Introduction and objectives of the work. Esophageal varices represent a life-threatening problem that is difficult to manage in everyday life. The objective of the paper is to demonstrate that the nurse practitioner is relevant at home in a type of patient, chronic ones, specifically those suffering from esophageal varices, and to demonstrate how the nurse is useful in patient education and prevention, in such a way as to improve the living conditions of the patient or prevent the disease itself. Materials and methods. A narrative review of the literature was performed, including scientific studies related to patient-related nursing practice with esophageal varices. Through the PICO model (P = patient = patient with esophageal varices I = intervention = home support of the caregiver instructed by the nurse C = comparison = patients without home support) the potential complications and possible interventions that can be delivered at home have emerged from the literature, in addition to preventive strategies on which to focus the educational intervention. Most important results. Studies have shown that the most effective nursing interventions are the correct information and education of the patient regarding alcohol intake, and correct information on vaccination prophylaxis. These were the most important results considering that both are causes of esophageal varices, and are so in a higher percentage than the other causal factors. Analyses. All the results have shown that it is possible to carry out useful interventions at home, and that the nurse can change the fate of a clinical picture by implementing interventions and through education to the patient and (if present) also to the caregiver. Especially in the fragile patient who has already developed esophageal varices, the caregiver must be able to recognize signs and symptoms of shock in order to alert hospital helpers. Discussion and conclusions. Home action is important because it is an environment known to the patient, and this allows him to lead a life of his own despite the disease. Chronicity not treated at home in the long run would lead to the depersonalization of the person, to a change in the state of health and also in other aspects of life. As far as possible, the patient's certainties should be kept in order to allow him to face the great change inherent in the diagnosis of the disease. The next step could be a policy for implementing the procedures and protocols relating to home management, in accordance with legislation 71 of 2022 which revolutionizes territorial assistance. Keyword. Prevention. Education. Esophageal varices. Nurse. Home.
Introduzione ed obiettivi del lavoro. Le varici esofagee rappresentano un problema potenzialmente letale e di difficile gestione nel quotidiano. L’obiettivo dell’elaborato è dimostrare che il professionista infermiere sia rilevante a domicilio in una tipologia di pazienti, quelli cronici, nello specifico quelli affetti da varici esofagee, e dimostrare come l’infermiere sia utile nell’educazione del paziente e nella prevenzione, in maniera tale da migliorare le condizioni di vita del malato o prevenire la malattia stessa. Materiali e metodi. È stata effettuata una revisione narrativa della letteratura, includendo studi scientifici inerenti alla pratica infermieristica correlata con il paziente con varici esofagee. Tramite il modello PICO (P= patient = paziente con varici esofagee I= intervention = supporto domiciliare del caregiver istruito dall’infermiere C = comparison = pazienti senza supporto domiciliare) sono emerse dalla letteratura le complicanze potenziali e i possibili interventi erogabili a domicilio, oltre alle strategie preventive su cui poter focalizzare l’intervento educativo. Risultati più importanti. Dagli studi è emerso che gli interventi infermieristici più efficaci siano la corretta informazione e educazione del paziente rispetto all’assunzione di alcool, e la corretta informazione sulla profilassi vaccinale. Questi sono stati i risultati più importanti valutando che entrambi sono cause di varici esofagee, e lo sono in percentuale maggiore rispetto agli altri fattori causali. Analisi. Tutti i risultati hanno dimostrato che a domicilio è possibile effettuare interventi utili, e che l’infermiere può cambiare la sorte di un quadro clinico attuando interventi e tramite educazione al paziente e (se presente) anche al caregiver. Soprattutto nel paziente fragile che ha già sviluppato le varici esofagee il caregiver deve saper riconoscere segni e sintomi di shock per allertare i soccorsi ospedalieri. Discussione e conclusioni. L’intervento a domicilio è importante poiché è un ambiente conosciuto al paziente, e ciò gli permette di condurre una vita propria nonostante la malattia. La cronicità non trattata a domicilio alla lunga porterebbe alla depersonalizzazione della persona, ad un cambiamento allo stato di salute e anche agli altri aspetti della vita. Per quanto possibile bisognerebbe conservare le certezze del paziente per permettergli di affrontare il grande cambiamento insito nella diagnosi di malattia. Il passo successivo potrebbe essere una politica di implementazione delle procedure e dei protocolli inerenti alla gestione domiciliare, in accordo alla normativa 71 del 2022 che rivoluziona l’assistenza territoriale. Parole chiave. Prevenzione. Educazione. Varici esofagee. Infermiere. Domicilio.
Ruolo dell' Infermiere a domicilio nella prevenzione e trattamento delle Varici Esofagee: revisione della letteratura
FILENI, ELISABETTA
2021/2022
Abstract
Introduction and objectives of the work. Esophageal varices represent a life-threatening problem that is difficult to manage in everyday life. The objective of the paper is to demonstrate that the nurse practitioner is relevant at home in a type of patient, chronic ones, specifically those suffering from esophageal varices, and to demonstrate how the nurse is useful in patient education and prevention, in such a way as to improve the living conditions of the patient or prevent the disease itself. Materials and methods. A narrative review of the literature was performed, including scientific studies related to patient-related nursing practice with esophageal varices. Through the PICO model (P = patient = patient with esophageal varices I = intervention = home support of the caregiver instructed by the nurse C = comparison = patients without home support) the potential complications and possible interventions that can be delivered at home have emerged from the literature, in addition to preventive strategies on which to focus the educational intervention. Most important results. Studies have shown that the most effective nursing interventions are the correct information and education of the patient regarding alcohol intake, and correct information on vaccination prophylaxis. These were the most important results considering that both are causes of esophageal varices, and are so in a higher percentage than the other causal factors. Analyses. All the results have shown that it is possible to carry out useful interventions at home, and that the nurse can change the fate of a clinical picture by implementing interventions and through education to the patient and (if present) also to the caregiver. Especially in the fragile patient who has already developed esophageal varices, the caregiver must be able to recognize signs and symptoms of shock in order to alert hospital helpers. Discussion and conclusions. Home action is important because it is an environment known to the patient, and this allows him to lead a life of his own despite the disease. Chronicity not treated at home in the long run would lead to the depersonalization of the person, to a change in the state of health and also in other aspects of life. As far as possible, the patient's certainties should be kept in order to allow him to face the great change inherent in the diagnosis of the disease. The next step could be a policy for implementing the procedures and protocols relating to home management, in accordance with legislation 71 of 2022 which revolutionizes territorial assistance. Keyword. Prevention. Education. Esophageal varices. Nurse. Home.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/11186