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Fontes GM, Perez MV, Miashiro EH, Neto AIDS, Grigio TR, Rodrigues LHS. Pericapsular Hip Block Guided by Ultrasonography in Elderly People with Hip Fracture in the Emergency Sector: Clinical Trial. Rev Bras Ortop 2024; 59:e284-e296. [PMID: 38606128 PMCID: PMC11007597 DOI: 10.1055/s-0044-1785494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/25/2023] [Indexed: 04/13/2024] Open
Abstract
Objectives This study evaluated pain intensity in elderly subjects with hip fractures admitted to the emergency sector and undergoing preoperative pericapsular nerve group (PENG) block. Additionally, the degree of tolerable hip flexion was assessed. Methods A prospective, randomized, and controlled clinical trial with parallel groups. The control group consisted of elderly subjects with hip fractures undergoing standardized intravenous systemic analgesia. The intervention group consisted of elderly patients with hip fractures undergoing PENG block and standardized systemic analgesia. The groups were evaluated at rest and during movement using the Pain Assessment in Advanced Dementia (PAINAD) scale. We determined pain intensity and reduction, in addition to the degree of tolerable flexion of the fractured hip. All patient assessments occurred before the medication or block administration and at 45 minutes, 12, 24, and 36 hours postmedication or block. Results Preoperatively and 24 hours after PENG block, elderly subjects with hip fracture showed a significant reduction in pain at rest or movement compared to control patients ( p < 0.05), with 60% of patients assessed at rest demonstrating desirable pain reduction (≥50%) and only 13.3% of the control group achieving the desired pain reduction. During movement, after undergoing PENG block, 40% of subjects demonstrated the desired pain reduction and no patient from the control group. The intervention group also showed a significant improvement in the tolerable hip flexion group ( p < 0.05). Conclusion Preoperative PENG block in elderly subjects with hip fractures admitted to the emergency sector provided a significant reduction in pain compared with the control group.
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Affiliation(s)
- Gustavo Martins Fontes
- Departamento de Ortopedia e Traumatologia, Hospital Municipal Dr. Alípio Corrêa Netto (HMACN), São Paulo, SP, Brasil
- Serviço de Terapia da Dor, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Marcelo Vaz Perez
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Edson Hidenori Miashiro
- Disciplina de Ortopedia e Traumatologia, Faculdade de Medicina, Fundação Educacional do Município de Assis (FEMA), Assis, SP, Brasil
| | - Antonio Isidoro de Sousa Neto
- Departamento de Ortopedia e Traumatologia, Hospital Municipal Dr. Alípio Corrêa Netto (HMACN), São Paulo, SP, Brasil
| | - Thiago Ramos Grigio
- Grupo de Dor, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brasil
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Smith TO, Harvey K. Psychometric properties of pain measurements for people living with dementia: a COSMIN systematic review. Eur Geriatr Med 2022; 13:1029-1045. [PMID: 35622210 PMCID: PMC9553783 DOI: 10.1007/s41999-022-00655-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/28/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Detecting pain in older people with dementia is challenging. Consequentially, pain is often under-reported and under-treated. There remains uncertainty over what measures should be promoted for use to assess pain in this population. The purpose of this paper is to answer this question. METHODS A search of clinical trials registered on the ClinicalTrial.gov and ISRCTN registries was performed to identify outcome measures used to assess pain in people with dementia. Following this, a systematic review of published and unpublished databases was performed to 01 November 2021 to identify papers assessing the psychometric properties of these identified measures. Each paper and measure was assessed against the COSMIN checklist. A best evidence synthesis analysis was performed to assess the level of evidence for each measure. RESULTS From 188 clinical trials, nine outcome measures were identified. These included: Abbey Pain Scale, ALGOPLUS, DOLOPLUS-2, Facial Action Coding System, MOBID-2, self-reported pain through the NRS or VAS/thermometer or Philadelphia Geriatric Pain Intensity Scale, PACSLAC/PACSLAC-2, Pain Assessment in Advanced Dementia (PAINAD), and Checklist for non-verbal pain behavior (CNPI). From these, 51 papers (5924 people with dementia) were identified assessing the psychometric properties of these measures. From these, there was strong- and moderate-level evidence to support the use of the facial action coding system, PACSLAC and PACSLAC-II, CNPI, DOLOPLUS-2, ALGOPLUS, MOBID, and MOBID-2 tools for the assessment of pain with people living with dementia. CONCLUSION Whilst these reflect measurement tools used in research, further consideration on how these reflect clinical practice should be considered. PROSPERO REGISTRATION CRD42021282032.
