Prevalenza e caratteristiche di dolore cronico nei pazienti dimessi dalla Terapia Intensiva e analisi dell’impatto sulla vita quotidiana e sulle scelte di trattamento terapeutico

  AIM: The aim of this study was to evaluate the prevalence and characteristics of Chronic Pain (CP) in survivors of critical illness. The secondary objective was to evaluate the impact of CP on an individual’s quality of life and unveiling current pain treatment practices. METHODS: This study was a cross-sectional survey. Twelve months after intensive care discharge, patients were contacted for an interview. Two questionnaires were administered (Brief Pain Inventory and Euroqol 5D instrument) to assess CP and quality of life. Data was obtained between 20 June and 20 December 2019. RESULTS: 118 patients participated in the study. An overall prevalence rate of 26.3% (n= 31) was found for CP in the study population. The highest prevalence of pain was observed in patients with 40-55 years (41.9%) (n= 13). The prevalence rate in males was 26.3%, similar compared to the rate in females (p=.99). The intensity of pain was similar among females (5.6) and males (5.8) (p=.35). Knees (15.3%), legs (12.7%) and minor joints (12.7%) were the most prevalent sites of pain. The perceived quality of life (EQ VAS) was 74.9 (+9.7) in patients without CP and 58.2 (+9.2) in patients with CP (p<.001). DISCUSSION: CP has significant negative consequences for patients. Thus, we want to emphasize the need to adopt a comprehensive and multidisciplinary approach to improving the patient’s condition and circumstances, contemplating both pharmacological treatments and non-pharmacological measures. KEY WORDS: Chronic pain, intensive care unit, prevalence, quality of life, questionnaires.  OBIETTIVO: Lo scopo di questo studio era di valutare la prevalenza e le caratteristiche del dolore cronico (DC) nei pazienti dimessi dalla Terapia Intensiva. L'obiettivo secondario era di valutarne l'impatto sulla qualità della vita e sulle scelte di trattamento terapeutico. METODI: Lo studio ha seguito un disegno trasversale. Dodici mesi dopo la dimissione dalla terapia intensiva, i pazienti sono stati contattati per un’intervista. Sono stati somministrati due questionari (Brief Pain Inventory e Euroqol 5D Instrument) per valutare il DC e la qualità della vita. I dati sono stati ottenuti tra il 20 giugno e il 20 dicembre 2019. RISULTATI: 118 pazienti hanno partecipato allo studio. Un tasso di prevalenza complessivo del 26.3% (n= 31) è stato trovato nella popolazione in studio. La più alta prevalenza è stata osservata nei pazienti con range di età 40-55 anni (41.9%) (n= 13). Il tasso di prevalenza negli uomini era del 26.3%, uguale a quello nelle donne (p= .99). L'intensità del dolore era simile tra donne (5.6) e uomini (5.8) (p= .35). Ginocchia (15.3%), gambe (12.7%) e articolazioni minori (12.7%) sono state le sedi più comuni di dolore. La qualità di vita percepita (EQ VAS) era 74.9 (+9.7) nei pazienti senza DC e 58.2 (+9.2) nei pazienti con dolore (p <.001). DISCUSSIONE: Il dolore ha un impatto negativo sui pazienti. Pertanto, vogliamo sottolineare la necessità di adottare un approccio multidisciplinare per migliorare le condizioni del paziente, considerando sia i trattamenti farmacologici che le misure non farmacologiche. PAROLE CHIAVE: Dolore cronico, terapia intensiva, prevalenza, qualità della vita, questionar

Translation and cross-cultural adaptation of the Clinical Care Classification system

Introduction: The Clinical Care Classification (CCC) system is one of the standard nursing terminologies recognized by the American Nurses Association, developed to describe nursing care through electronic documentation in different healthcare settings. The translation of the CCC system into languages other than English is useful to promote its widespread use in different countries and to provide the standard nursing data necessary for interoperable health information exchange. The aim of this study was to translate the CCC system from English to Italian and to test its clinical validity. Methods: A translation with cross-cultural adaptation was performed in four phases: forward-translation, back-translation, review, and dissemination. Subsequently, a pilot cross-mapping study between nursing activities in free-text nursing documentation and the CCC interventions was conducted. Results: All elements of the CCC system were translated into Italian. Semantic and conceptual equivalences were achieved. Altogether 77.8% of the nursing activities were mapped into CCC interventions. Conclusions: The CCC system, and its integration into electronic health records, has the potential to support Italian nurses in describing and providing outcomes and costs of their care in different healthcare settings. Future studies are needed to strengthen the impact of the CCC system on clinical practice. Keywords: Clinical Care Classification system; Cross-cultural comparison; Standardized Nursing Terminology; Translation