Person-centred care (PCC) is more than high-quality care: aimed to meet specific patient needs on equal terms, it also protects human rights (McCormack & McCance, 2017; United Nations, 1948). Although all health care should be person-centred, missed nursing care continues to have severe consequences for patients and organisations (Aiken et al., 2017; Francis, 2013; Griffiths et al., 2018). One reason is the biomedical model that dominates health care systems and even nursing practices (Feo,
Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.
AimsTo test a model for person‐centred pain management using qualitative evidence in the literature and refine it based on the results.DesignA qualitative systematic review with thematic synthesis using the Fundamentals of Care framework.Methods and Data SourcesA literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE‐CERQual approach were used in the synthesis including the assessment of confidence in the evidence.ResultsThe model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non‐pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions.ConclusionsThe strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation.Implications for the Profession and/or Patient CareThe model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person‐centred pain management in clinical practice.Patient or Public ContributionNo patient or public contribution.ImpactWhat Problem Did the Study Address? There is a need to transfer available evidence of person‐centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person‐centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient–nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non‐pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain.Reporting MethodRelevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Statement.
The cover image is based on the Original Research: Empirical Research – Qualitative Person‐centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework, by Therese Avallin et al., DOI .
AimTo develop and test a questionnaire using the Fundamentals of Care framework to measure person‐centred pain management.DesignCross‐sectional exploratory descriptive design.MethodsDevelopment in three phases: (a) literature search for questionnaires measuring person‐centred pain management, (b) seven‐step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the ‘Strategic and Clinical Quality Indicators in Postoperative Pain management’ questionnaire, the Fundamentals of Care framework and person‐centredness principles. Theoretical experts (n = 2) reviewed the questionnaire, further evaluated by providers (n = 5) and patients (n = 5) using a think‐aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital.ResultsThe evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person‐centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18–89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement.ConclusionThis first attempt at transforming the essential components of person‐centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management.Implications for the profession and/or patient careThe developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person‐centred pain management in acute surgical care, to relieve the patient from pain.Patient or public contributionPatients and providers were involved in testing the questionnaire.
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