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Abstract

Introduzione. Nel 2004, l'Istituto Oncologico della Svizzera Italiana (IOSI), ha avviato un programma per migliorare il trattamento del dolore cronico oncologico, attraverso la formazione degli operatori e l'introduzione di strumenti di monitoraggio. Scopo. Fare un valutazione dei risultati ottenuti per i pazienti (efficace controllo del loro dolore), con attenzione al ruolo richiesto agli infermieri (accertamento, monitoraggio e documentazione del dolore).

Metodo. Studio retrospettivo, sulla documentazione sanitaria dei pazienti ricoverati negli ultimi tre mesi dell'anno 2010, per verificare come sia stato rilevato e gestito il dolore da loro provato.

Risultati. Su 177 ricoveri considerati, 93 (52.6%) hanno provato dolore durante il ricovero e 85 sono stati inclusi nell'analisi. A 62/85 (72.9%) sono stati somministrati farmaci in riserva >= 2 giorni. Hanno trascorso da 2 a 28 giorni con dolore (mediana 4). Per 56/62 (90.3%) la terapia antalgica è stata modificata una o più volte e a 40 (63.4%) sono stati somministrati oppioidi forti durante il ricovero. In 8/62 casi il dolore non è stato documentato e complessivamente, sugli 85 pazienti con dolore, per 25 (29.4 %) non ne viene segnalata l'intensití  o eventuali altre caratteristiche.

Conclusioni. Allo IOSI vi è un buon controllo farmacologico del dolore. I farmaci analgesici sono prescritti gií  all'ingresso e vengono modulati in funzione delle necessití  dei pazienti, con anche ampia somministrazione di oppioidi. Da migliorare il monitoraggio e la misurazione del dolore da parte degli infermieri, il cui ruolo appare soprattutto orientato a contribuire alla gestione farmacologica di questo sintomo.

 

Pain management in patients of a Swiss Institute of Oncology and the role of nurses: from programs to reality

Parole chiave: gestione del dolore, valutazione del dolore, ruolo infermieristico, pazienti oncologici, linee guida sul dolore oncologico.

Introduction. In 2004, the Oncology Institute of Southern Switzerland (IOSI) started a program to improve cancer pain treatment, through training of health professionals and the introduction of monitoring tools .

Aim. The aim is to evaluate patient relief from pain (effective pain control), with attention to nursing role (pain assessment, monitoring and documentation).

Method. Retrospective study. The health records of patients admitted in the last three months of 2010 were consulted to evaluate how pain was assessed and managed.

Results. Out of 177 patients admitted, 93 (52.6 %) experienced pain during hospitalization and 85 were included in the analysis . Sixty-two out of 85 (72.9 %) received drugs in reserve > = 2 days. They had pain from 2 to 28 days (median 4). For 56/62 patients ( 90.3 %) analgesic therapy was changed one or more times and 40 of them ( 63.4 % ) received strong opioids during hospitalization . In 8/62 cases pain wasn't documented, and overall, in 25/85 (29.4 %) intensity or any other feature weren't documented.

Conclusions. At IOSI there is a good pharmacological control of pain. Analgesics are prescribed upon entry and are modulated according to patient needs, even with wide administration of opioids. The issue to improve is pain assessment and monitoring by nurses, whose role is mainly oriented to contribute to the pharmacological management of this symptom.

Key words: pain management, pain assessment, nursing role, cancer patients, cancer pain guidelines.

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Come citare
Valcarenghi, D., Pedrazzani, C., Di Giulio, P., Moser, L., & Bianchi, M. (2016). La gestione del dolore nei pazienti di un Istituto Oncologico Svizzero e il ruolo degli infermieri: dai programmi alla realtí . PROFESSIONI INFERMIERISTICHE, 69(3). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/276
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