Escala de dolor para pacientes pediátricos. Estudio de revisión sistematizada

Mayra Susana Alvarado-Guzmán; Jorge Alberto Amaya Aguilar

Mayra Susana Alvarado-Guzmán Departamento de Investigación en Enfermería. Instituto Nacional de Cardiología Ignacio Chávez (Ciudad de México, México)
Jorge Alberto Amaya Aguilar Departamento de Investigación en Enfermería. Instituto Nacional de Cardiología Ignacio Chávez (Ciudad de México, México)

Palabras clave: Dimensión del dolor, Pediatría, Dolor

Key-words: Dimension of pain, Pediatrics, Pain

Resumen

Introducción: El dolor es considerado el quinto signo vital por su relación que guarda con la estabilidad hemodinámica y psicológica del paciente, en especial si se trata de niños incapaces de expresarse; sin embargo, la valoración con herramientas poco fiables puede influir sobre la toma de decisiones del profesional de salud sobre el cuidado de estos pacientes. Objetivo: Describir las escalas de valoración usadas en el paciente pediátrico. Metodología: Revisión sistematizada con metodología integradora. Pasos de la enfermería basada en evidencia: pregunta clínica; descriptores en ciencias de la salud: pediatría, dimensión del dolor y dolor en español, inglés y portugués; búsqueda de evidencia científica (BiDi UNAM, CUIDEN, LILACS, PubMed y SciELO), artículos de texto completos publicados del 2012 al 2018; lectura y evaluación de la evidencia científica. Resultados: Se encontraron 50 artículos. Prevalecieron los estudios con nivel de evidencia III y grado de recomendación C, publicados en países anglosajones en idioma inglés del área médica. Se identificaron 5 dimensiones: parámetros, áreas de aplicación, rangos de edad, limitaciones, aplicación, validación y tipo de dolor. Conclusión: El conocimiento del profesional de enfermería sobre las herramientas de valoración del dolor en pediatría es esencial para el desarrollo de sus intervenciones, por su relevancia en la estabilidad hemodinámica y psicológica del paciente

Abstract

Introduction: Pain is considered the fifth vital sign due to its relationship with the hemodynamic and psychological stability of the patient, especially if it is children unable to express themselves; however, the assessment with unreliable tools can influence the decision of the health professional regarding the care of these patients. Objective: Describe the assessment scales used in the pediatric patient. Methods: A systematized review with integrative methodology was carried out. Evidence-based nursing practice: clinical question; health sciences descriptors: pediatrics, pain scale and pain in Spanish, English and Portuguese; search for scientific evidence (BiDi UNAM, CUIDEN, LILACS, PubMed and SciELO), full text articles published between 2012 and 2018; reading and evaluation of scientific evidence. Results: 50 articles were obtained. Prevailed studies with level III of evidence and grade of recommendation C, published in Anglo-Saxon countries in English of medical area. Five dimensions were identified: parameters, application areas, age range, limitations, application, validation and type of pain. Conclusions: Knowledge of the nursing professional about the pain assessment scales in pediatrics is essential to correctly develop their interventions, for its relevance in patient’s psychological and hemodynamic stability

