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Yetişkin Yoğun Bakım Hastasında Ağrının Değerlendirilmesi

Year 2012, Volume: 16 Issue: 2, 57 - 65, 31.12.2014

Abstract

Yoğun bakım ünitelerinde son yıllarda modern teknolojik gelişmelerle, hastaların tedavi ve bakımı gerçekleştirilmesine karşın, hastaların deneyimlediği ağrı yeterince önemsenmemektedir. Buna karşın, yoğun bakım hastaları için ağrı ciddi bir sorun olup yüksek oranda görülmektedir.
Ağrı derecesinin değerlendirmesinde en güvenilir gösterge hastanın kendi ağrı ifadesidir. Ancak, yoğun bakımda özellikle de entübe ve sedasyon altında olan hasta ağrısını ifade edememektedir. Bunedenle yoğun bakım hastalarında ağrı değerlendirilmesinde sözlü olmayan yanıta, davranışsal ifadelere
ve fizyolojik göstergelere yer veren ölçeklerin kullanılması anlamlı ve önemlidir. Bu makalede yoğun bakım hastalarında ağrı değerlendirilmesinde kullanılabilecek bu ölçeklere yer verilmektedir.

References

  • 1. Gunning K, Rowan K. ABC of intensive care: Outcome data and scoring systems. BMJ 1999;319(7204):241-4.
  • 2. Esen H, Öntürk ZK, Badır A, Aslan FE. Entübe ve sedatize yoğun bakım hastalarının pozisyon verme ve aspirasyon sırasındaki ağrı davranışları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2010;1(2):89-93.
  • 3. Gélinas C, Fortier M, Viens C, Fillion l, Puntillo K. Pain assessment and management in critically ill intubated patients: a retrospective study. Am J Crit Care 2004;13(2):126-35.
  • 4. Puntillo KA, Stannard D, Mias-kowski C, Kehrle K, Gleeson S. Use of a pain assessment and intervention notation (P.A.I.N.) tool in critical care nursing practice: nurses' evaluations. Heart Lung 2002;31(4):303-14.
  • 5. Bruster S, Jarman B, Bosanquet N, Weston D, Erens R, Delbanco TL. National survey of hospital patient. BMJ 1994;309(6968):1542- 6.
  • 6. Puntillo KA. Pain experiences of intensive care unit patients. Heart Lung 1990;19(5):526-33.
  • 7. Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001; 29(12):2258-63.
  • 8. Badır A, Eti Aslan F. Yoğun bakım ünitelerinde çok konuşulan, az sorgulanan bir konu: Ağrı. Yoğun Bakım Hemşireler Dergisi 2003;7(2): 100-8. 9. Feldt K. The chek list of nonverbal pain indicators. Pain Manage Nur 2000;1(1):13-20.
  • 10. Pudas-Tähkä SM, Axelin A, Aantaa R, Lund V, Salanterä S. Pain assessment tools for unconscious or sedated intensive care patients: a systematic review. J Adv Nurs 2009;65(5):946-56.
  • 11. Siffleet J, Young J, Nikoletti S, Shaw T. Patients’ self-report of procedural pain in the intensive care unit. J Clin Nurs 2007;16(11): 2142-8.
  • 12. Blakely WP, Page GG. Pathophysiology of pain in critically ill patients. Crit Care Nurs Clin North Am 2001;13(2):167-79.
  • 13. Summer GJ, Puntillo KA. Management of surgical and procedural pain in a critical care setting. Crit Care Nurs Clin North Am 2001;13(2):233-42.
  • 14. Stanik-Hutt JA. Protocols for practice: Applying research at the bedside. Critical Care Nurse 1998;18(5):85-8.
  • 15. Chong CA, Burchett KR. Pain management in the critical care. CEPD Rewiews 2003;3(6): 183-6.
