Prevalência, características e fatores associados à dor referida no período pré-operatório imediato de cesariana
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2016-04-14
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Universidade Federal de Goiás
Resumo
Reports of pain in the preoperative period are frequent and may be influenced by
socioeconomic, clinical, psychological and behavioral factors and by health conditions.
However, little is known about this pain in the preoperative period of cesarean section, one of
the surgeries performed more frequently in the global surgical setting. The aim of the study
was to identify the prevalence, characteristics and factors associated with pain in the
preoperative period immediately prior to cesarean section. This was a cross-sectional analysis
of data from the baseline of research matrix, cohort study, open and prospective, the data of
which were collected in the wards and apartments of a private hospital, contracted to the
Health Unic System (SUS), of the city of Goiânia, Brazil. The recruitment of women (n =
1082) was made between February 2014 and July 2015. The study sample consisted of 877
women. The outcome variable investigated was the report of any pain reported by women in
the immediate preoperative period. The pain characteristics include intensity, measured by
means of numeric pain scale of 11 points (END) which allows the intensity measured by
numbers representing the amount of pain felt (zero (0) = no pain; 1 , 2.3 and 4 = mild pain;
5:06 = moderate pain, 7.8 and 9 = severe pain, and ten (10) = worst possible pain),
location; onset and duration of painful episodes. The associated variables were: symptoms of
anxiety and depression, assessed through the Hospital Anxiety and Depression Scale (HADS),
as well as sociodemographic, clinical and behavioral variables and health related conditions.
For the statistical analysis, logistic regression was used to identify factors associated with
preoperative pain. In the multivariate analysis, variables that presented p-values <0,10 were
included. For all tests p-values <.05 were considered significant. The prevalence of
preoperative pain was 27.5% (CI: 95%:24.6-30.5). The locations most mentioned by the
women included the lower back (29.9%), pelvic/genital region (22.4%) and head (12.9%).
The pain appeared with more prevalence in the final trimester of pregnancy (37.8%), being
considered by the majority of the participants as a daily complaint (68.5%). The intensity was
classified as strong in 44.8% of cases. Preoperative pain was associated with pregnancyrelated pain (OR: 3.50; 2.23-5.252) and symptoms of anxiety (OR: 1.61; 1.14-2.28;
p=.006). The evaluation of pain in the preoperative period should include negative aspects,
such as anxiety, in order to use therapies for its management proper. In the prenatal care, it
is essential to evaluate the characteristics of pain that arises after the confirmation of the
pregnancy, in order to implement strategies to avoid prolonged contact with this experience
and consequent impairments in the postoperative period. Nurses are responsible for part of
this mission, together with obstetric nurses, who can and should fulfill their role as promoters
of health
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PEDROSO, C. F. Prevalência, características e fatores associados à dor referida no período pré-operatório imediato de cesariana. 2016. 92 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2016.