Aim To explore the experiences of anaesthesia nurses in assessing postoperative pain in patients undergoing total hip and/or knee arthroplasty. Methods Data were collected through four focus group interviews (FGI) using the critical incident technique (CIT). The participants were six men and 12 women, all registered nurses with further education in anaesthesia with at least five-year experience of caring for patients on a postoperative ward. Results Maintaining communication with orthopaedic patients, different ways to assess pain, the assessment of unresponsive patients, using pain assessment scales and different work circumstances influencing their use, were stated as the main problems the nurses emphasize while assessing the pain of patients. Conclusion Skills related to observing the behaviour and experience of pain in different individuals are needed to ensure an understanding of patients' pain, as well as the patients' ability to estimate their pain, where the intensity of the pain varies in different patients. Further studies are needed to examine the way health professionals assess pain, depending on the patients' ability to transform their pain from a subjective feeling into an objective numeric grade. The way individuals assess their pain differently and the way the resulting knowledge and experience of postoperative care may help nurses and other health-care professionals.
Sundberg M, Lidgren L, Dahl-W A, Robertsson O, Skar. Swedish Knee Arthroplasty Register Annual Report. Elvins Grafiska AB; 2014.
3.
Kehlet H, Wilmore D. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008. p. 189–98.
4.
Allvin R, Smith E, Rawal N, Ehnfors M, Kling A, Idvall E. The Postoperative recovery profile (PRP)a multi-dimensional questionnaire for evaluation of recovery profiles. J Eval Clin Pract. 2011. p. 236–43.
5.
Fletcher D, Fermanian C, Mardaye A, Aegerter P. Pain and Regional Anaesthesia Committee of the French Anesthesia and Intensive Care Society (SFAR): a patient-based national survey on postoperative pain management in France reveals significant achievement and persistent challenges. Pain. 2008. p. 441–51.
6.
Foss M. Enhanced recovery after surgery and implications for nurse education. Nurs Stand. 2011. p. 35–9.
7.
Dihle A, Helseth S, Kongsgaard U, Paul S, Miaskowski C. Using the American Pain Society’s outcome questionnaire to evaluate the quality of postoperative pain management in a sample of Norwegian patients. J Pain. 2006. p. 272–80.
8.
Hartog C, Rothaug J, Goettermann A, Zimmer A, Meissner W. Room for improvement: nurses’ and physicians’ views of a post-operative pain management program. Acta Anaesthesiol Scand. 2010. p. 277–83.
9.
Manias E, Bucknall T, Botti M. Nurses’ strategies for managing pain in the postoperative setting. Pain Manag Nurs. 2005. p. 18–29.
10.
Stiggelbout A, Van Der Weijden T, Wit D, Frosch M, Légaré D, Montori F, et al. Shared decision making: really putting patients at the centre of health care. BMJ. 2012. p. 256.
11.
Krupic F, Määttä S, Garellick G, Lyckhage E, Kärrholm J. Preoperative information provided to Swedish and immigrant patients before total hip replacement. Med Arch. 2012. p. 399–404.
12.
Krupic F, Eisler T, Garellick G, Kärrholm J. Influence of ethnicity and socioeconomic factors on outcome after total hip replacement. Scand J Caring Sci. 2013. p. 139–46.
13.
Gordon D, Dahl J, Miaskowski C, Mccarberg B, Todd K, Paice J, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. Arch Intern Med. 2005. p. 1574–80.
14.
Hjermstad M, Fayers P, Haugen D, Caraceni A, Hanks G, Loge J, et al. Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011. p. 1073–93.
15.
Wikstrom L, Eriksson E, Fridlund B, Arestedt K, Broström A. Healthcare professionals’ perceptions of the use of pain scales in postoperative pain assessments. Appl Nurs Res. 2013. p. 53–8.
16.
Harper P, Ersser S, Gobbi M. How military nurses rationalize their postoperative pain assessment decisions. J Adv Nurs. 2007. p. 602–11.
17.
