| Abstract | Uvod: Infektivne bolesti se očituju općim i specifičnim simptomima. Važnu ulogu u simpto-mima ima bol.
Cilj: Cilj rada je bio ispitati karakteristike boli i postojeću praksu ublažavanja boli u akutnoj fazi infektivnih bolesti.
Metode: Istraživanje je bilo prospektivno u razdoblju od ožujka do studenog 2019.godine. U-ključeni su hospitalizirani bolesnici s dijagnozama: erizipel, celulitis, herpes zoster, meningo-encefalitis ili spondilodiscitis. Prikupljeni su i statistički obrađeni demografski i klinički po-datci. Od kliničkih podataka prikupljeni su: dužina hospitalizacije, kategorizacija bolesnika, karakteristike boli, primjena fizikalne terapije, upalni parametri, kronične bolesti i terapija kro-ničnih bolesti. Analizirane su sestrinske intervencije koje su provedene u cilju smanjenja in-tenziteta boli. Analizirane intervencije su: primjena propisanog analgetika, uklanjanje distra-ktora, njega kožnih promjena, pozicioniranje bolesnika, krioterapija i elevacija ekstremiteta, umirivanje bolesnika, prijevoj rane, primjena antiemetika. Analizirani su i primijenjeni anal-getici s uključenim načinom primjene tijekom 24 sata od hospitalizacije nakon čega je prove-dena evaluacija intenziteta boli.
Rezultati: U istraživanje je uključeno 100 ispitanika; 48% su bile žene, koje su kod svih dijag-noza osim herpes zostera navodile viši intenzitet boli. Bolnost se u prosjeku javlja pet dana prije hospitalizacije i razlika raspodjele broja dana od početka boli do hospitalizacije je statis-tički značajna. Najviši intenzitet boli (8/10), prilikom hospitalizacije, zabilježen je u bolesnika sa spondilodiscitisom. Polovica bolesnika žalila se na glavobolju, a većina je na bol reagirali mirovanjem. Istraživanje je pokazalo da je intenzitet boli viši u bolesnika druge i treće katego-rije i u prosjeku iznosi 6, dok je kod bolesnika u prvoj kategoriji intenzitet boli u prosjeku 4,5. Bolesnici koji zahtijevaju viši stupanj zdravstvene njege duže su hospitalizirani. Kod svih bo-lesnika je u cilju smanjenja intenziteta boli, čiji je prosjek u trenutku hospitalizacije iznosio 6/10, provedena najmanje jednom sestrinska intervencija primjene ordiniranog analgetika koji su u 80% bolesnika propisivani prema potrebi. Rezultati dobiveni istraživanjem pokazuju da su najčešće propisivani analgetici ujedno i antipiretici. Evaluacija intenziteta boli 24 sata nakon hospitalizacije pokazala je prosječnu vrijednost od 3,5. Rezultati su pokazali da je intenzitet boli bio viši u bolesnika koji su primali fizikalnu terapiju s dijagnozama erizipela, celulitisa i herpes zostera, dok je kod spondilodiscitisa bio niži. Analiza vrijednosti leukocita i C reaktiv-nog proteina pokazuje da se radi o očekivanim vrijednostima laboratorijskih parametara za navedene bolesti.
Zaključak: Analizom prikupljenih podataka dobili smo uvid u karakteristike boli u akutnoj fazi infektivnih bolesti i postojeću praksu ublažavanja boli. |
| Abstract (english) | Background: Infectious diseases are manifested by general and specific symptoms in which pain plays an important role.
Aim: The aim of this research was to examine the characteristics of pain and the existing prac-tice of pain management in the acute phase of infectious diseases.
Methods: This prospective study, conducted from March to November 2019, included hospi-talized patients diagnosed with erysipelas, cellulitis, herpes zoster, meningoencephalitis or spondylodiscitis. Patients` demographic and clinical data were collected and statistically ana-lyzed. Clinical data included: duration of hospitalization, patient categorization, pain charac-teristics, application of physical therapy, inflammatory parameters, chronic illnesses and ther-apy of chronic illnesses. Nursing interventions carried out in order to decrease pain intensity were also analyzed including: administration of prescribed analgesic, removal of distractors, treatment of skin changes, patient positioning, cryotherapy and elevation of the extremities, calming of patient, wound dressing, application of antiemetics. We also analyzed types of an-algesics and their method of administration during the 24 hours following hospitalization, af-ter which pain intensity was evaluated.
Results: A total of 100 participants were included in this research; 48% were women, who reported a higher intensity of pain for all diagnoses except herpes zoster. Pain appeared on average five days prior hospitalization and the difference in the distribution of the number of days from the onset of pain to hospitalization was statistically significant. The highest pain intensity during hospitalization (8/10) was recorded in patients with spondylodiscitis. Half of the patients complained of headache, and the majority reacted to pain by resting. Our research has shown that pain intensity, 6 on average, was higher in the second and third category pa-tients, while in patients allocated to the first category, the pain intensity was on average 4.5. Patients who required a higher level of health care were hospitalized for longer period of time. In order to reduce pain intensity, which on average was 6/10 at the time of hospitalization, a nursing intervention that includes administration of appropriately prescribed analgesic was applied at least once in all patients. In 80% of patients, analgesics were prescribed as needed, and our research results have showed that the most frequently prescribed analgesics were also antipyretics. Evaluation of pain intensity 24 hours after hospitalization showed an average value of 3.5. The results have shown that pain intensity was higher in patients receiving phys-ical therapy who were diagnosed with erysipelas, cellulitis and herpes zoster, than in patients with spondylodiscitis. Leukocyte count and C-reactive protein analysis showed expected val-ues of these laboratory parameters for listed diseases.
Conclusion: The analysis of collected data provided insight into the characteristics of pain in the acute phase of infectious diseases and the existing practice of pain management. |