  • 16. Sarıcaoğlu F, Akıncı SB, Dal D, Aypar Ü. Yoğun bakım hastalarında analjezi ve sedasyon. Hacettepe Tıp Dergisi 2005;36(2): 86-90.
  • 17. Blenkharn A, Faughnan S, Morgan A. Developing a pain assessment tool for use by nurses in an adult intensive care unit. Intensive Crit Care Nurs 2002;18(6):332-41.
  • 18. Cheever KH. Reducing the effects of acute pain in critically ill patients. Dimens Crit Care Nurs 1999;18(3):14-23.
  • 19. Handcock H. The complexity of pain assessment and management in the first 24 hours after cardiac surgery: implications for nurses. Intensive Crit Care Nurs 1996; 12(6):346-53.
  • 20. (http://tr.jointcommissioninternational.org/entr/), (JCAHO, 1999-2000).
  • 21. Puntillo KA. Dimensions of procedural pain and its analgesic management in critically ill surgical patients. Am J Crit Care 1994; 3(2):116-22.
  • 22. Desbiens NA, Wu AW, Broste SK, Wenger NS, Connors AF, Lynn J, et al. Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. Crit Care Med 1996;24(12):1953-61.
  • 23. Ferguson J, Gilroy D, Puntillo K. Dimensions of pain and analgesic administration associated with coronary artery bypass grafting in an Australian intensive care. J Adv Nurs 1997;26(6):1065-72.
  • 24. Carroll KC, Atkins PJ, Herold GR, Mlcek CA, Shively M, Clopton P, et al. Pain assessment and management in critically ill postoperative and trauma patients: a multisite study. Am J Crit Care 1999;8(2):105-17.
  • 25. Chanques G, Jaber S, Barbotte E, Violet S, Sebbane M, Perrigault PF, et al. Impact of systematic evaluation of pain and agitation in an intensive care unit. Crit Care Med 2006;34(6):1691-9.
  • 26. Kabes AM, Graves JK, Norris J. Further validation of the nonverbal pain scale in intensive care patients. Crit Care Nurse 2009;29(1):59- 66. 27. Aslan FE. [The assessment methods of pain]. C.Ü. Hemşirelik Yüksekokulu Dergisi 2002;6 (1):9-16.
  • 28. Shannon K, Bucknall T. Pain assessment in critical care: what have we learnt from research. Intensive Crit Care Nurs 2003;19(3): 154-62. 29. Pasero C. Pain in the critically ill patient. J Perianesth Nurs 2003;18(6):422-5.
  • 30. Erdek MA. Pain in the critically ill patient. Techniqes in Regional Anesthesia and Pain Management 2003;7(3):161-5.
  • 31. Eti-Aslan F, Badir A, Selimen D. How do intensive care nurses assess patients’ pain? Nurs Crit Care 2003;8(2):62-7.
  • 32. Payen JF, Bosson JL, Chanques G, Mantz J, Labarere J; DOLOREA Investigators. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 2009;111(6): 1308-16.
  • 33. Stanik-Hutt JA, Soeken KL, Belcner AE, Fontaine DK, Gift A. Pain experience of traumatically injured patients in a critical care setting. Am J Crit Care 2001;10(4):252-9.
  • 34. Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioural Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs 2006;22(1):32- 9. 35. Pasero C. Pain in the critically illpatient. J Perianesth Nurs 2003;18(6):422-5.
  • 36. Cheever K. Reducing the effects ofacute pain in critically ill patients. Dimens Crit Care Nurs 1999;18(3):14-23.