Bibliografía

1. Pabón-Henao T, Pineda-Saavedra LF, Cañas-Mejía OD. Fisiopatología, evaluación y manejo del dolor agudo en pediatría. Salutem Scientia Spiritus. 2015; 1(2): 25-37.
2. Zisk-Rony RY, Lev J, Haviv H. Nurses’ Report of In-hospital Pediatric Pain Assessment: Examining Challenges and Perspectives. Pain Manag Nurs. 2015 Apr;16(2):112-20.
3. Hanke FB, Rieth EB, Escobar PB, Sonego JG, Fernandes EM. Avaliação da dor em neonatos e crianças em terapia intensiva. Rev Pesqui Cuid Fundam. 2014 ;6(3):909-917.
4. Vael A, Whitted K. An Educational Intervention to Improve Pain Assessment in Preverbal Children. PediatricNursing. 2014; 40(6): 302-306.
5. López-Guzmán J, Pazos-Alvarado R, Moyoa-García D, Galicia- Núñez A. Prevalencia e incidencia del dolor en los pacientes hospitalizados en el Hospital Infantil de México «Federico Gómez» en un período de seis meses. Rev Mex Anest. 2013: 36(2): 93-97.
6. Collado A. Piñón A, González U. el dolor infantil, un acercamiento a la problemática desde la bioética. Rev Cubana Pediatr. 2012; 84(2): 275-281.
7. Van Dijk M. Tibboel D. Update on Pain Assessment in Sick Neonates and Infants. Pediatric Clin N Am. 2012; 1167-1181.
8. Martins M, Olivera N, Doca F, Martínes F, Carlotti P. et al. Assessment and management of pediatric pain based on the opinions of health professionals. Psychol Neuroci. 2014; 1: 43- 53.
9. Yaffa R, Zisk-Rony, Lev J, Haviv H. Nurses´ Report of In Hospital Pediatric Pain assessment: Examining Challenges and perspective. Pain Manag Nurs. 2015 Apr;16(2):112-20.
10. Panjganj D, Bevan´s A. Children’s nurses’ post-operative pain assessment practices. RCNI.2016; 28(5): 30-33.
11. Niño-Puello M. El inglés y su importancia en la investigación científica algunas reflexiones. Rev Colombiana Cienc Anim. 2013; 5(1): 244-254.
12. Navarro FA. El inglés, idioma internacional de la medicina. Causas y consecuencias de un fenómeno actual. Panacea. 2001; 2(3): 35- 51.
13. Joestlein L. Pain, Pain, Go Away! Evidence Based Review of Developmentally Appropriate Pain Assessment for Children in postoperative Setting. Orthop Nurs. 2015; 34(5): 252-259.
14. Quinn BL, Kennedy LS, Cooley ME. Pediatric Pain Assessment by Drawn Faces Scales: A Review. Pain Manag Nurs.2014;15(4):909-18.
15. Monacha S, Taneja N. Assessment of paeditric pain: a critical review. J Basic Clin Physiol Pharmacol. 2016; 27(4): 323-331.
16. Kochman A, Howel J, Sheridan M, Shelton E. E, Lee S, et al. Kou M, Reliability of the Faces, Legs, Activity, Cry, and Consolability Scale in Assessing Acute Pain in the Pediatric Emergency Department. Pediatr Emerg Care. 2016; 33(1): 14- 17.
17. Grispan e Silva LD, Lima LS, Mendes MT, Pimenta AF. Scale of assessment of pain: the process of implementation in a pediatric intensive care unit. J Nurs UFPE. 2014; 8(4): 857-863.
18. Maxwell L, Malavolta C, Fraga M. Assessment of pain in the Neonate. Clin Perinatol. 2013;40(3):457-69.
19. Bai J, Hsu L, Tang Y, Van Dijk M. Validation of the COMFORT Behaivor Scale end the FLACC Scale for Pain Assessmenr in Chinese Children After Cardiac Surgery. ASPMN. 2012; 13(1): 18-26.
20. Zanchi C, Ferrara G, Montico M, D’Osualdo F, Rutugliano R, et al. Validation of the Italian version of the Non-Communicating Children’s Pain Checklist- Postoperative Version. Ital J Pediatr. 2017;43(1):75.
