title: The influence of context on pain practices in the NICU: perceptions of health care professionals.
abstract: In this qualitative descriptive study, we explored health care professionals' perceptions of the influence of context (i.e., organizational culture, structure, resources, capabilities/competencies, and politics) on evidence-based pain practices. A total of 16 focus groups with 147 health care professionals were conducted in three neonatal intensive care units (NICUs) in central and eastern Canada. Three overarching themes emerged from the data, which captured influences on optimal pain practices in the NICU, including (a) a culture of collaboration and support for evidence-based practice, (b) threats to autonomous decision making, and (c) complexities in care delivery. These results were consistent with theoretical conceptualizations of how context influences practice, as well as recent empirical research findings. This study supports the importance of context in shaping evidence-based practices by health care professionals in the management of pain in the NICU.
authors.affiliation: Hospital for Sick Children, Toronto, Ontario, Canada. b.stevens@utoronto.ca
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
authors.forename: Shirine
authors.initials: S
authors.lastname: Riahi
authors.forename: Roberta
authors.initials: R
authors.lastname: Cardoso
authors.forename: Marilyn
authors.initials: M
authors.lastname: Ballantyne
authors.forename: Janet
authors.initials: J
authors.lastname: Yamada
authors.forename: Joseph
authors.initials: J
authors.lastname: Beyene
authors.forename: Lynn
authors.initials: L
authors.lastname: Breau
authors.forename: Carol
authors.initials: C
authors.lastname: Camfield
authors.forename: G Allen
authors.initials: GA
authors.lastname: Finley
authors.forename: Linda
authors.initials: L
authors.lastname: Franck
authors.forename: Sharyn
authors.initials: S
authors.lastname: Gibbins
authors.forename: Alexandra
authors.initials: A
authors.lastname: Howlett
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
authors.forename: Patricia
authors.initials: P
authors.lastname: McKeever
authors.forename: Karel
authors.initials: K
authors.lastname: O'Brien
authors.forename: Arne
authors.initials: A
authors.lastname: Ohlsson
mesh_terms: D001291:Attitude of Health Personnel; D055317:Evidence-Based Practice; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015279:Organizational Culture; D010146:Pain / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'