  • 37. Brown AK, Chiristo PJ, W CL. Strategies for postoperative pain management. Best Pract Res Clin Anaesthesiol 2004;18(4):703-17.
  • 38. Pasero C, McCaffery M. Pain Ratings: the fifth vital signs. Am J Nurs 1997;97(2):15-6.
  • 39. Pasero C, McCaffery M. When patients can't report pain. Assessing patients with communication difficulties. Am J Nurs 2000;100(9): 22-3.
  • 40. Herr K, Coyne PJ, Key T, Manworren R, Mc- Caffery M, Merkel S, et al; American Society for Pain Management Nursing. Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Manag Nurs 2006;7(2):44-52.
  • 41. Aïssaoui Y, Zeggwagh AA, Zekraoui A, Abidi K, Abouqal R. Validation of a behavioral pain scale in critically ill, sedated, and mechanically ventilated patients. Anesth Analg 2005;101(5): 1470-6.
  • 42. Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioural Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs 2006;22(1):32-9.
  • 43. Ahlers SJ, van der Veen AM, van Dijk M, Tibboel D, Knibbe CA. The use of the Behavioral Pain Scale to assess pain in conscious sedated patients. Anesth Analg 2010;110(1): 127-33.
  • 44. Puntillo KA, Stannard D, Miaskowski C, Kehrle K, Gleeson S. Use of a pain assessment and intervention notation (P.A.I.N.) tool in critical care nursing practice: nurses' evaluations. Heart Lung 2002;31(4):303-14.
  • 45. Karayurt Ö, Akyol Ö. [Assesment of pain in intensive care patients]. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi 2008;11(4): 96-104.
  • 46. Thoung M. Sedation and analgesia assessment tools in ICU patients. Ann Fr Anesth Reanim 2008;27(7-8):581-95.
  • 47. Devlin JW1, Boleski G, Mlynarek M, Nerenz DR, Peterson E, Jankowski M, et al. Motor Activity Assessment Scale: a valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit. Crit Care Med 1999;27(7):1271-5.
  • 48. Odhner M, Wegman D, Freeland N, Steinmetz A, Ingersoll GL. Assessing pain control in nonverbal critically ill adults. Dimens Crit Care Nurs 2003;22(6):260-7.
  • 49. Kabes AM, Graves JK, Norris J. Further validation of the nonverbal pain scale in intensive care patients. Crit Care Nurse 2009;29(1):59- 66.
  • 50. Puntillo KA. Stitch, stitch. Creating an effective pain management program for Critically III Patients. Am J Crit Care 1997;6(4):259- 60.
  • 51. Blenkharn A, Faughnan S, Morgan A. Developing a pain assessment tool for use by nurses in an adult intensive care unit. Intensive Crit Care Nurs 2002;18(6):332-41.
  • 52. Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006;15(4):420-7.
  • 53. Gélinas C, Fillion L, Puntillo KA. Item selection and content validity of the Critical-Care Pain Observation Tool for non-verbal adults. J Adv Nurs 2009;65(1):203-16.
  • 54. Gèlinas C, Fillion L, Puntillo KA, Viens C. Fortier M. Validation of critical- care pain observation tool in adult patients. Am J Crit Care 2006;15(4):420-7.
  • 55. Klein DG, Dumpe M, Katz E, Bena J. Pain assessment in the intensive care unit: development and psychometric testing of the nonverbal pain assessment tool. Heart Lung 2010;39(6):521-8.
Year 2012, Volume: 16 Issue: 2, 57 - 65, 31.12.2014

