Instrumento de avaliação do paciente neuro-oncológico e cirúrgico pelo enfermeiro

Abstract

Neurological cancer is considered one of the most difficult neoplasms to treat, as many patients have incurable, debilitating tumors and even with surgery, the diagnosis cannot be cured. The nurse's clinical assessment of this neoplasm consists of an approach that understands the needs of the clinical and surgical neuro-oncology patient. In this sense, the nurse needs to have extensive knowledge of semiology and semiotics to carry out a specialized assessment of neuro-oncological and surgical patients. Create an instrument for evaluating neuro-oncological and surgical patients by nurses due to the need for an adequate and specific evaluation of the patient, as there is no instrument that evaluates this type of patient according to their particularities. This is a methodological study that sought to bring together the main scientific evidence discovered in PUBMED, Virtual Health Library (VHL) and SCIELO. To develop the material, an integrative literature review was carried out as the first step, in which it was possible to support and structure the creation of the instrument to evaluate surgical neuro-oncology patients in the perioperative period. PICo mnemonic strategy was used and the guiding question was: “How can the nurse evaluate the surgical neuro-oncology patient who experiences the pre-operative, intra-operative and post-operative moments?”. The descriptors “Cancer” were used; "Patient"; "Neurology"; “Oncological Surgery”; "Neurosurgery"; "Nursing"; “Surgical Nursing”; "Assessment"; “Neurological Examination”, grouped by the Boolean operator “AND”. Therefore, articles in Portuguese, English and Spanish published in the last 10 years and articles that talked about nursing assessment during the perioperative period were included. Texts that did not deal with the assessment of neurological and oncological patients or that did not deal with patients undergoing surgery were excluded. After selection, 450 articles were found, of which 9 were chosen for the final sample. It was evident that most articles highlight the importance of evaluating surgical neuro-oncology patients. However, studies do not delve into how a targeted assessment should be carried out for this type of patient. In this sense, the instrument created for evaluation fills this gap, as it evaluates the patient with a complete physical examination and throughout the perioperative period according to their needs, directing the nurse's assistance and optimizing their routine. Therefore, there is slow progress in research related to the topic, which makes understanding difficult. Therefore, there is a need to seek new approaches to direct the evaluation of surgical neuro-oncology patients. Furthermore, it is necessary for the nursing team to be at the forefront of the assessment and to do so requires qualification and specialization in the area to implement best practices.