Rønne Pernille Friis, Esbensen Bente Appel, Brødsgaard Anne, Biering-Sørensen Bo, Hansen Carrinna Aviaja
The Multidisciplinary Pain Center and Department of Anaesthesia, Pain and Respiratory Support, The Neuroscience Centre, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.
The University of Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen, Denmark.
J Pain Res. 2023 Sep 5;16:3029-3043. doi: 10.2147/JPR.S412721. eCollection 2023.
To explore patients' and family members' experiences of participating in an intervention using nurse-led family nursing conversations (NLFCs) targeting families affected by chronic non-cancer pain (CNCP), including the perceived impact of the intervention on the individual and the family. CNCP substantially impacts patients and families. Due to a lack of simple treatment solutions, the condition needs to be managed rather than cured. Family involvement seems a promising tool, but research evaluating specific approaches is limited. Interventions based on the family systems nursing framework by Wright and Leahey have been helpful in other populations. Nonetheless, the approach warrants further investigation and evaluation in patients with CNCP.
A phenomenological hermeneutical design was applied, and individual interviews were conducted with ten patients and ten family members who received the intervention. The analysis was inspired by Ricoeur's philosophy of text interpretation.
Three themes emerged during the analysis. "Taking part in the intervention while being affected by previous experiences" showed that patients and family members were affected by different experiences and burdens and therefore entered the intervention with varied starting points. "Being empowered through validation and understanding" showed that participants mainly viewed the intervention as beneficial, increasing patients' and family members' mutual understanding and underpinning acceptance of the chronic pain condition. "Being receptive to the intervention - mechanisms contributing to achieving benefit" identified contributing mechanisms influencing patients' and family members' experiences of the intervention. These mechanisms included confidence in the nurses' facilitation of the intervention, the timing of the intervention, the participant's level of acceptance, and readiness to engage in the intervention.
The intervention was mainly experienced as helpful. Thus, healthcare settings treating CNCP should consider implementing NLFC in clinical practice with adjustments to meet the vulnerability of the CNCP population.
探讨患者及其家庭成员参与一项干预措施的体验，该干预措施采用由护士主导的家庭护理对话（NLFCs），针对受慢性非癌性疼痛（CNCP）影响的家庭，包括该干预措施对个人和家庭的感知影响。慢性非癌性疼痛对患者及其家庭有重大影响。由于缺乏简单的治疗方案，这种疾病需要加以管理而非治愈。家庭参与似乎是一个有前景的工具，但评估具体方法的研究有限。基于赖特和利希的家庭系统护理框架的干预措施在其他人群中已证明有帮助。尽管如此，该方法在慢性非癌性疼痛患者中仍需进一步研究和评估。
采用现象学诠释学设计，对接受该干预措施的10名患者和10名家庭成员进行了个体访谈。分析受到里科尔文本解释哲学的启发。
分析过程中出现了三个主题。“在受既往经历影响的情况下参与干预”表明，患者和家庭成员受到不同经历和负担的影响，因此带着不同的起点进入干预。“通过认可和理解获得力量”表明，参与者主要认为该干预有益，增进了患者和家庭成员之间的相互理解，并支持对慢性疼痛状况的接受。“接受干预——有助于取得成效的机制”确定了影响患者和家庭成员干预体验的促成机制。这些机制包括对护士实施干预的信心、干预的时机、参与者的接受程度以及参与干预的意愿。
该干预措施总体上被认为是有帮助的。因此，治疗慢性非癌性疼痛的医疗机构应考虑在临床实践中实施护士主导的家庭护理对话，并进行调整以满足慢性非癌性疼痛人群的脆弱性需求。