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Affiliation(s)
- Toby O Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, NDORMS, University of Oxford, Oxford, OX3 7LD, UK.
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
| | - Karmen Harvey
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
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Righetti RF, Grams ST, Costa WNDS, Saraiva LT, de Salles ICD, Yamaguti WP. Neuromuscular Electrical Stimulation in Patients With Severe COVID-19 Associated With Sepsis and Septic Shock. Front Med (Lausanne) 2022; 9:751636. [PMID: 35252228 PMCID: PMC8888402 DOI: 10.3389/fmed.2022.751636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/11/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Neuromuscular electrical stimulation (NMES) can be applied to critically ill patients. However, its results on muscle strength and functionality in patients with COVID-19 are unknown. OBJECTIVE Evaluate the effects of intervention with NMES on muscle mass and functionality of patients with severe COVID-19 associated with sepsis and septic shock. METHODS Seven patients with COVID-19 associated with sepsis or septic shock were selected, but only 5 patients completed all days of the intervention with NMES. The intervention was performed by a single physiotherapist on 7 consecutive days in a daily session of 40 min. The outcome measures were the femoris cross-sectional area; thickness of the anterior compartment of the quadriceps muscle; rectus femoris echogenicity; International Classification of Functioning, Disability, and Health (ICF)-muscle strength; PFIT-s, DEMMI, and the SOMS; feasibility, and safety. The patients were evaluated on days 1, 5, and 8. RESULTS The rectus femoris cross-sectional area decreased significantly from days 1 to 8, but showed maintenance of the thickness of the anterior compartment of the quadriceps muscle from days 1 to 8. The MRC score increased significantly from days 1 to 5 and kept this improvement until day 8. All patients showed an increase in the MRC score and reduction of the ICF-muscle strength, meaning improved muscle strength from days 1 to 8. The PFIT-s increased significantly from days 1 to 5 and improved until day 8 compared to day 5. DEMMI and SOMS score increased significantly on day 8 compared to days 1 and 5. CONCLUSION Rehabilitation with NMES showed improvement in muscle strength and functionality of patients in this study with a potential protective effect on muscle mass loss in patients with critical COVID-19 associated with sepsis and septic shock. This study is the first report of the potential effects of neuromuscular electrical stimulation in patients with severe COVID-19 associated with sepsis and septic shock.
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Instruments for pain assessment in patients with advanced dementia: A systematic review of the evidence for Latin America. Palliat Support Care 2021; 18:741-747. [PMID: 31918779 DOI: 10.1017/s147895151900107x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Pain treatment is an essential component of care for elderly patients with advanced dementia. The objective of this study was to identify and analyze the different scales used for pain assessment in elderly persons diagnosed with dementia, in the literature available at the Latin American level. METHOD A systematic review was performed on the existing scales for pain assessment in elderly people diagnosed with Alzheimer's disease, vascular dementia, and dementia with Lewy bodies. RESULTS 226 articles were retrieved from the PUBMED, BIREME, and Scielo databases, of which a total of 10 articles entered the systematic review. The instruments identified in these publications were PAINAD, Abbey, McGill, and PACSLAC, while the Colored Pain Scale, Faces Pain Scale, and VAS scales were used as the silver standard. In Spanish, the Abbey scale, and in Portuguese, the PACSLAC scale showed the best reliability and validity coefficients. SIGNIFICANCE OF RESULTS It is concluded that there are only two appropriate scales for the assessment of pain in people with dementia in the region of interest of this study. It is recommended to generate more evidence for a more accurate assessment of pain in people with dementia.
