Assistência de enfermagem frente à complexidade das feridas neoplásicas para um manejo holístico: uma revisão integrativa
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Data
2021
Tipo de documento
Monografia
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
Santos, Rafael Santana
Orientador
Carvalho, Fabio Luiz Oliveira de
Coorientador
Resumo
As feridas neoplásicas constituem um agravo clínico que acomete cerca de 5 a 15% dos pacientes com câncer em estágio avançado, os quais se encontram sob cuidados paliativos e não têm um bom prognóstico. O foco principal do cuidado é o controle dos sinais e sintomas, em que os mais amedrontadores constituem o odor fétido, exsudato intenso e hemorragias, além de outros, como dor, prurido, cicatrização inviável, risco elevado para infecção, miíase, necrose tecidual e agressão ao tecido saudável. Além dessas alterações biológicas, ocorrem, também, alterações psicológicas, sociais, culturais e espirituais. Logo, tornam-se condições complexas e de difícil manejo, uma vez que se trata de uma temática pouco abordada na literatura, pesquisas e formação, resultando em uma lacuna no conhecimento prático e teórico dos enfermeiros. Foi traçado como objetivo geral: compreender as atribuições do enfermeiro no manejo das feridas neoplásicas para uma assistência embasada em uma abordagem holística. Enquanto os objetivos específicos são: analisar o conhecimento teórico e prático dos enfermeiros frente às feridas neoplásicas; compreender os principais desafios e as dificuldades para atuação do enfermeiro no manejo das feridas neoplásicas; discutir as principais alterações biopsicossociais provocadas por feridas neoplásicas; identificar as principais atribuições dos enfermeiros na assistência das feridas neoplásicas; compreender as intervenções educativas e inovadoras realizadas pelo enfermeiro no manejo das feridas neoplásicas. Trata-se de um estudo bibliográfico do tipo revisão integrativa, coletado através das bases de dados BVS (LILACS; MEDLINE; BDENF) e coletânea SciELO, através dos DeCS: Feridas, Ferimentos e Lesões, Neoplasias, Câncer, Assistência de Enfermagem, Cuidados de Enfermagem. Adotando-se como critérios de inclusão: estudos publicados nos últimos 10 anos, isto é, de 2011 a 2021, nos idiomas português e inglês. Após análise dos estudos, é notório que os profissionais de enfermagem possuem dificuldades, principalmente, no manejo do odor, exsudato e sangramento, os outros sintomas são controlados com mais facilidade. Nesse cenário, a principal intervenção para o manejo desses sinais e sintomas constitui a realização adequada dos curativos com coberturas apropriadas, ademais, o profissional deve ser criativo e implementar intervenções educativas e inovadoras. Conclui-se que os enfermeiros devem buscar capacitações e atualizações, desenvolvendo estudos sobre essa temática, aprimorando sua assistência a esse tipo de lesão, compreendendo o paciente em sua integralidade com um manejo holístico e resolutivo
Neoplastic wounds constitute a clinical condition that affects about 5 to 15% of patients with advanced cancer, whom are under palliative care and don’t have a good prognosis. The main focus of care is the control of signs and symptoms, in which the most frightening ones are the foul odor, intense exudate and hemorrhages, in addition to others, such as pain, itching, unviable healing, high risk for infection, myiasis, tissue necrosis and aggression against healthy tissue. In addition to these biological changes, psychological, social, cultural and spiritual changes also happen. So, they become complex and difficult to manage conditions, because it is a theme that is rarely discussed in the literature, researches and formation, resulting in a gap in the nurses’practical and theoretical knowledge. It was designed as a general objective: to understand the nurse’s duties in the management of neoplastic wounds for assistance based on a holistic approach. While the specific objectives are: to analyze the nurses’ theoretical and practical knowledge in the face of neoplastic wounds; to understand the main challenges and difficulties for nurses to act in the management of neoplastic wounds; to discuss the main biopsychosocial changes caused by neoplastic wounds; to identify the nurses’ main duties in the care of neoplastic wounds; to understand the educational and innovative interventions performed by nurses in the management of neoplastic wounds. It is an integrative review bibliographic study, collected through the VHL databases (LILACS; MEDLINE; BDENF) and SciELO collection, through the DeCS: Wounds, Wounds and Injuries, Neoplasms, Cancer, Nursing Care. Adopting as inclusion criteria: studies published in the last 10 years, that is, from 2011 to 2021, in the Portuguese and English languages. After analyzing the studies, it is clear that nursing professionals have difficulties, mainly in the management of odor, exudate and bleeding, the other symptoms are more easily controlled. In this scenario, the main intervention for the management of these signs and symptoms is the proper performance of dressings with appropriate coverings, in addition, the professional must be creative and implement educational and innovative interventions. It is concluded that nurses should look for formations and updates, developing studies about this theme, improving their assistance to this type of injury, understanding the patient in his entirety with holistic and resolving management.
Neoplastic wounds constitute a clinical condition that affects about 5 to 15% of patients with advanced cancer, whom are under palliative care and don’t have a good prognosis. The main focus of care is the control of signs and symptoms, in which the most frightening ones are the foul odor, intense exudate and hemorrhages, in addition to others, such as pain, itching, unviable healing, high risk for infection, myiasis, tissue necrosis and aggression against healthy tissue. In addition to these biological changes, psychological, social, cultural and spiritual changes also happen. So, they become complex and difficult to manage conditions, because it is a theme that is rarely discussed in the literature, researches and formation, resulting in a gap in the nurses’practical and theoretical knowledge. It was designed as a general objective: to understand the nurse’s duties in the management of neoplastic wounds for assistance based on a holistic approach. While the specific objectives are: to analyze the nurses’ theoretical and practical knowledge in the face of neoplastic wounds; to understand the main challenges and difficulties for nurses to act in the management of neoplastic wounds; to discuss the main biopsychosocial changes caused by neoplastic wounds; to identify the nurses’ main duties in the care of neoplastic wounds; to understand the educational and innovative interventions performed by nurses in the management of neoplastic wounds. It is an integrative review bibliographic study, collected through the VHL databases (LILACS; MEDLINE; BDENF) and SciELO collection, through the DeCS: Wounds, Wounds and Injuries, Neoplasms, Cancer, Nursing Care. Adopting as inclusion criteria: studies published in the last 10 years, that is, from 2011 to 2021, in the Portuguese and English languages. After analyzing the studies, it is clear that nursing professionals have difficulties, mainly in the management of odor, exudate and bleeding, the other symptoms are more easily controlled. In this scenario, the main intervention for the management of these signs and symptoms is the proper performance of dressings with appropriate coverings, in addition, the professional must be creative and implement educational and innovative interventions. It is concluded that nurses should look for formations and updates, developing studies about this theme, improving their assistance to this type of injury, understanding the patient in his entirety with holistic and resolving management.
Palavras-chave
Feridas, Câncer, Feridas neoplásicas, Assistência de enfermagem