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Treating without seeing: Pain management practice in a Thai context
School of Nursing, Rangsit University, Pathum Thani, Thailand.ORCID iD: 0000-002-1123-1336
School of Nursing, Rangsit University, Pathum Thani, Thailand.
The Red Cross University College, Stockholm, Sweden.
Swedish Red Cross University College, Stockholm, Sweden.ORCID iD: 0000-0003-3589-318X
2016 (English)In: Pain Research & Management, ISSN 1203-6765, E-ISSN 1918-1523, article id 9580626Article in journal (Refereed) Published
Abstract [sv]

Pain management is a core nursing function, and it plays a key role in postoperative care. It is important to understand the cultural context of nursing practices and how this affects effective pain management. The aim of this study was to describe the professional and cultural framework within which painmanagement is practiced on a Thai surgical ward. Spradley's ethnographic methodology was used. Data were collected through 98.5 hours of field observations and interviews at a surgical ward in Thailand. Three themes were constructed that describe the way Thai nurses practiced pain management: (i) complex communications system to address pain and to respond to it, (ii) the essence of Thai-ness, and (iii) a passive approach to pain management. The results indicate that, in the response to discomfort and pain, better pain management will result if there is a shift from functional to patient-centered care. The nursing culture needs to be further researched and discussed, in order to set priorities in line with the goals of national and international organizations for improving postoperative care and promoting patient comfort.

Place, publisher, year, edition, pages
2016. article id 9580626
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-31700DOI: 10.1155/2016/9580626ISI: 000390157600001Scopus ID: 2-s2.0-85006246812OAI: oai:DiVA.org:mdh-31700DiVA, id: diva2:932903
Available from: 2016-06-02 Created: 2016-06-02 Last updated: 2018-12-14Bibliographically approved
In thesis
1. Post-operative pain management practice: Current situation and challenges within nursing practice in a Thai context
Open this publication in new window or tab >>Post-operative pain management practice: Current situation and challenges within nursing practice in a Thai context
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Patients’ recovery after surgery is one of the most important health processes in planned hospital healthcare and has a direct impact on welfare and welfare systems. Therefore, what nurses do in the im­mediate postoperative period is of vital importance. This thesis addresses the question of understanding how nurses work in managing post-operative pain by exploring their daily nursing practices and experiences in responding to the patient in pain within a Thai cultural context.

The project applied a qualitative methodology where the local culture and its day-to-day practices of pain management were studied by using observations, focus groups, in-depth interviews and a critical incident interview approach with nurses. Informants were recruited at a public hospital in Bangkok in a surgical ward. In all, 100 hours of observations, 39 interviews and 69 descriptions of critical incidents related to nurse’s pain management were gathered. The data analysis followed the principles of qualitative research.

The findings showed that, although there is a clearly defined approach to pain management, the response system followed by the nurses to address patients’ pain is complex and includes much lead time between assessing patients’ pain and the nurses responding to the pain. Furthermore, nurses are caught in what is labeled a patient pa­radigm, where evidence of pain often is double- and triple-checked by scoring and recording signs that are then subject to confirmation by a third party. Underpinning this is a culture of pain management cultivated between the nurses that rests first and foremost on their own experiences and a working/professional culture where nurses offer each other practical help in urgent situations, but seldom discuss event-based strategies together. Nevertheless, when nurses described situations when they were successful in practicing pain management, they considered their own engagement and their availability of time, space and therapeutic options to be important.

Keywords: Culture of nursing, Nursing in pain management, Pain assessment, Perception of pain, Pain management, Pain post-operative

Place, publisher, year, edition, pages
Västerås: Mälardalen University, 2016
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 204
Keywords
Culture of nursing, Nursing in pain management, Pain assessment, Perception of pain, Pain management, Pain post-operative
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-31674 (URN)978-91-7485-272-1 (ISBN)
Public defence
2016-08-30, Raspen, Mälardalens högskola, Eskilstuna,, 13:00 (English)
Opponent
Supervisors
Available from: 2016-06-02 Created: 2016-06-01 Last updated: 2016-08-09Bibliographically approved

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Mazaheri, Monir

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