Engaging patients in their own pain management: an action research study - Buckinghamshire New University repository
Engaging patients in their own pain management: an action research study
thesis2.doc
thesis2.doc.txt
Traditionally analgesics have been the main stay of postoperative pain management. Taught non-pharmacological strategies have also been used. The possibility that patients may have a repertoire of self-generated strategies has tended to be overlooked. The aim of this study was to identify whether patients possess and utilise self-generated strategies for acute pain, and if so, to ascertain the effect of engaging patients in their postoperative pain management by supporting their strategies. To empower nurses to deliver effective pain management, and to promote evidence based practice, a second aim was to actively engage nursing staff in the process. A collaborative action research design based on critical theory was used to facilitate practitioner participation, enable practice development and generate a theoretical understanding of the issues. Three action research cycles were identified, each containing various methods and involving both patients and staff. The first cycle, entitled “telling the situation as it is”, described current practice from the ward staff’s perspective and identified 10 strategy themes through an outpatient survey. Cycle two focused upon “testing the proposed changes”. In contrast to many action research studies, a randomised controlled trial was undertaken to test the effect of incorporating patients’ self-generated strategies into postoperative pain management. The nursing staff were pivotal in both the decision to undertake the trial and in its management. The results indicated that identifying and supporting patients’ self-generated strategies significantly reduced postoperative anxiety, pain intensity and distress. Fewer experimental subjects required opiates, although non-steroidal anti-inflammatory consumption was increased in this group. Staff understanding and awareness of pain and their ability and confidence to manage pain increased. Certain staff also gained research skills. The third and final cycle, “creating change in practice: implementation and implications”, is being led by the nurses. The potential of action research to engage nurses in practice developments related to patient-centred care has been demonstrated.