Gorawara-Bhat R, Wong A, Dale W, Hogan T. Nurses' perceptions of pain management for older-patients in the Emergency Department: A qualitative study.
PATIENT EDUCATION AND COUNSELING 2017;
100:231-241. [PMID:
27591825 DOI:
10.1016/j.pec.2016.08.019]
[Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES
1) Identify themes arising from nurses' perceptions of assessing older-patients' pain; 2) use themes to guide development of optimal interventions to improve quality of pain assessment in the emergency department (ED).
METHODS
Nurse interviews (n=20) were conducted until theme saturation. They were transcribed, coded, and analyzed using qualitative methodology.
RESULTS
Two major themes-nurse 'challenges' and 'strategies' to overcome challenges, and their subthemes - classified as 'patient-related' or 'system-related,' were salient in nurses' perceptions. Strategies nurses reported for managing challenges were based in their own professional lived experiences.
DISCUSSION AND CONCLUSION
A 2×2 framework was developed to conceptualize challenges, strategies, subthemes and their classifications, yielding 4 typologies comprising challenge types matched with appropriate strategy types. While emergent challenges and strategies are corroborated in the literature, the present study is the first to develop a scheme of typologies beneficial for guiding the development of optimal interventions to improve the quality of assessing pain in older-patients.
PRACTICE IMPLICATIONS
The typology framework can guide the development of pain assessment tools and the needed combinations for assessing multidimensional pain in older-patients. Using the present findings, a new clinical intervention was shown to significantly improve pain management for older-patients in the ED.
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