Strategies of pain assessment used by nurses on surgical units.
The purpose of this study was to identify the criteria nurses actually used to assess postoperative pain and the kind of knowledge they drew on from past experience. A series of semistructured interviews were performed with 10 nurses while they conducted pain assessments with 30 postsurgical patients. Data were analyzed on the basis of Dahlgren and Fallsberg's (1991) analytic approach called phenomenography. Findings were compared with Sjostrom's 1995 study of nurses in Sweden. Nurses in this study, much like the group in Sweden, used three categories of criteria (i.e., how the patient looked, what the patient said, and experience with similar circumstances) and drew on their past experiences in four different ways (i.e., in terms of a typology of patients, a focus on listening to patients, what to look for, and what to do for patients) when assessing postoperative pain. In the most frequently reported strategy, nurses relied on criteria related to the patient's appearance and drew on their past experience in terms of what physical signs to look for (e.g., facial expressions, bodily movement, and heart rate). The variety of strategies used by nurses in this study opens an avenue for further investigating the linkage between underlying conceptions of pain (as essentially subjective vs. objective phenomenon) and the quality and effectiveness of nurses' assessments of pain and its management in postoperative and other contexts across nursing.
Kim
Hesook Suzie
HS
College of Nursing, University of Rhode Island, 2 Heathman Road, White Hall, Kingston, RI 02881, USA. suziekim@uri.edu
Schwartz-Barcott
Donna
D
Tracy
Susanne M
SM
Fortin
Jacqueline D
JD
Sjöström
Björn
B
D001291:Attitude of Health Personnel; D003142:Communication; D003463:Cues; D005149:Facial Expression; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006786:Hospitals, Urban; D006801:Humans; D007697:Kinesics; D008297:Male; D009511:New England; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000379:methods*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000451:nursing*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000451:nursing / Q000503:physiopathology / Q000523:psychology; D013527:Perioperative Nursing / Q000193:education / Q000379:methods*; D011182:Postoperative Care / Q000379:methods / Q000451:nursing*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014705:Verbal Behavior