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Please use this identifier to cite or link to this item: http://hdl.handle.net/1946/1225

Title: 
  • Title is in Icelandic The essential structure of the challenges of caring for patients with pain : a phenomenological study
Authors: 
Abstract: 
  • Abstract is in Icelandic

    Despite medical advances, hospitalised patients continue to suffer because of
    deficits in pain management, such as nurses’ under-medication. The aim of this
    study was to generate an in-depth understanding of what it is like for nurses to care
    for patients with pain. The purpose was to improve patients’ pain management.
    The research question was ‘what is the essential structure of nurses’ experience of
    caring for patients with pain?’ The research approach was phenomenology: the
    Vancouver School of doing phenomenology, and the sampling purposeful. The
    researcher participated in twenty dialogues (unstructured interviews), with the ten
    nurses who were co-researchers (participants), and were working on adult medical
    and surgical wards at three hospitals in Iceland. The data analysis was thematic,
    resulting in the essential structure of: ‘the challenges of caring for patients with
    pain’.
    Nurses’ experience of caring for patients with pain may be understood by viewing
    their role within a goal directed mission, where the nurses who have strong moral
    obligation to relieve pain, assumed the role of the patients’ advocates. Their
    mission was, however, complicated by several internal and external challenges and
    barriers. The most prevailing features were the fear of giving too much, strain of
    caring for addicts and terminal patients with pain, absence of or inadequate
    prescription, and sometimes lack of access to accountable physicians. A vital factor
    was to have decision on palliative care and clear rules about pain management,
    since such directives facilitated successful pain relief. One important turning point
    on the nurses’ journey was the ‘gate’ where they participated in mutual decisionv
    making along with the physician. Within these relations, having a voice was vital
    for the nurses while they generally felt that they were being listened to and
    respected. Knowing the patient and the physician facilitated all relations. Where
    physicians are responsible for all drug prescriptions, the nurses considered that in
    general using their influence or pressure was sufficient for them to be granted what
    was needed, but sometimes they had to insist and persist to achieve better solutions,
    or some closure. Many nurses bypassed the gate by altering the medication on their
    own initiative, or using independent nursing interventions. The outcome of the
    journey; positive or negative, affected the wellbeing of nurses as well as the
    patients, but distress also served as a drive for more action. Nurses’ major coping
    strategy was seeking support from nursing colleagues, and specialists in pain
    management but other methods also seemed to keep the nurses and their patients
    satisfied, even if the outcome was otherwise unsatisfactory.
    My conclusion is that, so as to be capable of performing in accord with their moral
    and professional obligations, nurses need various coexisting patterns of knowledge
    and the optimal organisational environment. Where former studies mainly focus on
    single dimensions of pain management, this study brings in multiple factors that
    influence nurses’ possibilities of providing satisfactory pain relief, such as
    personal, relational and cultural aspects.

Description: 
  • Description is in Icelandic Verkefnið er opið nemendum og starfsfólki Háskólans á Akureyri
Accepted: 
  • Jan 1, 2004
URI: 
  • http://hdl.handle.net/1946/1225


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Katrín Blöndal_e.pdf111.33 kBOpenPhenomenological - efnisyfirlitPDFView/Open
Katrín Blöndal_h.pdf139.43 kBOpenPhenomenological - heimildaskráPDFView/Open
Katrín Blöndal_heild.pdf696.08 kBMembersPhenomenological - heildPDF
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