Kalda, Ruth

Kangasniemi, Mari

Pölkki, Tarja

Treiman-Kiveste, Airin

English

Journals from University of Tartu

45eesti uuringud ma ailma teadusajakirjadesEesti Arst 2023; 102(1):45 Eesti Arst 2021; 100(2):x–x704eesti uuringud maa lma tead sajakirjades  eesti arst 100* Tegu on pilditõmmisega artikli päisest.a TÜ meditsiiniteaduste valdkond, b Oulu Ülikooli ja Oulu ülikoolihaigla õendusteaduse ja tervisekorralduse uurimisüksus, c TÜ peremeditsiini ja rahvatervishoiu instituut, d Turu Ülikooli õendusteaduse osakond,e Tartu Tervishoiu KõrgkoolImikute protseduurivalu hindamine ja mittefarmakoloogiline valutustamine Eesti  haiglates – õdede vaatekoht*TaustHaiglarav i aja l kogevad imikud mitmeid valul ikke protseduure, mis kutsuvad esile muutusi nende füsioloogilistes ja käitumuslikes näitajates, l isaks võib rav imata valu põhjustada stressi ning piken-dada ravil viibimise aega. Pediaatri-liste patsientide protseduurivalu ei hinnata, dokumenteerita ega ravita alati optimaalselt. Valu hindamisel tuleb arvestada lapse vanust ja arengutaset, seetõttu soovitatakse imikute valu hindamiseks kasutada mult imodaalseid va luskaalasid. Protseduurivalu leevendamiseks ja ebamugavustunde vähendamiseks sobivad lisaks farmakoloogilisele valutustamisele ka mittefarmakoloo-gilised meetodid. Need on minimaal-sete kõrvaltoimetega ja kulutõhusad, l isaks on neid kerge rakendada ning need ei vaja arsti korraldust. Probleemiks võivad osutuda perso-nali ebapiisavad teadmised valu hindamisest ja mittefarmakoloogi-listest valutustamise meetoditest, õe isiklikud hoiakud ning soovimatus juhendada ja julgustada vanemaid osalema imiku protseduurivalu leevendamises. MetoodikaKirjeldav läbilõikeline uuring viidi läbi 2019. aasta maist juunini nelja Eesti haigla vastsündinute ja imikute ning laste intensiivravi osakondade kõigi õdede (n = 149) seas. Andmed kogut i anonüümse ankeetküsi-mustikuga eesti ja vene keeles. 128 küsimustikku tagastati, neist 111 kaasati lõplikku analüüsi (vasta-mismäär 75%). Andmed analüüsiti statistiliselt ja esitati üldistatult. TulemusedUuringu tulemustest selgus, et üle poole õdedest (68%) nõustusid, et imikute valu hindamine ning süstemaatiline dokumenteerimine mõjutab valu leevendamist. Vasta-nutest pooled (51%) kinnitasid, et valuskaalad on imikute valu mõõt-misel olulised, samas ütles 58%, et suudavad valu hinnata usaldus-väärsel viisil ka ilma valuskaalasid kasutamata. Kõige enam kasutasid õed mittefarmakoloogi l ise valu leevendamise meetodina imiku puudutamist (83%), positsionee-rimist (78%) ja glükoosi andmist (63%). Vaid 23% õdedest julgustas ema imikut protseduuri ajal rinnaga toitma ja 11% kasutama känguru-hooldust. Valuteemalisel koolitusel oli viimase aasta jooksul osalenud vaid 10% vastanutest. Õdede vanus, haridustase ning töökogemus olid seotud parema valu-hindamise, mittefarmakoloogil iste valutus-tamise meetodite kasutamise ja vanemate nõustamisega. KokkuvõteUuringust selgus, et Eesti õdede teadlikkust protseduurivalust, selle hindamisest, dokumenteerimisest n ing va lutustamisest mittefar-makoloogi l iste meetoditega on vaja parendada. See ei ole Eestile ainuomane leid, sarnastele järeldus-tele on jõudnud ka teised uurijad mujal maailmas. Protseduurivalu objektiivseks hindamiseks tuleb Eesti haiglates võtta igapäevaselt kasutusele imikute protseduurivalu hindamise valideeritud valuskaala. L isaks vajavad õed oma igapäe-vatöös tõenduspõhiseid valuravi juhiseid ja koolitusi, sest teadlikkuse suurendamise abil saab muuta õdede hoiakuid, harjumusi ning arusaama protseduuri valust ja selle hindamise ning leevendamise vajalikkusest.Nurses' perceptions of infants’ procedural pain assessment andalleviation with non-pharmacological methods in EstoniaAirin Treiman-Kiveste, RN, MSca, e, Tarja Pölkki, PhDb, Ruth Kalda, PhD c, Mari Kangasniemi, PhDc, da Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Ravila 19, 50412 Tartu, Estoniab Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Medical Research Center, Oulu, Finlandc Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Estoniad University of Turku, Faculty of Medicine, Department of Nursing Science, Finlande Tartu Health Care College, Estoniaa b s t r a c ta r t i c l e i n f oArticle history:Received 