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- Chatchumni, Manaporn, et al.
(författare)
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Engagement and availability in shaping nurses’ management of postoperative pain : a qualitative study
- 2018
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Ingår i: Electronic Physician. - : Electronic Physician. - 2008-5842. ; 10:8, s. 7235-7242
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies reporting inadequate nursing care for patients indicate that nurses are negatively affected in such situations, and research is needed to study nursing care in postoperative situations. Objective: To describe situations of postoperative pain management in a surgical ward in Thailand. Methods: A qualitative approach using the Critical Incident Technique was chosen to investigate situations of postoperative pain management from the perspective of surgical nurses in Thailand. Data were collected through multiple semi-structured interviews with nine nurses over a five-week period. Results: The situations of surgical nurses described three elements that heavily influenced the quality of postoperative pain management: engagement in a trustful nurse-patient relationship, availability of pain medication and nursing care when needed, and imbalance between meeting the patient’s needs and completing routine nursing duties. Conclusion: The results help to expand our understanding of how Thai nurses manage pain in postoperative situations and indicate areas that could be improved in terms of how nurses respond to patients’ pain. Nurses challenge existing guidelines and facilitate development of new nursing guidelines and/or policies in pain management.
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| 2. |
- Chatchumni, Manaporn, et al.
(författare)
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Exploring the different management structures in nurses responses and treating of patients’ postoperative pain : A qualitative triangulation study
- 2019
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Ingår i: Electronic Physician. - : Electronic Physician. - 2008-5842. ; 11:2, s. 7536-7543
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nurses’ roles are an important aspect of their approaches to pain management and monitoring in the post-operative phase of recovery in a surgical ward. A barrier to successful pain management may be the nurse’s perceptions of the patient in pain, which are confounded by the patterns of communication within individual contexts. We need to study, grasp and understand the complexities of the pain management practice within the context of the surgical ward in order to be able to improve the practices and design appropriate interventions to help patients in need. Objective: The purpose of this study was to explore nurses’ postoperative pain management practices. Methods: This qualitative triangulation study was conducted in a surgical ward at a public hospital in Bangkok (Thailand) from 2012 to 2015. We applied four qualitative methods in the study: 1) observations in a postoperative pain management setting (100 hours); 2) in-depth interviews (12 nurses), 3) three focus group discussions (18 nurses), and 4) narratives relating to 69 critical incidents gathered during recurrent visits over a period of ten weeks (9 nurses). Content analysis, as outlined in grounded theory, was applied. Results: The 40 nursing staff made their observations of the participants by conducting go-along interviews while they worked in the surgical field. The group of nurses comprised of 20 females and 4 males, age-ranged between 21-49 years of age, and their nursing experience ranged from 1-28 years. From our analysis, nurses verified patients’ pain by using double- and triple-control methods to document and record it, thus managing pain by administrative procedures rather than being proactive in providing pain relief. Therefore, communication and information about the patients’ pain and subsequent treatment of postoperative pain caused delays that may hamper the adequate use of available analgesics for pain relief. Levels of experience in communicating between nurses, other professionals, and patients were a main cause of delays in treating and managing pain. Conclusion: The complex communication system that would improve the communication ways leads to better standards of practice and quality of care.
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| 3. |
- Chatchumni, Manaporn, et al.
(författare)
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Nurses’ Perceptions of Patients in Pain and Pain Management : A Focus Group Study in Thailand
- 2015
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Ingår i: Pacific Rim international journal of nursing research. - : Nonthaburi : Thailand Nursing and Midwifery Council. - 1906-8107. ; 19:2, s. 164-177
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Tidskriftsartikel (refereegranskat)abstract
- In Thailand, nurses have a key role in the assessment of symptoms and advising on pain management in patients with post-operative in a surgical ward. This study provides insight into nurses’ perceptions of patients in pain and subsequent pain management. A focus group discussion method was used with 18 registered nurses working in surgical wards. The data were analysed using qualitative content analysis.The participants’ descriptions of their perceptions of patients in pain and pain management were condensed into four themes. Two themes revolved around their perceptions of patient pain, uncomfortable patient, and restricted mobility and changed mood. The two remaining themes comprised intolerable pain would be managed, and managing pain through our own experience seems to be of importance in their professional assumption that evidence-based practice is inadequate for patients’ postoperative care. It is suggested that nurses work to a organized pain assessment guideline and pain management models according to cultural contexts. This should be developed within an understanding of the nurse-patient relationship, and specifically holistic nursing models of care can play an important role in bridging the connection between training and practice, not only between personal and professional perceptions of pain and selected strategies, but also between professional knowledge and nurses’ perceptions of patients in pain.The findings may have relevance for other similar contexts and settings.