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Romeiro V, Bullinger M, Marziale MHP, Fegadolli C, Reis RA, Silveira RCDCP, Costa-Júnior MLD, Sousa FAEF, Andrade VSD, Conacci BJ, Nascimento FK, Santos CBD. DISABKIDS® in Brazil: advances and future perspectives for the production of scientific knowledge. Rev Lat Am Enfermagem 2020; 28:e3257. [PMID: 32321044 PMCID: PMC7164929 DOI: 10.1590/1518-8345.3003.3257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/09/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: to map the Brazilian scientific production related to the stages of the
methodological process for the use of DISABKIDS® instruments
and/or forms adapted to Brazil. Method: scoping review, with searches conducted on10 electronic databases, plus
Google Scholar and contacts with researchers, without restriction of period
or language. Results: the mapping identified 90 scientific studies involving 46 instruments. Of
these, 11 (23.9%) included the elaboration and/or cultural adaptation of the
DISABKIDS® instruments to measure the Quality of Life of
children or adolescents with chronic conditions and 35 (76.1%) used the
Generic Measures and/or Specific Modules for the semantic validation of
other instruments. Conclusion: this scoping review allowed a comprehensive evaluation of the use of the
DISABKIDS® instrument and forms, in relation to the
validation of the instrument adapted to Brazil, presenting a positive
advance in the scenario with the development of academic/scientific projects
in the country, incorporating the method recommended by the literature for
the elaboration, cultural adaptation and validation of instruments and for
the systematized and standardized recording of the perception and
understanding of the target population about the measure of interest, using
DISABKIDS® forms adapted for this purpose.
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Affiliation(s)
- Viviane Romeiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Monika Bullinger
- University Medical Center Hamburg-Eppendorf, Instituto de Medicina Psicológica, Hamburgo, HB, Germany
| | - Maria Helena Palucci Marziale
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Claudia Fegadolli
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, São Paulo, SP, Brazil
| | - Roberta Alvarenga Reis
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre, RS, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Moacyr Lobo da Costa-Júnior
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Fátima Aparecida Emm Faleiros Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Valéria Sousa de Andrade
- Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba, MG, Brazil
| | - Beatriz Juliana Conacci
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Fernanda Karla Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Claudia Benedita Dos Santos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant # 311289/2017-7, Brazil
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Büyükturan Ö, Naharci Mİ, Büyükturan B, Kirdi N, Yetiş A. The Turkish Version of Pain Assessment in Advanced Dementia (PAINAD) Scale. ACTA ACUST UNITED AC 2018; 55:271-275. [PMID: 30224875 DOI: 10.29399/npa.22997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 12/12/2017] [Indexed: 11/07/2022]
Abstract
Introduction This study was conducted to test the reliability and validity of the Turkish version of the "Pain Assessment In Advanced Dementia (PAINAD) Scale". Methods One hundred and six older adults with advanced dementia (AD) were recruited in the study. Detailed medical history and demographic data of the participants were recorded. Initially, the Turkish version of PAINAD (PAINAD-TR), which was prepared by means of "back-translation", was applied. Along with this scale, Mini Mental State Examination, Clinical Dementia Rating scale, and Visual Analog Scale were also used. Results The Cronbach's α coefficient was 0.82 and 0.85 for the test and re-test, respectively. For the test-retest reliability of the PAINAD-TR scale, values of the intraclass correlation coefficient (ICC) and 95% confidence interval (CI) were 0.812 and 0.763-0.850 respectively. According to the results of a factor analysis carried out on the scale, a 2-domain structure was proved. Conclusion The PAINAD-TR scale can be used for the assessment and management of pain in non-communicative older adults with AD.