21. Ullan M, Perelló M, Jerez C, Gómez E, Planas M, Serrallonga N. Validation of the Spanish versión of the Parent´s Postoperative Pain Management pain scale. An Pediatr. 2016; 84 (2): 106-113.
22. Beltramini A, Milojevic K, Pateron D. Pain Assessment in Newborns, Infants, and Children. Pediatr Ann. 2017; 46(10): e387-e395.
23. Shamin F, Ullah H, Khan FA. Postoperative pain assessment using four behavioral scales in Pakistani children undergoing elective surgery. Saudi J Anaesth. 2015; 9(2): 174-178.
24. Ge X, Tao J-R, Wang J, Pan S-M, Wang Y-W. Bayesian estimation on diagnostic performance of Face, Legs, Activity, Cry, and Consolability and Neonatal Infant Pain Scale for infant pain assessment in the absence of a gold standard. Paediatr Anaesth.2015; 25: 834-839.
25. Cury J. M, Martinez E. F, Carlotti P. C, Pain assessment in neonates and infants in the post-operative period Following cardiac surgery. Postgrad Med J. 2013; 89:63-67.
26. Pölkki T, Korhonrn A, Axelin A, Saarela T, Lukkala H. Development and preliminary validation of neonatal Infant Acute Pain Assesment Scale (NIAPAS). Int J Nurs Stud. 2014; 51(12):1584-94I.
27. Pabón-Henao T, Pineda-Saavedra L-F, Cañas-Mejía O-D. Fisiopatología, evaluación y manejo del dolor agudo en pediatría. Salut Sci Spirit. 2015; 1(2):25-37.
28. Collado-Gómez L, Camacho-Vicente V, González-Villalba M, Sanz-Prades G, Bellón Vaquerizo B. Percepción del personal de enfermería sobre el manejo del dolor en neonatos. Enferm Intensiva. 2017: (AP 7 pág.)
29. Avila-Alvarez A. Carbajal R. Courtois E. Pertega-Diaz S. Anand K. et al. Valoración clínica del dolor en unidades de cuidados intensivos neonatales españoles. An Pediatr. 2015; 85(4): 181-188.
30. Noriega R. Valoración del dolor y su manejo. [Tesis Espacialidad Pediatría]. México: Universidad Nacional Autónoma de México; 2005.
31. Stevens BJ, Yamada J, Promislow S, et al. Pain Assessment and Management After a Knowledge Translation Booster Intervention. Pediatrics. 2016;138(4):e20153468.
32. Habich M. Letizia M. Pediatric Pain Assessment in the emergency Department: A Nursing Evidence-Based Practice. Pediatric nursing. 2015; 41(4): 198-202.
33. Alizadeh Z, Paymard A, Khalili A, Hejr H. A systematic review of pain assessment method in children. Ann Trop Med Public Health 2017; 10: 847-9.
34. Van Dijk M. Tibboel D. Update on Pain Assessment in Sick Neonates and Infants. Pediatric Clin N Am. 2012; 1167-1181. Collado M, Odales R, Piñón A, Alerm A, González U, Acosta L. El dolor infantil, un acercamiento a la problemática desde la bioética. Rev Cubana Pediatr. 2012; 84(2):257-281.
35. Bai J, Hsu L, Tang Y, Van Dijk M. Validation of the COMFORT Behaivor Scale end the FLACC Scale for Pain Assessmenr in Chinese Children After Cardiac Surgery. ASPMN. 2012; 13(1): 18-26.
36. Martins M, Olivera N, Doca F, Martínes F, Carlotti P. et al. Assessment and management of pediatric pain based on the opinions of health professionals. Psychol Neuroci. 2014; 1: 43- 53.
37. Young KD. Assessment of Acute Pain in Children. Clin Pediatr Emerg Med. 2017;18(4): 235-241.
38. Maxwell L, Malavolta C, Fraga M. Assessment of pain in the Neonate. Clin Perinatol. 2013;40(3):457-69.
39. Collado A. Piñón A, González U. el dolor infantil, un acercamiento a la problemática desde la bioética. Rev Cubana Pediatr. 2012; 84(2): 275-281.