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| 4. |
- Chatchumni, Manaporn, 1974-
(författare)
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Post-operative pain management practice : Current situation and challenges within nursing practice in a Thai context
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patients’ recovery after surgery is one of the most important health processes in planned hospital healthcare and has a direct impact on welfare and welfare systems. Therefore, what nurses do in the immediate postoperative period is of vital importance. This thesis addresses the question of understanding how nurses work in managing post-operative pain by exploring their daily nursing practices and experiences in responding to the patient in pain within a Thai cultural context.The project applied a qualitative methodology where the local culture and its day-to-day practices of pain management were studied by using observations, focus groups, in-depth interviews and a critical incident interview approach with nurses. Informants were recruited at a public hospital in Bangkok in a surgical ward. In all, 100 hours of observations, 39 interviews and 69 descriptions of critical incidents related to nurse’s pain management were gathered. The data analysis followed the principles of qualitative research.The findings showed that, although there is a clearly defined approach to pain management, the response system followed by the nurses to address patients’ pain is complex and includes much lead time between assessing patients’ pain and the nurses responding to the pain. Furthermore, nurses are caught in what is labeled a patient paradigm, where evidence of pain often is double- and triple-checked by scoring and recording signs that are then subject to confirmation by a third party. Underpinning this is a culture of pain management cultivated between the nurses that rests first and foremost on their own experiences and a working/professional culture where nurses offer each other practical help in urgent situations, but seldom discuss event-based strategies together. Nevertheless, when nurses described situations when they were successful in practicing pain management, they considered their own engagement and their availability of time, space and therapeutic options to be important.Keywords: Culture of nursing, Nursing in pain management, Pain assessment, Perception of pain, Pain management, Pain post-operative
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| 5. |
- Chatchumni, Manaporn, et al.
(författare)
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Thai Nurses’ experiences of post-operative pain assessment and its’ influence on pain management decisions
- 2016
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Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWhile many studies have addressed various issues with regards to pain management, there is limited knowledge about how nurses assess pain in surgical wards. This study aimed to describe Thai nurses’ experiences of pain assessment in a surgical ward.MethodsA cross-sectional explorative study was conducted. Participants were selected through theoretical sampling. Data was collected through interviews with twelve registered nurses working in surgical wards. Qualitative content analysis guided the analysis of the data.ResultsNurses use a double/triple check system, communicated to the healthcare team via records and protocols, and they used their skills and experiences in pain assessment. The results showed that nurses missed the opportunity to include the patients’ self-reported pain in their accounts. Though much evidence of pain was collected, this did not seem to benefit the patients. Furthermore, the nurses were not using instruments to measure pain, which illustrates the potential unreliability of professionals who have differing opinions concerning the patients’ pain.ConclusionsThai nurses worked based on a ‘patient-evidence’ paradigm when assessing patients in pain; this should be shifted to an evidence-based paradigm. Furthermore, by including the patients’ self-reported pain in their assessment, nurses would both improve the quality of the pain assessment and empower patients in their pain management. Pain management practices in Thailand should be improved through education, training, supportive innovation, and collegial competence development in order to improve the quality of care in the post-operative field.
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| 6. |
- Chatchumni, Manaporn, et al.
(författare)
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Using Critical Incident Technique to understand pain management situations in Thailand
- 2017
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Konferensbidrag (refereegranskat)abstract
- Background: Nursing care is an important concern in the field of pain management as it addresses situated efforts to achieve a person-centered care in pain management. Although it is clear that the effectiveness of the pain management practice needs to be improved, there is limited knowledge about the pain management practices of Thai nurses. This study address if Critical Incident Technique be a used to increase our understanding of Pain management in a Thai context.Methods: Critical Incident Technique was used to explore postoperative pain management provided by nurses in a surgical ward in Thailand. A purposive sample of nine registered nurses over a five-week period using a semi-structured interview guide were conducted and collected. Findings: All 69 situations were used to illustrate the successful and unsuccessful aspects of managing postoperative pain, and included Engagement is a manner of commitments, Availability is characteristic in the practicalities of managing pain for the patients, and Imbalance is being inconsistency between the patients' needs and nurses maintain their undertaking routines. Discussion: Nurses’ experience helped to grasp and understand how nurses treat pain in the postoperative setting; this study was conducted in order to further the understanding of this topic. The result show that Critical Incident Technique can serve to expand our knowledge how existing guidelines are facilitated by nurses. Further, the knowledge gained can serve as foundation to development of new nursing guidelines and/or policies in pain management, including improving nursing skills and education programs in pain management settings.
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