Nurses’ Advocacy of Clinical Pain Management in Hospitals: A Qualitative Study

Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n = 24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management.

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Ambulance personnel's experience of pain management for patients with a suspected hip fracture: A qualitative study

International Emergency Nursing ◽

10.1016/j.ienj.2014.12.003 ◽

2015 ◽

Vol 23 (3) ◽

pp. 244-249 ◽

Cited By ~ 7

Author(s):

D. Jakopovic ◽

A.-C. Falk ◽

V. Lindström

Keyword(s):

Hip Fracture ◽

Pain Management ◽

Qualitative Study

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The Placebo Effect in Pain Therapies

The Annual Review of Pharmacology and Toxicology ◽

10.1146/annurev-pharmtox-010818-021542 ◽

2019 ◽

Vol 59 (1) ◽

pp. 191-211 ◽

Cited By ~ 24

Author(s):

Luana Colloca

Keyword(s):

Pain Management ◽

Well Being ◽

Pain Processing ◽

Adherence To Treatment ◽

Placebo Effects ◽

Pain Experience ◽

Critical Elements ◽

Clinical Pain ◽

Pain Outcomes ◽

Positive Expectancies

Pharmacological strategies for pain management have primarily focused on dampening ascending neurotransmission and on opioid receptor–mediated therapies. Little is known about the contribution of endogenous descending modulatory systems to clinical pain outcomes and why some patients are mildly affected while others suffer debilitating pain-induced dysfunctions. Placebo effects that arise from patients’ positive expectancies and the underlying endogenous modulatory mechanisms may in part account for the variability in pain experience and severity, adherence to treatment, distinct coping strategies, and chronicity. Expectancy-induced analgesia and placebo effects in general have emerged as useful models to assess individual endogenous pain modulatory systems. Different systems and mechanisms trigger placebo effects that highly impact pain processing, clinical outcomes, and sense of well-being. This review illustrates critical elements of placebo mechanisms that inform the methodology of clinical trials, the discovery of new therapeutic targets, and the advancement of personalized pain management.

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Opioid Analgesics in Clinical Pain Management

Opioids II - Handbook of Experimental Pharmacology ◽

10.1007/978-3-642-77540-6_29 ◽

1993 ◽

pp. 697-743 ◽

Cited By ~ 14

Author(s):

K. M. Foley

Keyword(s):

Pain Management ◽

Opioid Analgesics ◽

Clinical Pain

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Using information and communication technologies to improve the management of pain from advanced cancer in the community: Qualitative study of the experience of implementation for patients and health professionals in a trial

Health Informatics Journal ◽

10.1177/1460458220906289 ◽

2020 ◽

Vol 26 (4) ◽

pp. 2435-2445

Author(s):

Julia Hackett ◽

Matthew J Allsop ◽

Sally Taylor ◽

Michael I Bennett ◽

Bridgette M Bewick

Keyword(s):

Palliative Care ◽

Pain Management ◽

Qualitative Study ◽

Information And Communication Technology ◽

Communication Technology ◽

Health Professionals ◽

Randomised Control Trial ◽

Care Practice ◽

Technology System ◽

Information And Communication

In cancer care, there are emerging information and communication technology systems being developed, enabling real-time information sharing between patients and health professionals. This study explored health professionals’ and patients’ perceptions of their engagement with an information and communication technology system for pain management to understand the mechanisms that could support implementation into routine palliative care practice. This was a qualitative study, embedded within a randomised control trial, using semi-structured face-to-face interviews. Data were analysed using thematic analysis. The role of health professionals was a key component to patient engagement with the information and communication technology system. Where patients engaged with the information and communication technology system, both patients and health professionals reported benefits to system use in addition to usual care. Implementation issues were identified that can be used to guide future system development to support pain management in the context of routine clinical care in palliative care services. Where interventions are dependent on multiple providers, collaborative working and consideration of the context within which they are set are needed.

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Factors That Hinder and Facilitate Cancer Patients' Knowledge About Pain Management—A Qualitative Study

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2018.12.334 ◽

2019 ◽

Vol 57 (4) ◽

pp. 753-760.e1 ◽

Cited By ~ 1

Author(s):

Mirjam Ekstedt ◽

Tone Rustøen

Keyword(s):

Pain Management ◽

Qualitative Study ◽

Cancer Patients

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‘It’s about willpower in the end. You’ve got to keep going’: a qualitative study exploring the experience of pain in inflammatory bowel disease

British Journal of Pain ◽

10.1177/2049463719844539 ◽

2019 ◽

Vol 13 (4) ◽

pp. 201-213 ◽

Cited By ~ 1

Author(s):

Louise Sweeney ◽

Rona Moss-Morris ◽

Wladyslawa Czuber-Dochan ◽

Laure Belotti ◽

Zoe Kabeli ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Pain Management ◽

Qualitative Study ◽

Bowel Disease ◽

Management Strategies ◽

Emotional Impact ◽

Management Interventions ◽

Inflammatory Bowel ◽

Behavioural Therapies ◽

Physical Impact

Background: Pain is a widely experienced symptom of inflammatory bowel disease (IBD), which has significant psychological and functional impacts on patients. Understanding the aetiology and management of chronic pain is a poorly understood area of IBD research. This qualitative study aimed to explore the experiences of individuals with IBD and pain, the pain management strategies they use and any needs for future pain management interventions. Methods: In all, 14 individuals with IBD were purposively recruited and interviewed (face-to-face or telephone) using a topic guide. Interviews were transcribed and analysed using inductive thematic analysis. Results: Themes identified were ‘vicious cycles’, ‘findings solutions’ and ‘attitudes’. The experience and impact of pain were rarely viewed in isolation, but rather within the context of a cycle of IBD symptoms. Other ‘vicious cycles’ identified included anxiety, avoidance and inactivity, and poor understanding and communication. Pain management included short- and long-term strategies. Searching for a solution for pain had an emotional impact on individuals. There were contrasting attitudes from participants, including defeat, tolerance and acceptance. Conclusion: This study provides an understanding of the experience of pain in IBD. The interaction of pain with accompanying IBD symptoms has an emotional and physical impact on individuals, and creates a barrier to adequate assessment, understanding and treatment of pain. Patients rely on their own experiences, and a trial and error approach to apply helpful strategies. Adjuvant behavioural therapies may be beneficial for patients experiencing pain and psychological distress, and to facilitate self-management.

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