Abstract

References

  • 1. Gunning K, Rowan K. ABC of intensive care: Outcome data and scoring systems. BMJ 1999;319(7204):241-4.
  • 2. Esen H, Öntürk ZK, Badır A, Aslan FE. Entübe ve sedatize yoğun bakım hastalarının pozisyon verme ve aspirasyon sırasındaki ağrı davranışları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2010;1(2):89-93.
  • 3. Gélinas C, Fortier M, Viens C, Fillion l, Puntillo K. Pain assessment and management in critically ill intubated patients: a retrospective study. Am J Crit Care 2004;13(2):126-35.
  • 4. Puntillo KA, Stannard D, Mias-kowski C, Kehrle K, Gleeson S. Use of a pain assessment and intervention notation (P.A.I.N.) tool in critical care nursing practice: nurses' evaluations. Heart Lung 2002;31(4):303-14.
  • 5. Bruster S, Jarman B, Bosanquet N, Weston D, Erens R, Delbanco TL. National survey of hospital patient. BMJ 1994;309(6968):1542- 6.
  • 6. Puntillo KA. Pain experiences of intensive care unit patients. Heart Lung 1990;19(5):526-33.
  • 7. Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001; 29(12):2258-63.
  • 8. Badır A, Eti Aslan F. Yoğun bakım ünitelerinde çok konuşulan, az sorgulanan bir konu: Ağrı. Yoğun Bakım Hemşireler Dergisi 2003;7(2): 100-8. 9. Feldt K. The chek list of nonverbal pain indicators. Pain Manage Nur 2000;1(1):13-20.
  • 10. Pudas-Tähkä SM, Axelin A, Aantaa R, Lund V, Salanterä S. Pain assessment tools for unconscious or sedated intensive care patients: a systematic review. J Adv Nurs 2009;65(5):946-56.
  • 11. Siffleet J, Young J, Nikoletti S, Shaw T. Patients’ self-report of procedural pain in the intensive care unit. J Clin Nurs 2007;16(11): 2142-8.
  • 12. Blakely WP, Page GG. Pathophysiology of pain in critically ill patients. Crit Care Nurs Clin North Am 2001;13(2):167-79.
  • 13. Summer GJ, Puntillo KA. Management of surgical and procedural pain in a critical care setting. Crit Care Nurs Clin North Am 2001;13(2):233-42.
  • 14. Stanik-Hutt JA. Protocols for practice: Applying research at the bedside. Critical Care Nurse 1998;18(5):85-8.
  • 15. Chong CA, Burchett KR. Pain management in the critical care. CEPD Rewiews 2003;3(6): 183-6.
  • 16. Sarıcaoğlu F, Akıncı SB, Dal D, Aypar Ü. Yoğun bakım hastalarında analjezi ve sedasyon. Hacettepe Tıp Dergisi 2005;36(2): 86-90.
  • 17. Blenkharn A, Faughnan S, Morgan A. Developing a pain assessment tool for use by nurses in an adult intensive care unit. Intensive Crit Care Nurs 2002;18(6):332-41.
  • 18. Cheever KH. Reducing the effects of acute pain in critically ill patients. Dimens Crit Care Nurs 1999;18(3):14-23.
  • 19. Handcock H. The complexity of pain assessment and management in the first 24 hours after cardiac surgery: implications for nurses. Intensive Crit Care Nurs 1996; 12(6):346-53.
  • 20. (http://tr.jointcommissioninternational.org/entr/), (JCAHO, 1999-2000).
  • 21. Puntillo KA. Dimensions of procedural pain and its analgesic management in critically ill surgical patients. Am J Crit Care 1994; 3(2):116-22.
  • 22. Desbiens NA, Wu AW, Broste SK, Wenger NS, Connors AF, Lynn J, et al. Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. Crit Care Med 1996;24(12):1953-61.
  • 23. Ferguson J, Gilroy D, Puntillo K. Dimensions of pain and analgesic administration associated with coronary artery bypass grafting in an Australian intensive care. J Adv Nurs 1997;26(6):1065-72.
  • 24. Carroll KC, Atkins PJ, Herold GR, Mlcek CA, Shively M, Clopton P, et al. Pain assessment and management in critically ill postoperative and trauma patients: a multisite study. Am J Crit Care 1999;8(2):105-17.
  • 25. Chanques G, Jaber S, Barbotte E, Violet S, Sebbane M, Perrigault PF, et al. Impact of systematic evaluation of pain and agitation in an intensive care unit. Crit Care Med 2006;34(6):1691-9.
  • 26. Kabes AM, Graves JK, Norris J. Further validation of the nonverbal pain scale in intensive care patients. Crit Care Nurse 2009;29(1):59- 66. 27. Aslan FE. [The assessment methods of pain]. C.Ü. Hemşirelik Yüksekokulu Dergisi 2002;6 (1):9-16.
  • 28. Shannon K, Bucknall T. Pain assessment in critical care: what have we learnt from research. Intensive Crit Care Nurs 2003;19(3): 154-62. 29. Pasero C. Pain in the critically ill patient. J Perianesth Nurs 2003;18(6):422-5.
  • 30. Erdek MA. Pain in the critically ill patient. Techniqes in Regional Anesthesia and Pain Management 2003;7(3):161-5.