Wikström L, Eriksson K, Fridlund B, Årestedt K, Broström A. Healthcare professionals’ descriptions of care experiences and actions when assessing postoperative pain -a critical incident technique analysis. Scand J Caring Sci. 2016. p. 802–12.
18.
Wang H, Tsai Y. Nurses’ knowledge and barriers regarding pain management in intensive care units. J Clin Nurs. 2010. p. 3188–96.
19.
Krupic F, Eisler T, Sköldenberg O, Fatahi N. Experience of anaesthesia nurses of perioperative communication in hip fracture patients with dementia. Scand J Caring Sci. 2015. p. 99–107.
20.
Rudolfsson G, Hallberg L, Ringsberg K. The nurse has time for me: the perioperative dialogue: from the perspective of patients. J Adv Perioperat Care. 2003. p. 77–84.
21.
Crossing the Quality Chasm: A new Health System for the 21st Century. National Academies Press; 2001.
22.
Watson J. The philosophy and science of caring. University Press of Colorado; 2008.
23.
Watson J. Applying the art and science of human caring. National League for Nursing Press; 1994.
24.
Watson J. Postmodern Nursing and Beyond. Churchill Livingstone; 1999.
25.
Watson J, Foster R. The attending nurse caring model: Integrating theory, evidence and advanced caring-healing therapeutics for transforming professional practice. J Clin Nurs. 2003. p. 360–5.
26.
Flanagan J. The critical incident technique. Psychol Bull. 1954. p. 327–58.
27.
Lafferty M, I. Focus group interviews as a data collecting strategy. J Adv Nurs. 2004. p. 187–94.
28.
Bradbury-Jones C, Tranter S. Inconsistent use of the critical incident technique in nursing research. J Adv Nurs. 2008. p. 399–407.
29.
Kvale S. Den kvalitativa forskningsintervjun (The qualitative research interview). Studentliteratur; 1997.
30.
The World Medical Association Declaration of Helsinki. Code of Ethics 1964 (revised). World Medical Association; 2005.
31.
Alharbi T, Carlström E, Ekman I, Jarneborn A. Olsson LE. Experiences of person-centered care -patients’ perceptions: qualitative study. BMC Nurs. 2014. p. 28.
32.
Jacobsen R, Mölrup C, Christrup L, Sjögren P. Patient-related barriers to cancer pain management: a systematic exploratory review. Scand J Caring Sci. 2009. p. 190–208.
33.
Agledahl K, Gulbrandsen P, Förde F, Wifstad A. Courteous but not curious: how doctors’ politeness masks their existential neglect. A qualitative study of video-recorded patient consultations. J Med Ethics. 2011. p. 650–4.
34.
Young J, Horton M, Davidhizar R. Nursing attitudes and beliefs in pain assessment and management. J Adv Nurs. 2006. p. 412–21.
35.
Van Dijk J, Kappen T, Schuurmans M, Van Wijck A. The relation between patients’ NRS pain scores and their desire for additional opioids after surgery. Pain Pract. 2014. p. 604–9.
36.
Van Dijk J, Van Wijck A, Kappen T, Peelen L, Kalkman C, Schuurmans M. Postoperative pain assessment based on numeric ratings is not the same for patients and professionals: A cross sectional study. Int J Nurs Stud. 2012. p. 65–71.
37.
Bergh I, Jakobsson E, Sjöström B. Worst experiences of pain and conceptions of worst pain imaginable among nursing students. J Adv Nurs. 2008. p. 484–91.
38.
Stomberg M, Wickström K, Joelsson H, Sjöström B, Haljamäe H. Postoperative pain management on surgical wards-do quality assurance strategies result in long-term effects on staff member attitudes and clinical outcomes? Pain Manag Nurs. 2003. p. 11–22.
39.
Ericson-Lidman E, Norberg A, Persson B, Strandberg G. Healthcare personnel’s experiences of situations in municipal elderly care that generate troubled conscience. Scand J Caring Sci. 2013. p. 215–23.
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