[Pruritus without skin manifestation--what kind of state of the art nursing intervention?].
The search for evidence based information and its evaluation for planning the care of a woman with pruritus without visible signs on her skin is exemplified and described in this article. Literature was sought with the key words "itch", "pruritus", and "elderly" in medline, Cinahl and the Cochrane library. Retrieved studies were appraised by the criteria for valid information of evidence based nursing. Most pruritus studies were about pruritus with skin rash or about pruritus connected to liver or renal failure. Randomised controlled trials about the treatment of pruritus were characterised by small sample sizes or were done with only men or women. The little knowledge found in these studies did not help resolve the complex individual situation of the patient. Treatment suggestions from the studies: to assess the causes and exacerbating factors of pruritus; to wash the skin with water only, e.g. without soap; to emulsify the skin with Vaseline or oil at least once daily; to prevent too much heat by covering the patient just enough for him or her to feel no cold; prescribing Atarax, a histamin inhibitor of the first generation at night time; to try the antidepressant drug Doxepin; and emulsification with alcohol, menthol and cool water. There is no evidence to predict results of any one of these suggested interventions. Further research regarding the pathophysiology and the effectiveness of interventions against pruritus is needed.
Schaffert-Witvliet
Bianca
B
Institut für Pflegewissenschaft, Universität Basel. bianca.schaffert@gmx.ch
D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D009730:Nursing Assessment; D010347:Patient Care Planning; D011537:Pruritus / Q000209:etiology / Q000451:nursing*