Seeking empowerment to comfort patients in severe pain: A grounded theory study of the nurse's perspective
Section snippets
Background
Pain in hospitalized patients remains a global problem despite improved pain management over the last 40 years (Sawyer et al., 2010, Wadensten et al., 2011). Unrelieved pain slows recovery and put patients at risk of chronic pain (Macintyre et al., 2010). Nurses are also affected by patients’ persisting pain, with implications for pain management practice (Blomberg et al., 2008, Blomqvist, 2003). From a personal perspective, nurses may have feelings of anxiety and helplessness (Blondal and
Aim
The aim of this study was to develop a substantive theory explaining the experience of caring for patients with severe pain from the perspective of nurses working in hospital wards. Severe pain was defined as pain self-reported by patients at an intensity of seven or more on a numerical scale of zero to ten, where zero represents no pain and ten represents the worst pain imaginable.
Setting
The study was conducted in a 610 bed public hospital in an Australian city of over 1.4 million people. Data were
Findings
This study developed the substantive theory of seeking empowerment to provide comfort to explain nurses’ experience of caring for patients in severe pain and their subsequent actions, including interactions with patients and colleagues. Nurses shared a regard for well-being that shaped their perceived roles as comfort providers and interpretation of effectiveness in that role. Severe pain was conceptualized as a distressing, incapacitating and nontherapeutic experience that threatened patients’
Discussion
While there is much to understand about the human experience of caring for patients who suffer with pain, the focus of this paper is the BPP used by nurses to manage feelings of disempowerment in such situations. Understanding dynamic coping processes used by nurses to resolve stress and exhaustion provides direction for interventions to empower pain management practice.
A strength of this study is that the findings are of practical significance and provide direction for theory development.
References (52)
- et al.
Person-centred interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study
Int. J. Nurs. Stud.
(2010) - et al.
The relationships among workplace stressors, coping methods, demographic characteristics, and health in Australian nurses
J. Prof. Nurs.
(2006) - et al.
Workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health of Japanese hospital nurses
Int. J. Nurs. Stud.
(2004) - et al.
Nurses’ strategies for managing pain in the postoperative setting
Pain Manage. Nurs.
(2005) - et al.
Evaluating the feasibility and effect of using a hospital-wide coordinated approach to introduce evidence-based changes for pain management
Pain Manage. Nurs.
(2012) Nurses’ assessment of postoperative patients’ pain
Pain
(1993)An overview of glaserian grounded theory
- et al.
Moving grounded theory into the 21st century: part 2 – mapping the footprints
Singapore Nurs. J.
(2006) - et al.
District nurses’ involvement in pain care: a theoretical model
J. Clin. Nurs.
(2008) Older people in persistent pain: nursing and paramedical staff perceptions and pain management
J. Adv. Nurs.
(2003)