Engagement and availability in shaping nurses’ management of postoperative pain: a qualitative study

Abstract

BackgroundStudies reporting inadequate nursing care for patients indicate that nurses are negatively affected in such situations, and research is needed to study nursing care in postoperative situations.ObjectiveTo describe situations of postoperative pain management in a surgical ward in Thailand.MethodsA qualitative approach using the Critical Incident Technique was chosen to investigate situations of postoperative pain management from the perspective of surgical nurses in Thailand. Data were collected through multiple semi-structured interviews with nine nurses over a five-week period.ResultsThe situations of surgical nurses described three elements that heavily influenced the quality of postoperative pain management: engagement in a trustful nurse-patient relationship, availability of pain medication and nursing care when needed, and imbalance between meeting the patient’s needs and completing routine nursing duties.ConclusionThe results help to expand our understanding of how Thai nurses manage pain in postoperative situations and indicate areas that could be improved in terms of how nurses respond to patients’ pain. Nurses challenge existing guidelines and facilitate development of new nursing guidelines and/or policies in pain management.

Exploring the different management structures in nurses responses and treating of patients’ postoperative pain: A qualitative triangulation study

“…Nurses act as coordinators in responding to patients in pain within a system that provides information, direction and support by using double-and triple-control methods which are mostly concerned with generating documents and records to support the patient's pain relief (17,20). These findings support previous evidence in pain assessment knowledge of the quality of care that is needed to support improved outcomes for patients who are in postoperative recovery (27).…”

“…Qualitative methods are especially useful when exploring complex phenomena, and the variety of chosen approaches here, may also offer new ways of examining the nurses' experiences of managing pain. The following approaches were used in this study: 1) making observations of the participants (and conducting go-along interviews) while they worked in the surgical field for a total of 100 hours (17), 2) focus group interviews with 18 nurses, who were divided into three groups of focus-group discussions (FGDs) (18), 3) in-depth interviews (12 nurses) (19), and 4) critical incident interviews with 9 nurses during recurrent visits over a period of ten weeks that collected 69 critical incidents (20). The nurses were chosen in accordance with theoretical sampling as Benner's nursing theory (21) was used for recruiting participants to the FGDs, in-depth interviews and critical incident interviews.…”

A Scoping Review of Pain Management Education Programs (PMEPs): Do They Prepare Nurses to Deal with Patients’ Postoperative Pain?

“…PMEPs offer a solution which can be as simple as refreshing their knowledge about effective pain management [ 1 , 2 ]. However, the effectiveness of PMEP on patient outcomes remains a challenge in the developed world and in low- and middle-income countries, where the consequences of inadequately treated postoperative pain for the patient in pain after surgery is more of concern [ 2 , 6 , 9 , 19 ]. The limitations of this review are related to its size, breadth, and the rigidity of the inclusion and exclusion criteria for PMEP definitions.…”

Core components of an effective pain management education programme for surgical nurses: A Delphi study*

“…Overall, surgical nurses were observed to have a passive approach to pain management (Chatchumni et al, 2016a ,b). Therefore, there is a need to shift to an evidence-based paradigm to help surgical nurses in Thailand manage post-operative pain (Chatchumni et al, 2016b , 2018 , 2019 , 2015 ).…”