  • 31. Eti-Aslan F, Badir A, Selimen D. How do intensive care nurses assess patients’ pain? Nurs Crit Care 2003;8(2):62-7.
  • 32. Payen JF, Bosson JL, Chanques G, Mantz J, Labarere J; DOLOREA Investigators. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 2009;111(6): 1308-16.
  • 33. Stanik-Hutt JA, Soeken KL, Belcner AE, Fontaine DK, Gift A. Pain experience of traumatically injured patients in a critical care setting. Am J Crit Care 2001;10(4):252-9.
  • 34. Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioural Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs 2006;22(1):32- 9. 35. Pasero C. Pain in the critically illpatient. J Perianesth Nurs 2003;18(6):422-5.
  • 36. Cheever K. Reducing the effects ofacute pain in critically ill patients. Dimens Crit Care Nurs 1999;18(3):14-23.
  • 37. Brown AK, Chiristo PJ, W CL. Strategies for postoperative pain management. Best Pract Res Clin Anaesthesiol 2004;18(4):703-17.
  • 38. Pasero C, McCaffery M. Pain Ratings: the fifth vital signs. Am J Nurs 1997;97(2):15-6.
  • 39. Pasero C, McCaffery M. When patients can't report pain. Assessing patients with communication difficulties. Am J Nurs 2000;100(9): 22-3.
  • 40. Herr K, Coyne PJ, Key T, Manworren R, Mc- Caffery M, Merkel S, et al; American Society for Pain Management Nursing. Pain assessment in the nonverbal patient: position statement with clinical practice recommendations. Pain Manag Nurs 2006;7(2):44-52.
  • 41. Aïssaoui Y, Zeggwagh AA, Zekraoui A, Abidi K, Abouqal R. Validation of a behavioral pain scale in critically ill, sedated, and mechanically ventilated patients. Anesth Analg 2005;101(5): 1470-6.
  • 42. Young J, Siffleet J, Nikoletti S, Shaw T. Use of a Behavioural Pain Scale to assess pain in ventilated, unconscious and/or sedated patients. Intensive Crit Care Nurs 2006;22(1):32-9.
  • 43. Ahlers SJ, van der Veen AM, van Dijk M, Tibboel D, Knibbe CA. The use of the Behavioral Pain Scale to assess pain in conscious sedated patients. Anesth Analg 2010;110(1): 127-33.
  • 44. Puntillo KA, Stannard D, Miaskowski C, Kehrle K, Gleeson S. Use of a pain assessment and intervention notation (P.A.I.N.) tool in critical care nursing practice: nurses' evaluations. Heart Lung 2002;31(4):303-14.
  • 45. Karayurt Ö, Akyol Ö. [Assesment of pain in intensive care patients]. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi 2008;11(4): 96-104.
  • 46. Thoung M. Sedation and analgesia assessment tools in ICU patients. Ann Fr Anesth Reanim 2008;27(7-8):581-95.
  • 47. Devlin JW1, Boleski G, Mlynarek M, Nerenz DR, Peterson E, Jankowski M, et al. Motor Activity Assessment Scale: a valid and reliable sedation scale for use with mechanically ventilated patients in an adult surgical intensive care unit. Crit Care Med 1999;27(7):1271-5.
  • 48. Odhner M, Wegman D, Freeland N, Steinmetz A, Ingersoll GL. Assessing pain control in nonverbal critically ill adults. Dimens Crit Care Nurs 2003;22(6):260-7.
  • 49. Kabes AM, Graves JK, Norris J. Further validation of the nonverbal pain scale in intensive care patients. Crit Care Nurse 2009;29(1):59- 66.
  • 50. Puntillo KA. Stitch, stitch. Creating an effective pain management program for Critically III Patients. Am J Crit Care 1997;6(4):259- 60.
  • 51. Blenkharn A, Faughnan S, Morgan A. Developing a pain assessment tool for use by nurses in an adult intensive care unit. Intensive Crit Care Nurs 2002;18(6):332-41.
  • 52. Gélinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care 2006;15(4):420-7.
  • 53. Gélinas C, Fillion L, Puntillo KA. Item selection and content validity of the Critical-Care Pain Observation Tool for non-verbal adults. J Adv Nurs 2009;65(1):203-16.
  • 54. Gèlinas C, Fillion L, Puntillo KA, Viens C. Fortier M. Validation of critical- care pain observation tool in adult patients. Am J Crit Care 2006;15(4):420-7.
  • 55. Klein DG, Dumpe M, Katz E, Bena J. Pain assessment in the intensive care unit: development and psychometric testing of the nonverbal pain assessment tool. Heart Lung 2010;39(6):521-8.
There are 51 citations in total.

Details

Primary Language Turkish
Subjects Nursing
Journal Section REVIEW
Authors

Esra Akın Korhan

Publication Date December 31, 2014
Published in Issue Year 2012 Volume: 16 Issue: 2

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