40. Yaffa R, Zisk-Rony, Lev J, Haviv H. Nurses´ Report of In Hospital Pediatric Pain assessment: Examining Challenges and perspective. Pain Manag Nurs. 2015 Apr;16(2):112-20.
41. Chang J, Versloot J. Flasher S, McCrystal K, Craig K. Pain assessment in Children Validity Of Facial Espresión Items in Observacional Pain Scales. Clin J Pain. 2015; 31(3): 189-197.
42. De Aymar CL, De Lima LS, Dos Santos CM, Moreno EA, Coutinho SB. Pain assessment and management in the NICU: analysis of an educational intervention for health professionals. J Pediatr. 2014; 90(3): 308-315.
43. Monacha S, Taneja N. Assessment of paeditric pain: a critical review. J Basic Clin Physiol Pharmacol. 2016; 27(4): 323-331.
44. López-Guzmán J, Pazos-Alvarado R, Moyoa-García D, Galicia- Núñez A. Prevalencia e incidencia del dolor en los pacientes hospitalizados en el Hospital Infantil de México «Federico Gómez» en un período de seis meses. Rev Mex Anest. 2013: 36(2): 93-97.
45. Herrera A, Evaluar la validez clínica y de contenido de la escala de dolor FLAAC en lactantes mexicanos. (tesis de internet). (México). Universidad Autónoma de México.2009.
46. Ullan M, Perelló M, Jerez C, Gómez E, Planas M, Serrallonga N. Validation of the Spanish versión of the Parent´s Postoperative Pain Management pain scale. An Pediatr. 2016; 84 (2): 106-113.
47. Howard RF, Liossi C. Pain assessment in children. Arch Dis Child. 2014, 99: 1123-1124.
48. Brahmbhatt A, Adeloye T, Ercole A, Bishop S, Smith H, Wheeler D, Assessment of post-operative pain in children: who knows best?. Pediatric Reports. 2012; 4(10): 34-37.
49. Vael A, Whitted K. An Educational Intervention to Improve Pain Assessment in Preverbal Children. PediatricNursing. 2014; 40(6): 302-306.
50. Andersen RD, Langius-Eklöf A, Nakstad B, Bernklev T, Jylli L. The measurement properties of pediatric observational painscales: A systematic review of Reviews. Int J Nurs Stud. 2017 Aug;73:93-101.
51. Maier CP, Lopes DM, Gonçalves F. Martegani AF, Pasin S, et al. Evaluation of Pain and Accuracy Diagnostic in Hospitalized Children. Int J Nurs. 2012; 23(2): 106-113.
52. Quinn B. L, Seibold E, Hayman L. Pain Assessment in Children Whit Special Needs: A Review Of Literature. J Except Child. 2015; 82(1): 44-57.
53. Cury J. M, Martinez E. F, Carlotti P. C, PAin assessment in neonates and infants in the post-operative period Following cardiac surgery. Postgrad Med J. 2013; 89:63-67.
54. Beltramini A, Milojevic K, Pateron D. Pain Assessment in Newborns, Infants, and Children. Pediatric Annals. 2017;46(10):e387-e395.
55. Martins de Melo G, Paula de Aguilar A, Falconieri De Moura A, Moreira M, Martins de Silva V. Pain assessment scale in newborns: integrative review. Rev Paul Pediatr. 2014; 32(4):395-402.
56. Mehrnoush N, Ashktorab T, Heidarzadeh M, Momenzadeh S, Khalafi J. Pain Management Perceptions of the Neonatal Nurses in NICUs and Neonatal Units in Ardebil, Iran. IJN. 2016; 7(4): 23-29.
57. Quinn BL, Kennedy LS, Cooley ME. Pediatric Pain Assessment by Drawn Faces Scales: A Review. Pain Manag Nurs.2014;15(4):909-18.
58. Shamin F, Ullah H, Khan FA. Postoperative pain assessment using four behavioral scales in Pakistani children undergoing elective surgery. Saudi J Anaesth. 2015; 9(2): 174-178.
