclusion that the methods of phantom pain alleviation performed by the community nurse were not successful. In that case, she would have to try several different non-pharmacological techniques