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关注差距:一项结合患者与护士对疼痛护理反思的定性研究

Mind the Gaps: A Qualitative Study Combining Patients' and Nurses' Reflections on Pain Care.

作者信息

Gjesdal Kine, Dysvik Elin, Furnes Bodil

机构信息

Faculty of Health Sciences, University of Stavanger, Norway.

出版信息

SAGE Open Nurs. 2019 Aug 13;5:2377960819868865. doi: 10.1177/2377960819868865. eCollection 2019 Jan-Dec.

Abstract

Chronic noncancer pain is a serious health problem, one that is often associated with physical debility and emotional suffering. Although chronic noncancer pain is one of the primary reasons that people seek medical care, a significant body of evidence indicates that chronic pain is underdiagnosed and undertreated. There is a consensus among professional stakeholders in pain care that there is a need to strengthen quality, capacity, and competence in pain management at all levels of health care. Thus, there is a need for more in-depth knowledge of both the recipients and the providers of pain care, and qualitative studies can contribute to this. The aim is to explore and combine the perspectives of patients receiving pain care and registered nurses providing care at pain clinics. A multimethod design was based on two qualitative studies consisting of semistructured interviews with patients receiving pain care ( = 10) and nurses providing pain care at pain clinics ( = 10). Qualitative content analysis was applied to interpret and abstract their experiences. The themes developed from triangulation revealed significant gaps between ideal pain care and actual practice: "Dissonance in reflections on personalized care," "A corresponding need for improved information flow in all levels," and "A corresponding need for improved structure in pain care." We suggest a stronger commitment to efficient information flow and person-centered communication to facilitate the patient involvement and self-management. In addition, more resources, education, and training are necessary to enable nurses and other professionals to act upon guidelines and ensure effective pain care.

摘要

慢性非癌性疼痛是一个严重的健康问题,常常与身体虚弱和情感痛苦相关。尽管慢性非癌性疼痛是人们寻求医疗护理的主要原因之一,但大量证据表明,慢性疼痛存在诊断不足和治疗不足的情况。疼痛护理领域的专业利益相关者达成了共识,即需要在各级医疗保健中加强疼痛管理的质量、能力和专业水平。因此,需要更深入地了解疼痛护理的接受者和提供者,定性研究可以对此有所帮助。目的是探索并整合接受疼痛护理的患者和在疼痛诊所提供护理的注册护士的观点。多方法设计基于两项定性研究,包括对接受疼痛护理的患者(n = 10)和在疼痛诊所提供疼痛护理的护士(n = 10)进行半结构化访谈。应用定性内容分析来解读和提炼他们的经历。通过三角互证得出的主题揭示了理想的疼痛护理与实际实践之间的显著差距:“个性化护理反思中的不一致”、“各级对改善信息流的相应需求”以及“疼痛护理中对改善结构的相应需求”。我们建议更坚定地致力于高效的信息流和以患者为中心的沟通,以促进患者参与和自我管理。此外,需要更多资源、教育和培训,以使护士和其他专业人员能够按照指南行事并确保有效的疼痛护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb3/7774408/c1b1e6a60b6f/10.1177_2377960819868865-fig1.jpg

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