Intervenções não farmacológicas no manejo da dor oncológica

Abstract

Introduction: Cancer is one of the leading causes of death worldwide and represents a public health challenge. Pain is one of the main symptoms reported by cancer patients, and the American Pain Society has recognized pain as the fifth vital sign, meaning the nursing team plays a fundamental role in recognizing and managing this pain. Therefore, non-pharmacological interventions for pain relief have shown significant results in cancer patients. General objective: To synthesize the main evidence on non-pharmacological interventions used by the nursing team in the management of pain in cancer patients. Method: This is a rapid systematic review, conducted according to PRISMA 2020 recommendations. The search was performed in the PubMed/MEDLINE, CINAHL, LILACS, SciELO and Cochrane Library databases, using controlled descriptors (DeCS/MeSH), free words and the following Boolean operators AND and OR. Randomized clinical trials published between January 2015 and June 2025, in Portuguese, English, and Spanish, with full text available, were included. The methodological quality of the studies was assessed using the PEDro scale, and the risk of bias was assessed using the Risk of Bias 2 (Rob 2) tool. Results: Forty-two studies were identified, of which two met the eligibility criteria and comprised the final sample, one of which was retrieved through manual search. Both investigated foot reflexology as a non-pharmacological intervention performed by trained professionals. The studies demonstrated a reduction in pain intensity, as well as benefits on fatigue, sleep quality, and nausea, with no reported adverse events. The methodological assessment indicated satisfactory quality and a judgment of "some concerns" regarding the risk of bias. Discussion: The findings corroborate recent evidence that points to foot reflexology as a promising integrative practice for pain management in cancer patients. However, the heterogeneity of intervention protocols, the lack of standardization in the measurement of outcomes, the reduced number of randomized clinical trials, and methodological limitations, such as blinding difficulties, restrict the robustness of the available evidence and hinder comparisons between studies. Conclusion: Foot reflexology has shown promising results as a non-pharmacological intervention for pain management in cancer patients, also contributing to the reduction of associated symptoms and to improving quality of life. However, its incorporation into clinical practice must be based on the work of trained professionals and on evidence of higher scientific quality, requiring new randomized clinical trials with standardized protocols and long-term follow-up.