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Affiliation(s)
- Öznur Büyükturan
- Ahi Evran University, School of Physical Therapy and Rehabilitation, Kırşehir, Turkey
| | - Mehmet İlkin Naharci
- Health Sciences University, Gülhane Training and Research Hospital, Divisions of Geriatrics, Ankara, Turkey
| | - Buket Büyükturan
- Ahi Evran University, School of Physical Therapy and Rehabilitation, Kırşehir, Turkey
| | - Nuray Kirdi
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Aysu Yetiş
- Ahi Evran University, Training and Research Hospital, Department of Neurology, Kırşehir, Turkey
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Lino CRDM, Brüggemann OM, Souza MDLD, Barbosa SDFF, Santos EKAD. ADAPTAÇÃO TRANSCULTURAL DE INSTRUMENTOS DE PESQUISA CONDUZIDA PELA ENFERMAGEM DO BRASIL: UMA REVISÃO INTEGRATIVA. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072017001730017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: identificar e analisar as abordagens teóricas e propostas processuais utilizadas na adaptação transcultural de instrumentos de pesquisa para a língua portuguesa, pela enfermagem brasileira. Método: revisão integrativa de artigos que descreviam o processo de adaptação transcultural de instrumentos utilizados na prática clínica hospitalar, publicados entre 2005-2016. A busca foi realizada na MEDLINE®, CINAHL®, Scopus®, Web of science®, LILACS®, BDENF e SciELO®. Foram analisados 22 artigos, identificando-se as etapas do processo de adaptação, a abordagem metodológica, o instrumento e especialidade clínica. Resultados: todos os estudos utilizaram a abordagem universalista e em 20 deles Beaton foi o referencial metodológico adotado. Dentre os pontos fortes, destacam-se a adoção de referenciais metodológicos, cumprimento e detalhamento dos procedimentos adotados no processo, validação de conteúdo e avaliação psicométrica. Entretanto, a fragilidade predominante foi a ausência de informações importantes do processo de adaptação. Conclusão: evidencia-se uma supervalorização da avaliação psicométrica, em detrimento do cumprimento rigoroso do processo adaptação. Os achados possibilitam a elaboração de recomendações para estudos de adaptação transcultural, que podem subsidiar futuras pesquisas deste método.
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Costa GDD, Souza RA, Yamashita CH, Pinheiro JCF, Alvarenga MRM, Oliveira MADC. [Evaluation of professional knowledge and attitudes on dementia patient care: a trans-cultural adaptation of an evaluation instrument]. Rev Esc Enferm USP 2015; 49:298-308. [PMID: 25992830 DOI: 10.1590/s0080-623420150000200016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 11/28/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the trans-cultural adaptation of the evaluation instrument entitled Atenció Sanitària de Les Demències: la visió de L' Atenció Primarià from Catalan into versions in Portuguese for doctors and nurses. This study evaluates the knowledge and perspectives of these professionals in their treatment of patients diagnosed with dementia in cases of primary care. METHOD The adaptation followed internationally accepted rules, which include the following steps: translation, synthesis, back-translation, revision by a committee of specialists, and a test run with 35 practicing doctors and 35 practicing nurses in Brazil's Family Health Strategy (Estratégia Saúde da Família, or ESF in Portuguese). RESULTS The translation, synthesis, and back-translation steps were performed satisfactorily; only small adjustments were required. The committee of specialists verified the face validity in the version translated into Portuguese, and all of the items that received an agreement score lower than 80% during the initial evaluation were revised. In the test run, the difficulties presented by the health care professionals did not reach 15% of the sample, and therefore, no changes were made. CONCLUSION The Portuguese translation of the instrument can be considered semantically, idiomatically, culturally, and conceptually equivalent to the original Catalan version and is, therefore, appropriate for use in Brazil.
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