59. Margonari H, Hannan MS, Schlenk EA. Quality Improvement Initiative on Pain Knowledge, Assessment, And Documentation Skills of Pediatric Nurses. Pediatr Nurs. 2017 Mar-Apr;43(2):65-70.
60. Kochman A, Howel J, Sheridan M, Shelton E. E, Lee S, et al. Kou M, Reliability of the Faces, Legs, Activity, Cry, and Consolability Scale in Assessing Acute Pain in the Pediatric Emergency Department. Pediatr Emerg Care. 2016; 33(1): 14- 17.
61. Ruiz G. Y, García B. L. El rol de enfermería en la valoración y manejo del dolor infantil en los servicios de urgencias hospitalarios. Nuber Cientif. 2015; 2(16):23-30.
62. Rivas AL, Rivas ER. Validación de escala de valoración del dolor en recién nacido en una unidad de neonatología. Bustos LM Cienc. Enferm. 2012; 18(2): 93-99.
63. Sellán S.C, Díaz M. M, Vázquez S. A. Valoración del dolor y aplicación de intervenciones terapéuticas enfermeras en el paciente neonatal y pediátrico, en contextos asistenciales hospitalarios. Rev Cubana Enferm. 2012; 28(2): 144-155.
64. Carvalho A. G, Oliveira F. J, Vital S D, Laura C. C, Lopes N. C. et al. Dor en recém-nascidos: identificaçao, avaliaçao e intervençoes . RBE. 2015; 29(3): 261-270.
65. Grispan e Silva LD, Lima LS, Mendes MT, Pimenta AF. Scale of assessment of pain: the process of implementation in a pediatric intensive care unit. J Nurs UFPE. 2014; 8(4): 857-863.
66. Saul R, Peters J, Bruce E. Assessing acute and chronic pain in children and young people. Nurs Stand. 2016; 31(10): 51-63.
67. Hanke FB, Rieth EB, Escobar PB, Sonego JG, Fernandes EM. Avaliação da dor em neonatos e crianças em terapia intensiva. Rev Pesqui Cuid Fundam. 2014 ;6(3):909-917.
68. Ge X, Tao JR, Wang J, Pan SM, Wang YW. Bayesian estimation on diagnostic performance of Face, Legs, Activity, Cry, and Consolability and Neonatal Infant Pain Scale for infant pain assessment in the absence of a gold standard. Paediatr Anaesth. 2015;25(8):834-839.
69. Witt N, Coynor S, Edwards C, Bradshaw H. A Guide to Pain Assessment and Management in the Neonate. Curr Emerg Hosp Med Rep. 2016; 4: 1–10.
70. Anand K, Eriksson Mats, Boyle EM, Avila-Alvarez A, Andersen RD, et al. Assessment of continuous pain in newborns admitted to NICUs in 18 European countries. Acta Paediatr. 2017;106 (8):1248-1259.
71. Obrecht JA, Van Hulle Vincent C, Ryan CS. Implementation of evidence-based practice for a pediatric pain assessment instrument. Clin Nurse Spec. 2014 Mar-Apr;28(2):97-104.
72. Panjganj D, Bevan A. Children's nurses' post-operative pain assessment practices. Nurs Child Young People. 2016 Jun 8;28(5):29-33.
73. Pölkki T, Korhonen A, Axelin A, Saarela T, Laukkala H. Development and preliminary validation of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS). Int J Nurs Stud. 2014 Dec;51(12):1585-94.
74. Joestlein L. Pain, Pain, Go Away! Evidence-Based Review of Developmentally Appropriate Pain Assessment for Children in a Postoperative Setting. Orthop Nurs. 2015 Sep- Oct;34(5):252-9.
75. Zanchi C, Massaro M, Ferrara G, Montico M, D'Osualdo F, Rutigliano R, Taddio A, Vecchi Brumatti L, Cozzi G, Barbi E. Validation of the Italian version of the Non-Communicating Children's Pain Checklist-Postoperative Version. Ital J Pediatr. 2017 Aug 22; 43(1):75

Escala de dolor para pacientes pediátricos. Estudio de revisión sistematizada

Pain scale for pediatric patients. A systematized review

Resumen

Abstract

Bibliografía