Evaluación e intervención interdisciplinaria del dolor en Unidades de Cuidado Intensivo

El dolor es un problema importante para los pacientes hospitalizados en las UCI porque genera malestar y distrés. Además, la investigación ha demostrado que en algunos pacientes críticos el dolor agudo puede persistir después de alta y convertirse en crónico. La gestión eficaz del dolor en pacientes críticos requiere un enfoque interdisciplinario, que incorpore la visión y trabajo de expertos que representan una amplia variedad de especialidades clínicas. Así, la utilización de la intervención psicológica en el tratamiento del dolor es una parte integral de un enfoque global. Basado en una revisión de la evidencia científica, se identifican y señalan: (1) los tipos de dolor más comunes; (2) las características del dolor; (3) las patologías más frecuentes asociadas con la presencia de dolor; (4) los procedimientos que generan dolor en la UCI; (5) los métodos de evaluación del dolor; (6) la intervención del mismo y; (7) la contribución del psicólogo en la evaluación y manejo del dolor con el paciente, los familiares y los profesionales de la salud. La revisión realizada indica que los procesos psicológicos influyen tanto en la experiencia del dolor como en los resultados del tratamiento, por lo tanto la integración de los principios psicológicos en el tratamiento del dolor parecen tener potencial mejora de los resultados beneficiando la salud del paciente.

Clinical prediction of occupational and non-specific low back pain

Non-specific Occupational Low Back Pain (NOLBP) is a health condition that generates a high absenteeism and disability. Due to multifactorial causes is difficult to determine accurate diagnosis and prognosis. The clinical prediction of NOLBP is identified as a series of models that integrate a multivariate analysis to determine early diagnosis, course, and occupational impact of this health condition. Objective: to identify predictor factors of NOLBP, and the type of material referred to in the scientific evidence and establish the scopes of the prediction. Materials and method: the title search was conducted in the databases PubMed, Science Direct, and Ebsco Springer, between1985 and 2012. The selected articles were classified through a bibliometric analysis allowing to define the most relevant ones. Results: 101 titles met the established criteria, but only 43 metthe purpose of the review. As for NOLBP prediction, the studies varied in relation to the factors for example: diagnosis, transition of lumbar pain from acute to chronic, absenteeism from work, disability and return to work. Conclusion: clinical prediction is considered as a strategic to determine course and prognostic of NOLBP, and to determine the characteristics that increase the risk of chronicity in workers with this health condition. Likewise, clinical prediction rules are tools that aim to facilitate decision making about the evaluation, diagnosis, prognosis and intervention for low back pain, which should incorporate risk factors of physical, psychological and social.

Implementation of ‘School Back’ by the ‘Core’ technique in a factory of geotextiles to prevent back pain

Introduction: This article aims to show an alternative intervention for the prevention and control of back pain to the people of a production plant of geotextiles for the construction exposed to handling and awkward postures through the implementation of the Back School using the CORE technique. This technique being understood as trainer of the stability musculature of the spine; whose benefit is proportionate the muscular complex of the back, stability and avoid osteomuscular lesions and improved posture. Objective: To present the results about the implementation of the back school by the CORE technique for prevention of back pain in a population of forty-eight male collaborators. Materials and methods: The back school began with talks of awareness by the occupational health physician explaining the objectives and benefits of it to all participants. Once this activity was done, was continued to evaluate all plant employees to establish health status through the PAR-Q questionnaire, who were surveyed for the perception of pain using visual analog scale (VAS) and stability was determined column through the CORE assessment, to determine the training plan. Then, were made every six months the revaluations and implementation of a survey of assistant public perception to identify the impact of the implementation of the school back on the two variables referred (pain perception and stability of column). Results: The pain perception according VAS increased in the number of workers asymptomatic in 12% and based in the satisfaction survey 94% of population reported that with the development of this technique decrease the muscle fatigue in lumbar level; and 96% of population reported an improvement in the performance of their work activities. Discussion: Posterior to the analysis of all results, it is interpreted that back schools practice through CORE technique, contributes to the prevention and / or control of symptoms at the lumbar level in population of productive sector exposed to risks derived from the physical load, provided that ensure its continuously development and supervised for a competent professional.