Manejo não farmacológico da dor em pediatria: construção e validação de um protocolo

Abstract

Pain is a sensory-emotional, subjective and individual experience that affects quality of life and plays a warning role by indicating biological dysfunctions. It is considered as the fifth vital sign. Non-pharmacological methods favor a more peaceful experience in child hospitalization, using ludic and non-invasive techniques. The nursing team plays an important role in identifying and managing pain. The objective is to elaborate and validate a protocol for the non-pharmacological management of pain in a pediatric unit. This is a methodological study that developed and validated a protocol to be used in the non-pharmacological management of pain in pediatrics at a federal university hospital. Seven nurses participated in the study. Echer's budgets (2005) were adopted for this study, which describe the stages of the construction process of didactic materials for health care. The construction process involved the following steps: submission of the project to the Ethics and Research Committee; carrying out an integrative literature review using the PICO strategy in Medline, BDENF, Lilacs and Scielo databases and libraries, and organization according to PRISMA. Then, an interview was carried out with nurses where a questionnaire was used with questions related to personal and professional characterization data; and a second part with closed questions about prior knowledge about pain and its management in pediatrics. In the subsequent stage, the elaboration of the first version of the protocol was worked on, based on the integrative literature review, and validation by the judges. Seven judges participated in the validation stage of the protocol. For statistical analysis of the protocol and its validation, the content validity index (CVI) and Kappa concordance (k) were used. As a result of the literature review, three studies were obtained that made up the final sample and through which the first version of the instrument with 15 domains and 36 items was organized. In the second moment, the judges validated the content and appearance using a round of the Delphi technique, where 19 items obtained an agreement index below the cutoff point, which was defined as 0.80. The instrument underwent changes after the evaluation, for its final use. It is expected that the creation of a protocol will contribute to the reorganization of the nursing team's conduct, standardization of pain assessment and management strategies.