13 April 2020Revised 5 September 2021Accepted 5 September 2021Purpose: The purpose of this studywas to describe nurses perceptions of infants' procedural pain assessment andalleviation with non-pharmacological methods including parental guidance in departments of neonatal and in-fant medicine and Neonatal Intensive Care (NICUs).Design and methods: A descriptive cross-sectional survey was carried out among all nurses (n= 149) who wereworking in neonatal and infant departments or NICUs in Estonian hospitals. Altogether, 128 questionnaires werereturned an 111 respondents were eligible (75% response rate). The data were analysed using statisticalmethods.Results:More than half of the nurses agreed that systematic documentation of the measurement of pain is nec-essary for nursing care and that it affects pain alleviation in infants. Half of the respondents (51%) confirmedthat pain scales are important in the measurement of infants' pain, but 58% claimed they were able to assesspain in a reliable way without using pain assessment scales. Nurses also reported that they were unfamiliarwith most pain scales and they were not routinely used in everyday practice. Nurses said that the most usefulnon-pharmacological pain alleviation methods were touching (83%) and positioning infants (78%), the mostrarely used were skin-to-skin care (12%) and encouraging mothers to breastfeed the infant (34%). The majorityof respondents (79%) reported that they do not know or do not have written instructions on pain assessment intheir workplace, and only a few (10%) reported that they have participated in pain management courses duringthe last year.Conclusions: There is a need to increase the use of pain assessment scales and pain documentation in everydaypractice in those hospitals in Estonia. The use of scales in pain assessment was valued by few nurses. It seemsthat there is a lack of knowledge on non-pharmacological methods, and nurses reported using only a few non-pharmacological pain alleviation methods and guided parents on using them.Practice implications: Nurses need pain management guidelines for everyday work, and in addition to nurses,written guidelines for parents are needed.© 2021 Elsevier Inc. All rights reserved.Keywords:Neonatal procedural paininfants' procedural painPain alleviationNon-pharmacological methodsIntroductionPain refers to an unpleasant sensory and emotional experience asso-ciatedwith or resembling that associatedwith, actual or potential tissuedamage (Raja et al., 2020). Infants react to acute pain with ch nges inphysical and behavioural patterns because it causes physiological stress,and this affects a child's healing process (Johnston et al., 2017; Wittet al., 2016). Pain responsiveness evaluation and measurement arevital components of good pain management practice (Association ofPaediatric Anaesthetists of Great Britain and Ireland, 2012). Forhealthcare professionals, evaluating pain in infants is difficult as infantsare unable to express or confirm their pain verbally (Pölkki et al., 2018).During hospitalisation, the most common procedures that causeshort-termpain for infants are heel pricks, injections and vascular punc-tures (Cruz et al., 2016; Lago et al., 2009). Painful procedures are also de-scribed as the most distressing aspects of medical treatment for bothinfants and their parents. Untreated pain in infants may result in ex-tended time spent in hospital, the memory of a painful experience, ora low pain threshold (Brummelte et al., 2012; Johnston et al., 2017;Perry et al., 2018).Journal of Pediatric Nursing 62 (2022) e156–e163⁎ Corresponding author.E-mail address: Airin.treiman-kiveste@ut.ee (A. Treiman-Kiveste).https://doi.org/10.1016/j.pedn.2021.09.0060882-5963/© 2021 Elsevier Inc. All rights reserved.Contents lists available at ScienceDirectJournal of Pediatric Nursingj ourna l homepage: www.ped ia t r i cnurs ing.org

Imikute protseduurivalu hindamine ja mittefarmakoloogiline valutustamine Eesti haiglates – õdede vaatekoht

https://ojs.utlib.ee/index.php/EA/article/view/22273

Imikute protseduurivalu hindamine ja mittefarmakoloogiline valutustamine Eesti haiglates – õdede vaatekoht

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