Pain, psychological distress and health-related quality of life at baseline and 3 months after radical prostatectomy

BACKGROUND: Inadequate management of postoperative pain is common, and postoperative pain is a risk factor for prolonged pain. In addition to medical and technical factors, psychological factors may also influence the experience of postoperative pain. METHODS: Pain was measured postoperatively at 24, 48, and 72 hr in hospital and after 3 months at home in 140 patients undergoing radical prostatectomy (RP). Patients answered questionnaires about anxiety and depression (HAD scale) and health-related quality of life (SF-36) at baseline and 3 months after surgery. RESULTS: In the first 3 postoperative days, mild pain was reported by 45 patients (32%), moderate pain by 64 (45%), and severe pain by 31 (22%) on one or more days. High postoperative pain scores were correlated with length of hospital stay and with high pain scores at home. Forty patients (29%) reported moderate (n = 35) or severe (n = 5) pain after discharge from hospital. Patients who experienced anxiety and depression preoperatively had higher postoperative pain scores and remained anxious and depressed 3 months after surgery. The scores for the physical domains in the SF-36 were decreased, while the mental health scores were increased at 3 months. Anxiety and depression were negatively correlated with all domains of the SF-36. CONCLUSION: There is a need for nurses to be aware of the psychological status of RP patients and its impact upon patients' experience of postoperative pain and recovery. The ability to identify patients with psychological distress and to target interventions is an important goal for future research

Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura Prevención de lesiones de piel en el perioperatorio: revisión integradora de la literatura Perioperative prevention of skin injury: an integrative literature review

A tomada de decisão do enfermeiro na sua prática diária necessita ser fundamentada em conhecimento científico. A prática baseada em evidências é uma abordagem que preconiza a utilização de resultados de pesquisas na prática clínica, sendo a revisão integrativa um de seus recursos. A presente investigação é uma revisão integrativa que teve como objetivo avaliar as evidências disponíveis sobre as intervenções eficazes de enfermagem para a prevenção de lesões de pele no paciente cirúrgico, no período transoperatório, ou em decorrência desse. Para a seleção dos artigos utilizou-se duas bases de dados, Cinalh e Medline, e a amostra desta revisão constituiu-se de 14 artigos. Após análise dos artigos incluídos na revisão os resultados dos estudos apontaram que os dispositivos considerados mais eficazes na prevenção de lesões de pele foram em ordem descrecente o colchão de ar micropulsante, cobertura de colchão de polímero de visco elástico seco e almofadas de gel, sucessivamente.<br>La toma de decisiones en la práctica diaria del enfermero necesita ser basada en conocimiento científico. La práctica basada en evidencias es una aproximación que establece la utilización de resultados de investigaciones en la práctica clínica, con la revisión integradora como uno de sus recursos. La finalidad de esta revisión integradora es buscar y evaluar las evidencias disponibles sobre las intervenciones eficaces de enfermería para la prevención de lesiones de piel en el paciente quirúrgico, en el período transoperatorio, o como resultado del mismo. Utilizamos dos bases de datos, Cinahl y Medline, para la selección de los artículos, resultando en una muestra de 14 artículos. Tras el análisis de los artículos incluidos en la revisión, los resultados de los estudios indicaron que los dispositivos considerados los más eficaces en la prevención de lesiones de piel fueron, sucesivamente, el sistema de colchón dinámico pulsante multi-célula, la almohada de polímero seco visco-elástico y almohadas con gel.<br>Nursing decision making in daily practice needs to be based on scientific knowledge. Evidence-based practice establishes the use of research results in clinical practice, with integrative literature review as one of its resources. This integrative review aimed to find and evaluate the available evidence on efficient nursing care interventions for the prevention of skin injuries in surgical patients, during or as a result of the perioperative period. To select the articles, we used two databases, Cinahl and Medline, resulting in a sample of 14 articles. The results of this analysis indicated that the devices considered most efficient in the prevention of skin injuries were, in decreasing order, the multi-cell pulsating dynamic mattress system, a dry visco-elastic polymer pad and gel cushions