Rejeh Nahid, Ahmadi Fazlollah, Mohammadi Eesa, Kazemnejad Anoshirvan, Anoosheh Moniereh
Nursing Department, Tarbiat Modares University, Tehran, Iran.
Scand J Caring Sci. 2009 Jun;23(2):274-81. doi: 10.1111/j.1471-6712.2008.00619.x.
Despite decades of research and the availability of effective analgesic approaches, many patients continue to experience moderate to severe pain after surgery. Greater research efforts are needed to identify the factors that impede effective pain management. Despite the fact that a variety of research and clinical studies on all aspects of pain have been conducted in many countries, the factors affecting pain management have not been completely identified.
To identify nurses' experiences and perceptions about the barriers to postoperative pain management.
A qualitative approach was adopted using content analysis of semi-structured interviews carried out with 26 Iranian registered nurses from three large educational hospitals in Tehran city. The data were analysed using constant comparative method.
Ninety-three primary codes were achieved. Four main themes emerged from the data. From the participants' points of view, 'lack of educational preparation', 'nurses' limited authority', 'limited nurse-patient relationship', and 'disturbances in pain management interventions' are considered barriers to pain management.
The conclusion embraces implications for clinical practice to improve the knowledge of nurses and nursing manager and insight in postoperative pain management. Clearly, programmes for change must address not only knowledge improvement, but also the wider complex influences on barriers to pain management.
尽管经过数十年的研究并已有有效的镇痛方法,但许多患者术后仍持续经历中度至重度疼痛。需要加大研究力度以确定阻碍有效疼痛管理的因素。尽管许多国家针对疼痛的各个方面开展了各种研究和临床研究,但影响疼痛管理的因素尚未完全明确。
确定护士对术后疼痛管理障碍的经验和看法。
采用定性研究方法,对来自德黑兰市三家大型教学医院的26名伊朗注册护士进行半结构化访谈,并对访谈内容进行分析。采用持续比较法对数据进行分析。
共获得93个原始编码。数据中出现了四个主要主题。从参与者的角度来看,“缺乏教育准备”“护士权限有限”“护患关系受限”以及“疼痛管理干预措施受到干扰”被视为疼痛管理的障碍。
该结论包含了对临床实践的启示,以提高护士和护理管理者的知识水平,并增进对术后疼痛管理的理解。显然,变革计划不仅要解决知识提升问题,还要应对对疼痛管理障碍产生更广泛复杂影响的因素。