Abstract
ABSTRACT BACKGROUND AND OBJECTIVES: To outline best practices guidelines to control pain and dyspnea of cancer patients in an urgency setting. CONTENTS: PI[C]O question, with resource to EBSCO (Medline with Full Text, CINAHL, Plus with Full Text, British Nursing Index), retrospectively from September 2009 to 2014 and guidelines issued by reference entities: Oncology Nursing Society (2011), National Comprehensive Cancer Network (2011; 2014) and Cancer Care Ontario (2010), with a total of 15 articles. The first stage for adequate symptoms control is systematized evaluation. Pharmacological pain control should comply with the modified analgesic ladder of the World Health Organization, including titration, equianalgesia, opioid rotation, administration route, difficult to control painful conditions and adverse effects control. Oxygen therapy and noninvasive ventilation are control modalities of some situations of dyspnea, where the use of diuretics, bronchodilators, steroids, benzodiazepines and strong opioids are effective strategies. Non-pharmacological measures: psycho-emotional support, hypnosis, counseling/training/instruction, therapeutic adherence, music therapy, massage, relaxation techniques, telephone support, functional and respiratory reeducation equally improve health gains. CONCLUSION: Cancer pain and dyspnea control require comprehensive and multimodal approach. Implications for nursing practice: best practice guidelines developed based on scientific evidence may support clinical decision-making with better quality, safety and effectiveness.
Highlights
Every year, there will be an additional 14 million new cases of people with cancer, and the expectation is that it will triple by 2030, as a result of the survival[1]
The results referring to cancer pain are presented, subdivided in the initial assessment, pharmacological and Research in the EBSCO Database
High-quality evidence obtained from meta-analyses, systematic reviews of randomized clinical trials (RCT)
Summary
Every year, there will be an additional 14 million new cases of people with cancer, and the expectation is that it will triple by 2030, as a result of the survival[1]. In an advanced stage of the disease, dyspnea is one of the symptoms that take a particular relevance, often associated with pain (about 45%), representing a symptom cluster driver of greater anxiety and fatigue responsible for the demand for health care, making it crucial to have serious investments to control it[3,4,5,6]. In this sense, the purpose is to highlight the guidelines for good nursing practice in pain and dyspnea control in patients with cancer in the emergency service.
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