Division of Emergency Medicine, University of Cape Town (UCT), Cape Town, Western Cape, South Africa.
Department of Anaesthesia and Perioperative Medicine, University of Cape Town (UCT), Cape Town, Western Cape, South Africa.
Int Emerg Nurs. 2021 Sep;58:101042. doi: 10.1016/j.ienj.2021.101042. Epub 2021 Jul 29.
A growing body of evidence suggests that pain knowledge and management are poor, perhaps more so in the prehospital setting. The daily challenges that emergency care providers face in dealing with prehospital pain remain unclear. This study aimed to gain a deeper understanding of acute prehospital pain assessment and management in the Western Cape, South Africa.
A series of focus group discussions, using a constructivist paradigm and qualitative content analysis were conducted.
The key themes emerging from six focus groups (total 25 emergency care providers) related to the difficulties of assessing pain in this setting, factors affecting clinical reasoning in this (hostile) setting, the realities of prehospital pain care for non-advanced life support practitioners, along with emergency departments' lack of understanding and appreciation of the prehospital environment, and participants' suggestions to improve pain practice.
Several barriers and enablers, some novel, to pain assessment and management in the South African prehospital setting were identified. Our findings provide valuable insight and understanding of the challenges related to pain care prehospital providers face, in other similar prehospital settings, but also to the global body of knowledge on prehospital barriers and enablers of pain assessment and management.
越来越多的证据表明，疼痛知识和管理水平较差，在院前环境中可能更为明显。急救人员在处理院前疼痛方面面临的日常挑战仍不清楚。本研究旨在更深入地了解南非西开普省的急性院前疼痛评估和管理。
采用建构主义范式和定性内容分析，进行了一系列焦点小组讨论。
来自六个焦点小组（共 25 名急救人员）的主要主题涉及在这种情况下评估疼痛的困难、影响该环境下临床推理的因素、非高级生命支持从业者进行院前疼痛护理的现实情况，以及急诊科对院前环境的理解和重视不足，以及参与者对改善疼痛实践的建议。
在南非院前环境中，确定了一些评估和管理疼痛的新的障碍和促进因素。我们的研究结果为了解与院前提供者面临的疼痛护理相关的挑战提供了有价值的见解和理解，这些挑战不仅存在于其他类似的院前环境中，也存在于全球关于院前疼痛评估和管理障碍和促进因素的知识体系中。
