Abstract
Developing and validating a scale to assess perioperative thirst discomfort. A methodological research conducted in 2014 and 2015 at the surgical center of a public hospital in the north of Paraná, Brazil. The scale was developed after literature review, followed by face and content validation, and reliability assessment through its internal consistency and inter-observer equivalence. Seven items make up the scale: dry mouth; dry lips; thick tongue; thick saliva; dry throat, bad taste and desire to drink water. The content validity index for attributes and items was 0.98, and the reliability index was 1 for the scale attributes and items. Internal consistency assessed by Cronbach's alpha was 0.91 and inter-rater equivalence was 1, as measured by weighted kappa coefficient. ThePerioperative Thirst Discomfort Scaleshowed high content and reliability indexes. Elaborar e validar uma escala para avaliação do desconforto da sede perioperatória. Pesquisa metodológica realizada em 2014 e 2015, no centro cirúrgico de um hospital público do norte do Paraná. A escala foi elaborada após revisão bibliográfica, seguida de validação aparente e de conteúdo e avaliação da fidedignidade através de sua consistência interna e da equivalência inter observadores. Sete itens compuseram a escala: boca seca; lábios ressecados; língua grossa; saliva grossa; garganta seca; gosto ruim e vontade de beber água. O índice de validade de conteúdo para atributos e itens foi de 0,98, e o índice de fidedignidade foi de 1 para os atributos e itens da escala. A consistência interna avaliada pelo alfa de Cronbach foi de 0,91, e a equivalência interobservadores foi de 1, medida pelo coeficiente de kappa ponderado. A escala de desconforto da sede perioperatóriademonstrou altos índices de validade de conteúdo e fidedignidade.
Highlights
Thirst is described as the desire to drink water, influenced by physiological factors and an individual’s life habits(1)
Thirty representative attributes from the construct “thirst discomfort” were defined: bitter mouth, coarse mouth, irritated mouth, dry mouth, tiredness, brittle oral cavity, difficulty swallowing, headache, easy bleeding from oral cavity, sore throat, coarse throat, dry throat, bad taste in the mouth, hyposalivation, parched lips, cracked lips, thick tongue, dry tongue, bad breath, slightly dry eyes, dry eyes, loss of appetite, burning throat, burning in the stomach, thick saliva, drowsiness, dizziness, desire to drink water, desire to swallow and xerostomia
Based on an operationalization of the attributes, we obtained seven corresponding items: my mouth is dry; my lips are dry; I feel my tongue is thick; my saliva is thick; my throat is itchy; I have a bad taste in my mouth; I feel like drinking water
Summary
Thirst is described as the desire to drink water, influenced by physiological factors and an individual’s life habits(1). When not quenched by water intake, thirst becomes an unpleasant feeling so imperative that it can outweigh all the others(2). Surgical patients are part of a group at high risk of developing both osmotic and hypovolemic thirst(1,3). Patients are exposed to several factors predisposing to the thirst symptom, such as prolonged preoperative fasting, anesthetic-surgical medications, orotracheal intubation and blood loss(1-4). When the confluence of these factors are added to anxiety, irritability, stress and fear of anesthesia and surgery(2,4-5), it results in thirst being one of the most distressing aspects for the patient. Patients’ reports on the experience of thirst in the perioperative period describe it as intense suffering, with allusions to thoughts of despair and even death(7). Thirst remains undervalued, undermeasured and undertreated in clinical practice(1,8)
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