Sestrinski glasnik br. 3 / 2012. - Hrvatska udruga medicinskih sestara

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186 Sestrinski glasnik/Nursing Journal 17 (2012) 178–187<br />1] Jačinu boli [kad je moguće tražiti od bolesnika da procijeni<br />jačinu boli na skali, npr. nema boli, lagana bol,<br />umjerena bol, jaka bol, izrazito jaka bol];<br />2] Toleranciju na bol [maksimalna jačina ili trajanje koje<br />pacijent može izdržati];<br />3] Karakteristike boli [lokaciju, trajanje, učestalost];<br />4] Utjecaj boli na dnevne aktivnosti [spavanje, apetit, koncentraciju,<br />interakciju s drugima];<br />5] Način suzbijanja boli [što je bolesnik činio ili misli da bi<br />mu pomoglo olakšati bol ili je učiniti podnošljivom].<br />Sestrinske dijagnoze i sestrinsko medicinski<br />problemi<br />1] bol;<br />2] smanjeno podnošenje napora;<br />3] tjeskoba;<br />4] socijalna izoliranost;<br />5] strah;<br />6] SMBS-održavanje domaćinstva;<br />7] poremećeni seksualni odnosi;<br />8] poremećeni obiteljski odnosi;<br />9] depresija;<br />Intervencije<br />1] poticati bolesnika na verbalizaciju emocija, strahova<br />2] odgovarati na postavljena pitanja<br />3] pružiti podršku bolesniku<br />4] dati bolesniku usmene i pisane informacije o dozvoljenim<br />aktivnostima<br />5] ohrabrivati bolesnika<br />6] pokazati suosjećanje bolesniku<br />7] pokazati bolesniku da mu vjerujemo<br />8] uvjeriti bolesnika da se svi bolovi mogu riješiti<br />9] uputiti bolesnika kako da nas dozove u slučaju potrebe<br />10] upoznati bolesnika i naučiti ga tehnikama ublažavanja<br />boli (ritmičko disanje, odvlačenje pozornosti)<br />11] objasniti bolesniku važnost održavanja normalne tjelesne<br />težine<br />12] poticati bolesnika na aktivnost (objasniti mu negativne<br />posljedice neaktivnosti)<br />13] tražiti bolesnika da vodi dnevnik boli<br />14] poticati bolesnika na interakciju s drugima (razni oblici<br />druženja i zabave)<br />15] savjetovati i poticati na promjenu životnog kao moguću<br />metodu kontrole boli (zdrave prehrambene navike,<br />umjerena tjelesna težina, fizička aktivnost…)[4].<br />Zaključak<br />Medicinska sestra provodi više vremena s bolesnikom koji<br />proživljava bol, od svih drugih članova zdravstvenog tima.<br />Učinkovito tretiranje boli polazi od dobre procjene i evaluacije<br />postupaka/metoda. Treba imati na umu da je bolesnik<br />najveći ekspert za svoju bol. Takvim pristupom i načinom<br />rada, bolesnik će očuvati svoje ljudsko dostojanstvo i povjerenje<br />u cjelokupni zdravstveni tim, bez obzira na težinu<br />bolesti i konačni ishod liječenja.<br />Literatura<br />[1] Deyo RA, Phillips WR. Low back pain. A primary care challenge. Spine.<br />1996;21:2826-32.<br />[2] Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive<br />time and cost due to common pain conditions in the US workforce..<br />JAMA. 2003;29:2443-54.<br />[3] Luo X, Pietrobon R, Sun SX, Liu GG, Hey L. Estimates and patterns of<br />direct health care expenditures among individuals with back pain in<br />the United States.. Spine. 2004;2:979-86.<br />[4] Shekelle PG, Adams AH, Chassin MR, Hurwitz EL, Brook RH. Spinal manipulation<br />for low-back pain.. Ann Intern Med. 1992;11:7590-8.<br />[5] Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. Spinal manipulative<br />therapy for low back pain. A meta-analysis of eff ectiveness<br />relative to other therapies.. Ann Intern Med. 2003;13:8871-81.<br />[6] Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. A review of the evidence<br />for the eff ectiveness, safety, and cost of acupuncture, massage<br />therapy, and spinal manipulation for back pain.. Ann Intern Med.<br />2003;13:8898-906.<br />[7] Koes BW, van Tulder MW, Ostelo R, Kim Burton A, Waddell G. Clinical<br />guidelines for the management of low back pain in primary care: an<br />international comparison.. Spine. 2001; 13: 2513-4.<br />[8] Borkan JM, Koes B, Reis S, Cherkin DC. A report from the Second International<br />Forum for Primary Care Research on Low Back Pain. Reexamining<br />priorities.. Spine. 1998;23:1992-6.<br />[9] Bouter LM, van Tulder MW, Koes BW. Methodologic issues in low back<br />pain research in primary care.. Spine. 1998;23:2014-20.<br />[10] van Tulder M, Malmivaara A, Esmail R, Koes B. 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