Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220037-en
Brazilian Journal of Pain
Review Article

Characterization of pain in hospitalized patients: narrative review

Caracterização da dor em pacientes hospitalizados: revisão narrativa

Bárbara Bernardes Lobo; Erikson Custódio Alcântara

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Abstract

BACKGROUND AND OBJECTIVES: Pain can be influenced by the period of hospital stay, causing different losses to the patient. Professionals must properly collect and record this data to treat pain. The aim of this study was to investigate the different characteristics of pain in hospitalized patients.

METHODS: A systematic review was carried out in the Medline, LILACS and Pubmed databases, based on the descriptors “pain” AND “patients” AND “hospitalized” with their respective terms in Portuguese until October 2020. A total of 2,085 articles were found, of which 2,064 underwent careful evaluation and 20 were selected to compose this review based on the inclusion and exclusion criteria outlined.

RESULTS: Pain is more common and more severe in postoperative (90.8%) and palliative care wards, above all, it is frequently reported by young women. It lasts for more than three months in many patients and interferes with activities of daily living. Adequate analgesia is of great importance in this scenario. One-dimensional instruments are most commonly used to assess pain in hospitals. Attention is drawn to the absence or omission of non-pharmacological therapies for pain management, which can be considered a safe alternative without increasing the use of drugs.

CONCLUSION: Pain is very present and severe in hospitalized patients, demonstrating a failure in hospital analgesia protocols worldwide. Due to the work overload of professionals, pain is still under-evaluated.

HIGHLIGHTS

  • Pain still does not receive the proper attention in the hospital environment. There are failures in the requisites of systematized, appropriate assessment and the professionals’ trust in the patients’ reports, especially the record in medical charts and adequate analgesic treatment.
  • Pain is very present in hospitalized patients, regardless of the cause for hospitalization and, as a result, it limits the quality of life and daily activities, besides resulting in biopsychosocial changes.
  • Training for interprofessional hospital staf is strongly recommended to improve pain management in this scenario.

Keywords

Inpatients, Hospitalization, Pain, Review

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor pode ser infuenciada pelo período de internação hospitalar, acarretando diferentes prejuízos ao paciente. Os profissionais devem coletar e registrar adequadamente esse dado para tratar a dor. O objetivo deste estudo foi investigar as diferentes características da dor em pacientes hospitalizados.

MÉTODOS: Foi realizada uma revisão sistematizada nas bases de dados Medline, LILACS e Pubmed, com base nos descritores “dor” AND “pacientes” AND “internados” com seus respectivos termos em inglês até outubro de 2020. Encontrou-se, no total, 2.085 artigos, dos quais 2.064 passaram por criteriosa avaliação e 20 foram selecionados para compor esta revisão com base nos critérios de inclusão e exclusão delineados.

RESULTADOS: A dor é mais comum e mais intensa em alas de pós-operatórios (90,8%) e de cuidados paliativos, sobretudo, é frequentemente relatada por mulheres jovens. Tem duração superior a três meses em muitos pacientes e interfere nas atividades de vida diária. Uma adequada analgesia representa grande importância nesse cenário. Os instrumentos unidimensionais são mais utilizados para avaliar a dor em hospitais. Chama atenção a ausência ou omissão de terapias não farmacológicas para o manejo da dor, a qual pode ser considerada uma alternativa segura sem aumentar o uso de fármacos.

CONCLUSÃO: A dor se mostrou muito presente e intensa em pacientes hospitalizados, demonstrando haver falha nos protocolos hospitalares de analgesia em todo o mundo. Por sobrecarga de trabalho dos profissionais, a dor ainda é subavaliada.

DESTAQUES

  • No ambiente hospitalar, a dor ainda não recebe a devida atenção. Há falhas nos quesitos de avaliação sistematizada, apropriada e confança dos profissionais nos relados dos pacientes, sobretudo o registro nos prontuários e tratamento analgésico adequado.
  • A dor está muito presente nos pacientes internados, independentemente do motivo da hospitalização e, com isso, limita a qualidade de vida e as atividades diárias, além de causar alterações biopsicossociais.
  • Recomenda-se fortemente a capacitação para equipe interprofissional dos hospitais para melhorar o manejo da dor nesse cenário.

Palavras-chave

Dor, Hospitalização, Pacientes internados, Revisão

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Submitted date:
04/26/2021

Accepted date:
08/18/2022

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